How is Breast Cancer Identified and Diagnosed?

You as an individual are the first stop on the quest to recognize and report any abnormalities in your breasts. By checking your breasts on a monthly basis, a woman is doing the most important task to identify a problem early. Any of the following signs found during a breast self-exam should be reported to a doctor as soon as possible:

• Any lump or thickening in your breast or armpit.

• Any scaly, thickened or inward-turning nipple.

• Any discharge from your nipple.

• Dimpled or reddened skin or sores on your breast.

• Strange veins in any irregular pattern on your breast.

• Breast pain.

Mark your calendar at the same time every month with the initials “BSE” for Breast Self-Exam and support each other in ensuring that a breast exam is done according to the information in the handout that will be given to you at the end of this program. Notify your doctor as soon as possible if you notice any abnormalities.

The monthly self-exam is not the same as that performed by your doctor. The doctor or a trained nurse takes a careful personal and family history, and then performs a clinical breast examination. This examination uses touch to specific areas of the breast and underarm areas to detect any abnormalities or changes.

A mammogram is another type of exam. Mammography is the best way to detect breast cancer in its earliest, most treatable stage. Surprisingly, mammography can detect a tumor on average one to three years before a woman can feel the lump in her breast. Mammography also can locate cancers that are too small to be felt during a clinical breast examination performed by a specialist. The mammogram test is performed by a technician who has had training in conducting the procedure. The test uses X-rays to look at the tissues of the breast, one breast at a time, using two views of each breast. The technician only exposes the area to be tested (one breast at a time) and only a long as necessary. The technicians work rapidly and carefully to minimize any discomfort that is felt during the test.

A physician or radiologist, reads the mammogram and provides the results to your doctor. The radiologist may contact you to have a repeat test if there is a question about anything that is seen on the mammogram. Sometimes the radiologist will conduct another test that is called an ultrasound to take another type of look at an area of possible concern that was identified on the
mammogram. This test uses sound waves and bounces them off the tissues of the breast. The sound waves are used to create a high quality picture of the area that the radiologist wants to examine further.

Based on the results of these tests, your doctor may or may not request a biopsy as a procedure to take a sample of the breast mass cells or tissue that were found on the mammogram or ultrasound test and remain a concern. After the sample is removed from the breast it is taken to a laboratory. A laboratory pathologist –a doctor who specializes in diagnosing abnormal tissue changes –reviews a sample using a microscope. They look for abnormal cell shapes or growth patterns. Thankfully, nearly 80% of suspicious lumps that are tested turn out to be harmless. When cancer is present, the pathologist determines the type of cancer and whether it has spread beyond the ducts or lobules of your breast. If it has spread this is an invasive or more serious type of cancer.

The diagnosis of breast cancer and creation of a treatment plan for each individual is generally accomplished by a team of experts who work together with the woman involved. Each woman needs to evaluate the advantages and limitations of each type of treatment, and work with what will often be a team of physicians to develop the best and most effective approach to treatment and survival.