Breast Cancer
How is the disease diagnosed?
Lumps may be found by a woman or her partner. Some lumps are detected by the healthcare provider during a physical exam. Sometimes the lump cannot be felt but is found on a screening mammogram. If abnormalities are found on a screening mammogram, a diagnostic mammogram may be done. An ultrasound may be done to show whether the lump is a fluid-filled cyst or a solid mass.
After the lump is discovered, a tissue sample must be taken to determine if it is cancer. Tissue samples may be obtained with the following procedures:
Ductal lavage. A very thin needle is inserted into a milk duct and cells are washed out with saline.
Excisional biopsy. The surgeon removes all of the lump or suspicious tissue, as well as a surrounding area of healthy tissue.
Fine needle aspiration. The provider uses a thin needle to obtain fluid and cells from the lump.
Incisional biopsy. A surgeon removes a sample of the lump or suspicious tissue.
Needle biopsy. If the lump is seen only on mammogram, a needle is guided under X-ray to take a sample.
The fluid and tissue will be carefully studied to determine first if it is cancer. If so, the tissue then will be tested to see how aggressive the cancer is. A woman may also undergo other specialized X-rays to see if the cancer has spread beyond the breast.
Other tests will be done to determine factors that will affect treatment choices. The most common factors are as follows:
aggressiveness of the tumor cells
the presence of certain proteins, such as the HER2 gene that is associated with a higher risk of repeated breast cancer
sensitivity to estrogen or progesterone
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