Breast cancer affects far too many people. The good news, however, is that breast cancer can be detected early by performing breast self-exams and visiting your doctor for regular screenings. Breast screenings are especially important, considering many women experience no breast cancer symptoms at all. The earlier breast cancer is detected, the easier it is to treat successfully.
During an office visit, you will have a physical exam that will include questions about your personal and family medical history. Your doctor may order more imaging tests, such as a mammogram.
During an in-office breast exam, your doctor checks both of your breasts. During the exam, you may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips.
In addition to looking for differences in size or shape between your breasts, your doctor will check your breasts’ skin for a rash, dimpling, or other abnormal signs. Your nipples may be squeezed to check for fluid.
Your health care provider will check your entire breast, underarm, and collarbone area by using the pads of their fingers to feel for lumps. A lump is generally the size of a pea before anyone can feel it. The exam is done on one side and then the other. Your health care provider checks the lymph nodes near the breast to see if they are enlarged.
If a lump is present, its size, shape, and texture will be examined. Your health care provider will also check to see if the lump moves easily. Benign (noncancerous) lumps often feel different from malignant (cancerous) ones. Lumps that are soft, smooth, round, and movable are likely to be benign. On the other hand, a malignant lump is a hard, oddly shaped lump that feels firmly attached within the breast. Regardless, further tests are needed to make an accurate diagnosis.
A mammogram, which is an x-ray picture of tissues inside the breast, can often show a breast lump before it can be felt. They can also display a cluster of calcium specks, called microcalcifications. Lumps or specks can be from cancer, precancerous cells, or other conditions. Further testing is needed to find out whether abnormal cells are present.
Women should get regular screening mammograms to detect breast cancer early— even before they have symptoms. According to the American Cancer Society:
If the mammogram shows an abnormal area of the breast, your doctor may order more detailed images. Doctors use diagnostic mammograms to learn more about unusual breast changes, such as a lump, pain, thickening, nipple discharge, or change in breast size or shape. Diagnostic mammograms may focus on a specific area of the breast, offering more detailed views than traditional screening mammograms.
Other imaging tests may be ordered if an abnormal area is found during a clinical breast exam or with a mammogram. These can include:
A biopsy is the removal of tissue to look for cancer cells. It is the only way to tell for sure if cancer is present. If an abnormal area is found during an exam or on a mammogram, you will likely need a biopsy.
Your doctor may refer you to a surgeon or breast cancer specialist for a biopsy. The surgeon or doctor will remove fluid or tissue from your breast in one of several ways:
A pathologist will check the removed breast tissue or fluid for cancer cells. If any are found, the pathologist will be able to determine what kind of cancer is present. The most common type of breast cancer is ductal carcinoma, a type of breast cancer that begins in the cells lining the breast ducts. Another type is lobular carcinoma is another type, which starts in the lobules of the breast.
If you are diagnosed with breast cancer, your doctor may order special lab tests on the removed breast tissue:
It may take several weeks to get the results of these tests. While the wait can be hard, your doctor must go over these test results thoroughly to determine the best cancer treatment option.
Blood tests, which may be done before or after surgery, could also be needed. There are different types of blood tests, which include:
Once all diagnostic tests are completed, your doctor will go over the results with you. If the diagnosis is cancer, these results also help the doctor describe the disease, which is done through staging. Depending on the stage of cancer, additional imaging tests may be recommended. If there is a suspicious area found outside of the breast and nearby lymph nodes, additional biopsies of those areas may be needed to find out if it is cancer.