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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    If Paget's disease is suspected, the radiologist will likely perform a ductogram, also called ductography or galactography. The doctor gently inserts a small, hollow tube into the ductal opening of the nipple, then injects a small amount of a contrast dye into the tube and takes an x-ray. The dye helps the doctor see the duct on the tube and identify any problems.
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    A , Health Education, answered

    Most women never think to question their diagnosis of breast cancer. If your doctor tells you that you have breast cancer, you probably do.

    But breast cancer is complicated and mystifying under a microscope, sometimes even for experienced pathologists, the specialist doctors who read and interpret tissue samples. To make a diagnosis between benign cells (noncancerous) and malignant cells (cancer) is much more complex than you would ever first imagine.

    Because of this complexity, the pathology reports diagnosing breast cancer can be wrong. For example, researchers at the Johns Hopkins University in Baltimore, Maryland, found that about 1.4 percent of the time, a pathologist mistakenly diagnoses cancer, misidentifies the type of cancer, or misses a cancer totally. Even more common are pathologists’ errors that can significantly change the type of treatment patients receive. These errors can make a world of difference between receiving conservative treatments versus aggressive surgeries.

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    A Diagnostic Radiology, answered on behalf of
    What is digital breast tomosynthesis (DBT)?
    Digital breast tomosynthesis (DBT, or 3D mammography), works like a standard mammogram. In this video, radiologist Jennifer Rollenhagen, MD, of Mercy Health, explains how DBT provides greater accuracy, especially for those with dense breast tissue.

    Trinity Health recognizes that people seek medical information on a variety of topics for a variety of reasons. Trinity Health does not condone or support all practices covered in this site. As a Catholic health care organization, Trinity Health acts in accordance with the Catholic tradition.

    Please note, the information contained on this website is provided to supplement the care provided by your physician. It is not intended to be a substitute for professional medical advice. Always seek the advice of a qualified health care provider if you have questions regarding your medical condition or before starting any new treatment. In the event of a medical emergency always call 911 or proceed to your nearest emergency care facility.
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    Unlike other breast cancers, inflammatory breast cancer (IBC) usually does not cause a distinct lump in the breast. Therefore, a breast self-exam, clinical breast exam or even a mammogram may not detect IBC. Ultrasounds may also miss inflammatory breast cancer. However, the changes to the surface of the breast caused by IBC can be seen with the naked eye.

    Symptoms of IBC can develop rapidly, and the disease can progress quickly. Any sudden changes in the texture or appearance of the breast should be reported to your doctor immediately.

    For women who are pregnant or breast-feeding, redness, swelling, itchiness and soreness are often signs of a breast infection such as mastitis, which is treatable with antibiotics. If you are not pregnant or nursing and you develop these symptoms, your doctor should test for IBC.

    If your doctor prescribes antibiotics and your symptoms do not disappear, several diagnostic tests may help determine whether cancer cells are present in the breast:
    • Mammogram: Often the first step in diagnosing IBC, a mammogram may show thickened skin, usually without a visible mass. The affected breast may also appear larger and denser than the other breast. However, inflammatory breast cancer may not be detected by mammogram because there are no visible lumps.
    • Magnetic resonance imaging (MRI): If a mammogram is normal, an MRI may be used to detect abnormalities in the breast tissue.
    • Positron emission tomography (PET) and computed tomography (CT): A combined PET and CT scan can find IBC that has moved to nearby and/or distant lymph nodes, one of the most common areas to which IBC spreads.
    • Skin biopsy: A definitive diagnosis of IBC is made by breast biopsy. If a breast exam or imaging study shows signs of IBC, your doctor will remove a sample of breast tissue and examine it under a microscope. Only a biopsy can show for sure that inflammatory breast cancer is present. If an apparent infection is not going away, you can consider asking your doctor for a skin biopsy.
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    Wire localization of the breast is a technique used to guide a surgeon to a nonpalpable suspicious abnormality seen on a mammogram or sonogram (image obtained by ultrasonography). This technique helps to ensure removal of the entire abnormality while minimizing the amount of normal breast tissue excised.
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    A Internal Medicine, answered on behalf of
    How does family history affect my risk of breast cancer
    Family history is often a cause of many cancers. Accordingly, it can increase the risk for breast cancer, says Tejas Raiyani, MD. In this video, learn about the importance of family history.
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    Adenoid cystic carcinoma (adenocystic carcinoma) is a type of breast cancer. These breast cancers have both cylinder-like (cystic) and glandular (adenoid) features and make up less than 1% of breast cancers. Because they rarely spread to the lymph nodes and distant areas, these tumors usually have a very good prognosis. 
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    A , Hematology & Oncology, answered

    For any person with a BRCA mutation, I recommend speaking with a genetic counselor. He or she will be able to help you understand your level of risk—some BRCA mutations are more serious than others, but ultimately this means that you have an increased risk of breast cancer, ovarian cancer for women and prostate cancer for men. A genetic counselor will be able to help you understand what “increased risk” means for you by looking at your family history. In some cases and depending on the level of risk, it may be advisable to undergo preventative treatments. Examples might be prophylactic mastectomy or proactive drug therapy.

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    A , Health Education, answered

    You’ve been told you have breast cancer. Maybe you’re feeling overwhelmed, angry, and afraid. One way to move beyond these feelings is to sharpen your mind. It’s time to go back to school on one of the most important subjects you’ll ever study - learning about breast cancer.

    Your diagnosis starts with your pathology report, a description of cells and tissues from your biopsy or surgical tissue sample. A pathology report is written by a pathologist, a medical doctor who specializes in preparing, reviewing, and reporting on tissue samples. Pathologists make a diagnosis of breast cancer and determine its extent by looking at tissue samples under a microscope.

    Understanding your pathology report is critical. It holds the key to your diagnosis, prognosis, and treatment plan. All of your treatment decisions will be based on your pathology report. If your medical oncologist refuses to discuss your pathology report with you or give you a copy of it, find another doctor. You want a doctor who sees teaching you to be a well-informed patient as part of his job.

    As advanced oncology nurse Melissa Craft stresses, “I tell my patients, always, always get a copy of your pathology report and have the doctor explain it to you in detail.”

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    The BRAC Analysis Rearrangement Test (BART) is an additional level of analysis, which goes beyond DNA sequences of genes. BART looks for large rearrangements, deletions, and insertions of DNA material. A positive BART result has the same medical implications as a mutation found with more routine types of analysis. Anyone who has had comprehensive BRCA1/2 testing could go on for BART analysis. It is a matter of yield (chances of finding a mutation), and cost. For high-risk families (multiple cases of breast cancer; early-onset usually; often ovarian cancer in the family), the yield is 1-3%. The cost is $650.