Breast Cancer Diagnosis

Breast Cancer Diagnosis

Breast Cancer Diagnosis
Beyond a breast exam or mammogram, there are various tests and methods for doctors to diagnose and track progress of breast cancer. The process involves imaging and lab tests, including ultrasounds, MRIs, a breast biopsy and even bones scans to locate tumors and stage the cancer. A medical oncologist or breast surgeon help explain a breast cancer diagnosis and provide treatment options. Learn more about diagnosing breast cancer with expert advice from Sharecare.

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    How Is Inflammatory Breast Cancer (IBC) Diagnosed?
    Inflammatory breast cancer is diagnosed during an exam due to visual signs, says Laurie Rudolph from Reston Hospital Center. Learn more in this video.
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    In the 1800s, Rudolph Virchow, a doctor and pathologist, described a whole slew of various tumors based on their appearance under a microscope. Until very recently, the appearance of the breast cancer under the microscope was the most important information doctors had to determine the type of tumor. The two most common types of tumors are infiltrating ductal cancer, which has a frequency of 70% to 80%, and invasive lobular cancer, which has a frequency of 5% to 10%.

    In the 21st century, there are new methods of classifying breast cancers. Doctors extract the nucleic acids from the breast cancer cells and look at the proteins expressed by the cancers in a DNA array. Thousands of genes have been observed, and breast cancers can be classified based on their gene expression. Doctors are learning more and more about the genes that drive the breast cancer and cause it to behave the way it does. This is leading to a shift in how cancers are classified. While in the past only chemotherapy was used, now tumors are classified by their molecular profiles and there are therapies that can target the molecular defect and leave the normal cells alone.
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    A core biopsy is also called a needle biopsy. A core biopsy is similar to a Fine Needle Aspiration (FNA), but your doctor uses a bigger needle to remove the tissue sample for lab evaluation. The drawback to core biopsies, according to Dr. Uthman, is that a small sample may get only the benign changes and miss malignant changes. A reliable and increasingly common procedure in large cancer centers is the use of ultrasound techniques for core biopsies. Another but less frequent practice is the use of the stereotactic core biopsy. A stereotactic core biopsy is used when the lesions (abnormal tissue) can only be seen on a mammogram.

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    Some types of breast cancer biopsies are statistically more likely to be wrong (called false positives). The validity of your biopsy sets the stage for deciding if you need a second opinion or another testing procedure to make sure you actually have breast cancer.
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    Papillary carcinoma is a type of breast cancer which can be separated into noninvasive and invasive types. It includes cells arranged in small, fingerlike projections. These cancers are more common in older women and make up no more than 1-2% of all breast cancers.
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    How Do I Get a BRCA Test?
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    A hormone receptor status is one prognostic factor of breast cancer. There are two types of hormone receptors, estrogen and progesterone. Having a positive hormone receptor status means that hormones can stimulate your breast cancer cells to grow and thrive. This is a good sign, because it indicates that your cancer will respond to hormonal therapies. Tumors are tested for a response to both of these two female hormones, estrogen and progesterone. When a tumor responds to either just estrogen, or both estrogen and progesterone, your doctor will likely recommend hormonal therapy.

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    HER2/neu is a protein that is found on the surface of breast cells. The formal name is human epidermal growth factor receptor 2, and it is also known as HER-2, c-erbB-2, ErbB-2, and ERBB2.

     

    The HER2/neu protein sends messages to cells from growth factors outside the cells. Growth factors tell cells, including cancer cells, to grow and divide. The term “overexpression” means there are too many copies of the oncogene (tumor gene).

     

    Everyone has the HER2/neu protein. But in some breast cancers, the cells produce much more HER2/neu protein than normal. These breast cancers are called HER2/neu-positive cancers. Breast cancers that have few HER2/neu protein, or none at all, are called HER2/neu-negative cancers.

     

    HER2/neu-positive breast cancers grow faster than HER2/neu-negative breast cancers. This is an important test of your tumor because it functions not only as a prognostic indictor (HER2/neu-positive tumors are more aggressive) but also as an indicator of the best treatments.

     

    Approximately 25–30 percent of breast cancers have an overexpression (also called “amplification”) of the HER2/neu gene. The overexpression of this receptor in breast cancer is associated with increased disease recurrence and worse prognosis. This is not an inherited gene like the ones you get from your mother or father.

     

    Breast cancer scientists and researchers are making progress in finding ways to boost the immune system’s ability to fight excess HER2/neu protein. Treatment drugs, such as Herceptin, are now available. Ask your doctor to talk with you about your treatment options if you have an HER2/neu-positive breast cancer.

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    A woman can be an active participant in improving her chances for early detection of breast cancer. The American Cancer Society recommends that, beginning at 45, women have a mammogram every year. At age 55, that interval can be scaled back to every other year. Women who have a higher than average risk of breast cancer (for example, women with a family history of breast cancer) should seek expert medical advice about whether they should be screened before age 40, and how frequently they should be screened.
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    The development of intraductal approaches to diagnosis and treatment represents one of the most important advances in breast disease treatment. Intraductal endoscopic techniques allow surgeons to perform evaluations through the nipple using very fine micro-endoscopes without surgery and without general anesthesia. This minimally invasive approach has been proved highly successful in the detection of papillomas. An endoscopic papillomectomy can diagnose pathologic nipple discharge.