Diagnosing and Treating Breast Cancer

Diagnosing and Treating Breast Cancer

Breast cancer is usually discovered in one of two ways. A woman might find some signs irregularities in her breasts, or her doctor identifies some clinical symptoms during a routine exam or mammogram.

If one is experiencing any common symptoms of breast cancer — such as changes in the shape and feel of the nipple or breast — make sure to see a doctor as soon as possible to get tested. It is better to get checked rather than let the cancer progress.

During this initial visit, the doctor will examine the symptoms that have been identified as well as perform additional tests to determine a diagnosis. The information gathered from these tests will help the doctor, along with an oncologist, decide on the best form of action.

Tests that help identify breast cancer include:

  • Diagnostic mammogram: A mammogram is an X-ray of breast tissue. Tumors and other growths may be visible, depending on how large they are. Mammograms might miss very small growths. Diagnostic mammograms provide slightly clearer and more detailed images than screening mammograms and usually focus on an area of the breast that has been identified as suspicious.
  • Ultrasound: An ultrasound might be used to help a doctor understand whether a lump in the breast is solid or filled with fluid, as a cyst would be.
  • Magnetic resonance imaging (MRI): An MRI can make a very detailed picture of the breast tissue. This test might be used in addition to a mammogram.
  • Biopsy: When the doctor identifies a lump or tissue that could be cancerous, a biopsy is ordered. This means that some tissue or fluid from the area will be removed for further examination. A biopsy is usually an outpatient procedure, although there may be some discomfort associated with it.A pathologist trained in identifying cancerous cells will examine the tissue from the biopsy to determine whether you have cancer. But remember, just because you have been sent to have a biopsy does not mean you have cancer. You might have other kinds of benign breast growths instead.If the pathologist does find cancer cells, an oncologist will want to know the stage of the cancer. Stage is a measure based on how large the tumor is and whether it has spread to other parts of the breast or body. Cancers are rated from stage 0 (very early cancer that may be small or has not yet spread) to stage IV (cancer that is very far progressed and has spread to other parts of the body). Generally speaking, cancer is easier to treat in an early stage, but if you are told you have stage IV cancer, do not assume that treatment will not work.

At this point, the doctors also might test the cancer cells themselves to get more information that can help determine what treatments will work best.

Once the woman and her medical team (all the doctors involved in the case) have all of this information, they can start talking about treatment.

Treatment options include surgery to remove all or part of the cancerous tissue, radiation therapy, chemotherapy, hormone therapy and biological therapy. The medical team can recommend the best approach to treatment based on the kind of cancer, how far it has progressed and the woman’s health and well-being. Anyone with breast cancer should find out about all available treatment options so that the best decision can be made. Patients who are actively involved in their cancer treatment feel they have more control over their disease and might have better outcomes.

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National Cancer Institute, U.S. National Institutes of Health http://www.cancer.gov

Written by Madeline Roberts Vann, MPH

Reviewed by Susan L. Luedke, MD

St. Louis Cancer & Breast Institute

St. Louis University Medical Center

Last updated September 2008