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Breast Cancer - Diagnosis Of Breast Cancer




Breast Cancer Diagnosis

 
Breast cancer is detected on routine screening test using mammogram or after a breast lump is detected followed up with investigations. After a lump is found, an ultrasound and mammogram is advised and a tissue sample is take out from the lump using a fine needle aspiration cytology known as FNAC, which is then analyzed to see whether malignant cells are present.
 
The cancer is also tested to check if it contains estrogen receptors in which condition this is termed as ER positive cancer. Other organs such as abdomen, bones, lungs, and brain etc. are also examined using CT scan and MRI to detect the possible spread of cancer to other parts of the body.
 
Breast cancer is usually diagnosed on routine screening procedures or after the detection of symptoms.  Women, who notice lump in their breasts, change in their breasts, or discharge from the breasts should consult their physician to diagnose the tumor as cancerous or non-cancerous.
 

Diagnosis of Breast Cancer involves the below:
 
Examination of the breasts and surrounded lymph nodes
 
Both the breasts, nipples, lymph node in the armpits, under the collar bone and neck are examined. The lump or skin changes are noted. If the lump appears to be fixed to the skin over it or tissues and chest wall under it, it is most likely to be cancerous.
 
Mammogram


 
A mammogram is an X-ray of the breasts. Mammograms are done routinely to screen women over 50 to detect breast lumps and cancer. Women below 50 years of age have denser breast, which make it difficult for the mammogram to detect cancerous lumps.
 
Breast Ultrasound


 
Women less than 35 years of age need breast ultrasound scans to detect, as because the younger women have denser breasts, which makes the mammogram not very effective as ultrasound to detect cancer. Breast Ultrasound uses high frequency sound waves to give an image of the tissues inside of the breast.  An ultrasound helps detecting if the breast lump contains any liquid like mucous or solid cells.
 
Biopsy


 
Biopsy involves taking out a sample of tissue cells from the breast lump and then examine them under a microscope to check if they are cancerous. There is more than one type of breast biopsy. Initially, a small amount of tissue is taken out from the lump using a fine needle, called Fine needle aspiration cytology or FNAC. The most common type of breast biopsy is the needle biopsy. When the lump is not defined clearly by imaging studies such as ultrasound or X-ray, then MRI may be used to guide the needle aspiration for the biopsy. Larger amounts of tissues can be withdrawn for biopsy using core biopsy method or excisional tissue biopsy. Sample of lymph nodes or the whole of lymph nodes from the armpits will also be taken to detect cancer spread to the lymph nodes. To diagnose the type and grade of breast cancer, biopsy of the tumor is the surest way.
 
CT scan, MRI, X-rays, and liver ultrasound for metastasis
 
The above are required to see whether the cancer has spread to the liver or lungs. An MRI scan of the breast is needed to clarify and assess the extent of cancer within the breast. A bone scan is recommended to check if the disease has spread to the bones. Blood tests are recommended to check for functioning and/or involvement of the kidneys and liver as well.
 
Hormone Receptor Test

Hormone receptor test is recommended to determine the specific types of treatment that may be useful for a patient. Breast cancer cells are stimulated to grow by female hormones estrogen and progesterone in some women with ER (estrogen receptors) or PR (progesterone receptors) on the tumor. These women respond to therapies, which stop the effects of hormones or lower the levels of these hormones, known as hormone therapy.
 
HER2/NEU Protein Test


 

In some women, hormones encourage the growth of some type of breast cancers and other types are stimulated by a protein known as Human Epidermal Growth Factor Receptor 2 (HER2). This type of cancers can be treated using medications to stop the effects of HER2. This type of treatment is called biological therapy.