Breast cancer can be difficult to diagnose as the symptoms are often vague and many other conditions can have similar symptoms. If your doctor suspects breast cancer, diagnosis will usually comprise of several steps such as examination of the breast, mammography, ultrasonography or MRI, and biopsy.
Examination of the Breast: During a breast examination, the doctor will look at the breast for changes (such as shape, skin), palpate (feel) the breasts, the armpits and the areas around your collarbone. This may reveal a lump or just feel a thickening.
Mammography: Mammogram is a type of X-ray, which is used to diagnose breast cancer in the initial stages. If the mammogram is done before you have signs or symptoms of the disease, it is called screening mammogram. Screening mammography can detect the cancer in early stages before it spreads. If the cancer is detected at an early stage, it is likely to be smaller with limited spread to lymph nodes and adjacent tissues and therefore, more likely to be responsive to treatment as compared to cancers detected by women through self-examination. As breast cancer can be detected at an early stage with mammography, women are recommended to go for regular mammography to diagnose breast cancer. If your doctor advises mammogram after a lump or other sign or symptom of the breast disease is observed, it is called diagnostic mammogram. The diagnostic mammogram helps to confirm or assess changes found during examination or screening mammogram. The mammogram can help to diagnose if the lump in the breast is breast cancer, but no test is 100% reliable.
[Read: How is Mammography Done?]
Ultrasound: This is a painless and non-invasive test, which is useful to view the internal structures in the body. Areas of the breast that can be hard to visualize on a mammogram such as the area closest to the chest wall, can be inspected on an ultrasound. It can show if the mass in the breast is filled with fluid (cystic) or solid and can be used to take a guided biopsy or the removal of the fluid. Ultrasound, however, is not used in place of mammogram but it is used more often to further evaluate and complement the findings of a mammogram.
MRI scan (magnetic resonance imaging): It provides better details of the structures of the different parts of the body that is examined. It is not routinely used for screening of cancer but may be done to appraise the findings seen on the mammography or ultrasound.
Breast Biopsy: Biopsy is the definitive test that is used to diagnose breast cancer. If mammogram or ultrasound suggests chances of cancer in the breast, your doctor will do a biopsy of the breast tissue. The methods used to obtain a tissue sample include fine needle aspiration (a fine needle is used to take sample), core needle biopsy (a hollow needle is used for sampling), or ultrasound guided breast biopsy. The tissue obtained by biopsy is examined under a microscope for abnormality or malignant changes. Your doctor will discuss with you and then decide on the biopsy procedure that is most appropriate for you. The biopsy tissue is examined by a pathologist (a doctor who specialises in diagnosing diseases by looking at cells and tissues under a microscope) for presence of cancer. If cancer cells are found on the biopsy, the tissue will be tested for presence of hormone receptors.
Read to know more about Breast Cancer Diagnosis and Prognosis