How is Breast Cancer Diagnosed?

Breast cancer diagnosis encompasses a number of examinations and tests that are conducted to either confirm or rule out a diagnosis of Breast Cancer.

Breast Cancer Diagnosis Tests

A Breast Cancer diagnosis varies and is typically staged. Generally, Breast Cancer diagnosis can involve the following examinations and tests.

Complete history and physical examination including breast exam
Mammography
Breast Ultrasound
Breast MRI
Fine Needle Aspiration Biopsy (FNAC)
Core Biopsy

The decision on which tests will be conducted is determined by the doctor after an examination.

How to Prepare for Breast Cancer Diagnosis?

Most of these tests can be performed in the outpatient department and require no special preparation. Each test or procedure is explained to the patient first, in order to ensure informed consent is received.

A breast exam can be conducted in the doctor’s office. Mammography, Breast Ultrasound, Contrast-Enhanced Mammography (CEM) and Breast MRI are radiological tests that help make the diagnosis of breast cancer and aid planning for surgery.

Fine Needle Aspiration Biopsy (FNAC) is a minimally invasive test which can give a cancer diagnosis but core biopsy can diagnose cancer and give us much more information about the cancer and the likely treatments it will need. Core biopsy is always preferred over FNA.

What Information Can Breast Cancer Diagnosis Tests Provide?

Initial Breast Cancer diagnostics include:

A mammogram can identify abnormalities in the density of the breast tissue, prompting further testing.
Ultrasounds can also identify abnormalities in the density of the breast tissue, and also identify whether a breast lump is a solid mass or a fluid-filled cyst.
Breast Biopsies provide more information. They are conducted with the help of ultrasound, and samples are sent to the laboratory to be examined by trained pathologists, who can identify any cancer cells present and their staging.

The results of these test are necessary to plan the next step in any treatment.

Stages of Breast Cancer

Breast cancer stages range from 0 to IV with

Stage 0 Breast Cancer - indicating cancer that is noninvasive or contained within the milk ducts.
Stage I Breast Cancer - evidence of a tumour that is smaller than 20mm and has not spread to the lymph nodes
Stage II Breast Cancer - either no evidence of a tumour in the breast, but cancer is in 1 to 3 auxiliary lymph nodes or a tumour that is smaller than 20 mm and has spread to the axillary lymph nodes, or where the tumour is larger than 20 mm but not larger than 50 mm and has not spread to the axillary lymph nodes
Stage III Breast Cancer - The cancer of any size has spread to several axillary lymph nodes or to internal mammary lymph nodes, but has not spread to other parts of the body or, where a tumour larger than 50 mm that has spread to 1 to 3 axillary lymph nodes, or finally the tumour has spread to the chest wall or caused swelling or ulceration of the breast, it may have also spread to axillary or internal mammary lymph nodes but not to other parts of the body
Stage IV Breast Cancer - also called metastatic Breast Cancer, indicates cancer that has spread to other areas of the body.

Breast cancer staging also takes into account

Your cancer's grade;
Any presence of tumour markers, such as receptors for estrogen, progesterone and HER2; and proliferation factors.