Breast Cancer:
Diagnosis and Staging

This page covers tests that are often used to help diagnose and stage breast cancer.
Depending on the symptoms you have, you may also be asked to undergo other tests and investigations.

“Cancer has shown me what family is. It showed me a love that I never knew really existed.” 

 Michael Douglas 

Diagnostic Tests to Determine Cancer Type

Once the doctor is sure of an abnormality, a biopsy is done to determine further details about the type of cancer present.

Biopsy

What to expect

Biopsy involves the removal of a sample of breast cells or tissues for laboratory testing and is the only definitive method to diagnose breast cancer. It is a way to evaluate a suspicious area or lump in your breast to determine whether it is cancerous.

In order to perform the biopsy, your doctor will ask you to remove the clothes from the top half of your body or undress completely. It is important that you choose a doctor and clinical team that you are comfortable with to perform your procedure. 

For a few days after the biopsy, your breast may feel sore and bruised. Wearing a supportive bra can help with this. Don’t hesitate to talk to your clinical team about pain medication if you feel you might need it. The pain and bruising will generally subside in a couple of weeks. If it persists, please contact your doctor immediately. 

There are three types of biopsies used for breast cancer:

Fine-needle aspiration (FNA) biopsy is a quick, simple test in which a thin needle is used to remove tissue or fluid for examination under a microscope.
Core biopsy which involves the removal of a tissue sample using a wide needle for examination under a microscope. This procedure is also called core needle biopsy. Before your doctor starts the procedure, he or she will typically inject a local anaesthetic into the area to numb it. You may feel a little pain or a sensation of pressure for a short time during the biopsy.
Excisional biopsy which involves the removal of an entire lump or a portion of the tissue from a suspicious area for diagnosis. The doctor will make a cut in the skin to remove the portion of tissue. You will usually be given a general anaesthetic (i.e. you will be asleep) during the procedure. There will be stitches on the affected area – once you heal, you may need to have them removed by your doctor or they may dissolve on their own.
HER2/neu Test

What to expect

The human epidermal growth factor type 2 receptor (HER2/neu) test is a type of blood test used to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If more HER2/neu genes or higher levels of HER2/neu protein than normal is detected, the cancer is called HER2/neu positive. This type of breast cancer is predicted to grow more quickly and spread to other parts of the body.

Gene Expression Tests

What to expect

Gene testing is done to check for gene mutations if you have a strong family history of breast cancer. In order to identify the cancer further, tissue samples are taken to test for changes in the BRCA1 & BRCA2 genes. These samples are usually removed during the biopsy. If your test result shows the presence of BRCA1 or BRCA2 genes, your doctor may want to perform additional testing on your children, parents, siblings or other family members that share their genes with you in order to determine their risk of developing breast cancer.

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