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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    A Nursing, answered on behalf of
    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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    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.
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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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    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 , Oncology, answered
    A bone scan can help show whether a cancer has spread (metastasized) to your bones. It can be more useful than standard x-rays because it can show all of the bones of the body at the same time.
    For this test, a small amount of low-level radioactive material is injected into a vein (intravenously, or IV). The substance settles in areas of bone changes throughout the entire skeleton over the course of a couple of hours. You then lie on a table for about 30 minutes while a special camera detects the radioactivity and creates a picture of your skeleton.
    Areas of bone changes appear as "hot spots" on your skeleton -- that is, they attract the radioactivity. These areas may suggest the presence of metastatic cancer, but arthritis or other bone diseases can also cause the same pattern. To distinguish between these conditions, your cancer care team may use other imaging tests such as simple x-rays or CT or MRI scans to get a better look at the areas that light up, or they may even take biopsy samples of the bone.
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    A Surgery, answered on behalf of
    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 , Cardiology (Cardiovascular Disease), answered

    Complicating things are the criteria radiologists and pathologists use to distinguish benign breast tumors from ductal carcinoma in situ (DCIS) and other early breast cancers may vary by institution or clinician, and is intensely influenced by expertise of the interpreters. Like any other diagnosis, mistakes can be made.

     

     

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    A , Psychiatry, answered

    Part of your initial consultation with any cancer specialist should include an estimate of how responsive your cancer will be to the treatment plan being proposed, and how that fits in with your general health or other medical conditions. Together, those pieces of information can help form an initial prognosis.

    As a shortcut, many people erroneously think that a later stage cancer (stage III or IV) has a worse prognosis than an earlier stage (I or II) prognosis, but that just isn't so. Some cancers are quite reponsive to treatment at any stage.

    Knowing your prognosis is important but only part of the full picture. Putting together the prognosis for a response to treatment and your personal characteristics (amount of information you'd like to have, how active to be in decision-making, whether you're genrally optimistic, pessimistic or realistic and how that matches your oncologist) takes some planning.  For more information about What Is Important to Me, and Questions I Want Answered, please see LEARN to Live Through Cancer: What You need to Know and Do published by Demos Health.

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    Avoiding cancer risk factors such as smoking, being overweight and lack of exercise may help prevent certain cancers. Increasing protective factors such as quitting smoking, eating a healthy diet and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.

    This answer is based on source information from the National Cancer Institute.
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    During wire localization of the breast, the radiologist uses either mammographic or ultrasonographic guidance to place a needle adjacent to the abnormality (usually either a mass or a cluster of calcifications). Once the position of the needle has been confirmed (usually in two mammographic projections), a thin wire is placed through the needle. The needle is withdrawn, leaving the wire in place to guide the subsequent surgical excision. The surgeon removes the abnormality and the wire in the operating room. The excised tissue is imaged by either mammography or ultrasonography to confirm that the abnormality has been removed.