Tests and diagnosisBy Mayo Clinic staff
Diagnosing breast cancer
Tests and procedures used to diagnose breast cancer include:
- Breast exam. Your doctor will check both of your breasts, feeling for any lumps or other abnormalities. Your doctor will likely check your breasts in varying positions, such as with your arms above your head and at your side.
- Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
- Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Your doctor may recommend an ultrasound to help determine whether a breast abnormality is likely to be a fluid-filled cyst or a solid mass, which may be either benign or cancerous. Breast ultrasound is helpful to guide radiologic biopsy to get a sample of breast tissue if a solid mass is found.
- Removing a sample of breast cells for testing (biopsy). A biopsy to remove a sample of the suspicious breast cells helps determine whether cells are cancerous. The sample is sent to a laboratory for testing. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer and whether the cancer cells have hormone receptors.
- Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye. This test may be ordered after a breast biopsy confirms cancer, but before surgery to give your doctor an idea of the extent of the cancer and to see if there's any evidence of cancer in the other breast.
Other tests and procedures may be used depending on your situation.
Staging breast cancer
Once your doctor has diagnosed your breast cancer, he or she works to establish the extent (stage) of your cancer. Your cancer's stage helps determine your prognosis and the best treatment options. Complete information about your cancer's stage may not be available until after you undergo breast cancer surgery.
Tests and procedures used to stage breast cancer may include:
- Blood tests, such as a complete blood count
- Mammogram of the other breast to look for signs of cancer
- Chest X-ray
- Breast MRI
- Bone scan
- Computerized tomography (CT) scan
- Positron emission tomography (PET) scan
Not all women will need all of these tests and procedures. Your doctor selects the appropriate tests based on your specific circumstances.
Breast cancer stages range from 0 to IV, with 0 indicating cancer that is very small and noninvasive. Stage IV breast cancer, also called metastatic breast cancer, indicates cancer that has spread to other areas of the body.
- Breast cancer. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003090-pdf.pdf. Accessed March 17, 2011.
- What you need to know about breast cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/breast/AllPages/Print. Accessed March 19, 2011.
- Chlewbowski RT, et al. Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women. Journal of the American Medical Association. 2010;304:1684.
- Giuliano AE, et al. Axillary dissection vs. no axillary dissection in women with invasive breast cancer and sentinel node metastasis. Journal of the American Medical Association. 2011;305:569.
- Van Wely BJ, et al. Systematic review of the effect of external beam radiation therapy to the breast on axillary recurrence after negative sentinel lymph node biopsy. British Journal of Surgery. 2011;98:326.
- Robert NJ, et al. RIBBON-1: Randomized, double-blind, placebo-controlled, phase III trial of chemotherapy with or without bevacizumab for first-line treatment of human epidermal growth factor receptor 2-negative, locally recurrent or metastatic breast cancer. Journal of Clinical Oncology. In Press. Accessed March 22, 2011.
- Burstein HJ. Bevacizumab for advanced breast cancer: All tied up with a RIBBON? Journal of Clinical Oncology. In Press. Accessed March 22, 2011.
- Choueiri TK, et al. Congestive heart failure risk in patients with breast cancer treated with bevacizumab. Journal of Clinical Oncology. 2011;29:632.
- Petrelli F, et al. Bevacizumab in advanced breast cancer: An opportunity as second-line therapy? Medical Oncology. In Press. Accessed March 22, 2011.
- Gnant M, et al. Endocrine therapy plus zoledronic acid in premenopausal breast cancer. The New England Journal of Medicine. 2009;360:679.
- Coleman R, et al. Zoledronic acid use in cancer patients. Cancer. 2011;117:11.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2011.
- Unexpected AZURE results lead to rethink for Zometa. Expert Review of Anticancer Therapy. 2011;11:329.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. April 3, 2011.
- FDA commissioner removes breast cancer indication from Avastin label. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/ucm279485.htm. Accessed Nov. 18, 2011.