Most people discover breast cancer by noticing a mass or abnormal feature on their chest during self-examination by themselves or with their doctor. Sometimes, these abnormalities are discovered during a screening mammogram, and in some instances, women will notice a swollen breast or red nodule under their arm. The process of diagnosing and testing cancer cells can be an elaborate process. There’s a wide variety of tests to pick from, based on your age, health, symptoms, and the results of earlier medical tests.

These tests include, but certainly not limited to, the following:

Imagining Tests: Diagnostic mammography, ultrasound, and MRI
Biopsy: Fine needle aspiration, core needle, surgical, image-guided, and sentinel lymph node.

Doctors and pathologists will conduct many tests in the process of diagnosing and treating breast cancer. They’ll decide which tests are the best option based on your age and overall health, what symptoms you’re showing, results of prior medical tests, and the type of suspected cancer.

Imaging Tests for Breast Cancer

Imaging tests are conducted to show pictures of what’s inside your body. These are beneficial to see the areas surrounding the cancerous tissue, how far cancer has spread, and if the treatment is working.

MRI

MRI’s is a popular option because it’s painless and doesn’t require any special preparation, as well as providing a detailed image of what’s happening in your body. An MRI uses magnetic fields while a special dye is given to the patient before the screening. This dye helps the image be as clear as possible. Doctors may routinely schedule MRI tests during treatment in order to surveil the cancerous tissue and adjust the treatment as needed.

Ultrasound

Ultrasounds are useful for tracking changes in breast tissue, especially changes that can be felt but don’t appear on a mammogram. Ultrasounds are helpful in differentiating fluid-filled cysts and solid masses, which can help them determine if further testing for cancerous cells is necessary. They’re a popular testing choice for many practitioners and can be conducted safely, as they do not expose the patient to radiation.

Diagnostic Mammography

Diagnostic mammography is often used when a woman is experiencing symptoms of breast cancer, such as an unexplained lump or discharge from the nipple. It may also be used to get a more detailed image if something suspicious appears on a screening mammogram.

Biopsy for Breast Cancer

There are numerous variations of biopsies for cancer cell collection. While imagining tests can help detect the presence of cancerous tissue, biopsies are the only way to get a definite diagnosis of cancer. Different biopsies are classified by the technique used to collect the tissue and the size of the needle. Because there are so many biopsy techniques, we’ll go over the most popular options for breast cancer patients according to the American Cancer Society.

Fine Needle Aspiration

An FNA biopsy (fine needle aspiration), a very thin and hollow needle is attached to a syringe a very small amount of tissue from the suspected area. This needle is even thinner than the size used for blood tests, so it’s minimally invasive.

Lymph Node Biopsy

In some instances, a doctor may need to conduct a biopsy on the lymph nodes underneath the arms to see if cancer has spread. This can be conducted in multiple ways, either during surgery when the breast tumor is removed, with a sentinel lymph node biopsy, or an axillary lymph node dissection. Your doctor will know the best option based on your needs.

Surgical Biopsy

Sometimes surgery is required to remove the specimen needed to properly test the potentially cancerous tissue. During these procedures, the doctor or surgeon will typically remove the entire mass or abnormal growth as well as the surrounding breast tissue.

Core Needle Biopsy

A core needle biopsy is similar to fine-needle aspiration except it uses a larger needle. These are common when a doctor has felt changes or seen suspicious areas on an ultrasound, mammogram, or MRI. This is typically the preferred type of biopsy for breast cancer patients.

How are Breast Cancer Tissues Analyzed?

After the tissue is collected from a biopsy, the sample is sent to a lab where a pathologist will analyze it and provide the doctor with their findings for an official diagnosis. Your medical professionals will consider multiple factors while analyzing the cancerous tissue.

Tumor Features

Pathologists will study the tumor under a microscope to determine if the cancer is invasive or non-invasive, ductal, lobular, or another type of cancer. They’ll also determine if cancer has spread to the lymph nodes by measuring the distance from the tumor to the edge of the tissue removed. This is known as the margin width.

ER-positive and PR-positive Cancers

ER and PR analysis determine the patient’s risk of cancer returning and what kind of treatment will decrease the chance of reoccurrence. Hormonal therapy is usually used to decrease the chance of the cancer returning.

Grade

The grade of a tumor refers to the differentiation between cancerous cells and healthy cells and how fast or slow they are growing. “Well-differentiated” cancer cells look similar to healthy tissue and have different cell groupings, while “poorly-differentiated” cancer cells look very different from healthy tissue. Grade is categorized by three levels including grade 1 (well-differentiated), grade 2 (moderately differentiated), and grade 3 (poorly differentiated).

Summary

It’s important to conduct regular self-examinations to track any abnormalities that appear on your breast, or you can ask your doctor to regularly conduct examinations. Doctors and pathologists have endless options available to them and will use the tests that are best for you and your situation. Our biorepository collects and safely store cancerous cells, utilizing tissue microarrays, frozen tissue samples, biofluid samples, and more.

Sources:

https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-ultrasound.html
https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-biopsy.html#:~:text=A%20core%20biopsy%20uses%20a,if%20breast%20cancer%20is%20suspected.
https://www.cancer.net/cancer-types/breast-cancer/diagnosis
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/mammogram-procedure