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 , Surgery, answered

    The BRCA gene test can be done as a blood test or a saliva test. During the blood test, you will have an elastic band wrapped around your arm and then a small needle will be used to draw blood from one of the veins in the arm. For the saliva test, you will swish mouthwash in your mouth and then spit it into a collection cup. There will be no pain or discomfort for the saliva test.

    Both the blood test and saliva tests are equally accurate.

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    A , Plastic Surgery, answered
    A breast lump can indicate either a benign or malignant process. Benign processes may include cysts, fibroadenomas, or even an infection (abscess). This must be diffentiated from a malignancy or carcinoma. Signs of infection may include redness, purulence, fever, and increased swelling. If in doubt, a biopsy should be performed with a pathological diagnosis.
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    Computer-aided detection and diagnosis (CAD): Over the past 2 decades, computer-aided detection and diagnosis (CAD) has been developed to help radiologists detect suspicious changes on mammograms. This can be done with standard film mammograms or with digital mammograms.

    Computers can help doctors identify abnormal areas on a mammogram by acting as a second set of "eyes." For standard mammograms, the film is fed into a machine which converts the image into a digital signal that is then analyzed by the computer. Alternatively, the technology can be applied to a digital mammogram. The computer then displays the image on a video screen, with markers pointing to areas that the radiologist should check especially closely.

    It's not yet clear how useful CAD is. Some doctors find it helpful, but a recent large study found it did not significantly improve the accuracy of breast cancer detection. It did, however, increase the number of women who needed to have breast biopsies. Further research is needed.

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    There is no doubt that breast cancer can run in families, so it's likely that there is a hereditary factor. It is important to note that only about 10 percent of women diagnosed with breast cancer have a family history. Just because one of your relatives had breast cancer does not mean you are absolutely fated to develop it.

    Scientists have identified two genes, BRCA 1 and BRCA 2, that seem to be associated with an increased risk for breast cancer. In fact, five to ten percent of women diagnosed with breast cancer will be carriers of one of these mutations.

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    A , Health Education, answered

    The pathologist determines if the cells studied under the microscope are cancerous (malignant), precancerous (premalignant: at high risk of becoming cancerous), or benign (harmless).

    If you are told it’s benign, don’t just run out the door to celebrate. You still want a copy of the pathology report, because there’s one key term you need to look for: atypical hyperplasia. If you have this, you have an increased risk of breast cancer in the future. Most pathologists now know how important this is and comment on it in their reports. But don’t take any chances. If your report says “hyperplasia of the usual kind,” then you’re probably fine.

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    A Surgery, answered on behalf of
    A detailed personal risk assessment will not necessarily dictate treatment of the newly discovered lump but can add perspective. Risk analysis is helpful in planning a long-term approach to breast health and a screening strategy.

    The salient risk factors, in order of importance, are: 1) personal history of familial genetic mutations (Angelina Jolie’s BRCA1 and BRCA2 mutation, for example); 2) personal history of previous breast cancer; 3) personal history of non-malignant proliferative benign disorders (sclerosing adenosis, ductal hyperplasia or atypical ductal hyperplasia, for example); 4) breast density on mammography; 5) family history of breast cancer and 6) previous radiation therapy to the chest (for example, Hodgkin’s disease treatment).

    The risk factor generating the greatest misconception is a positive family history of breast cancer, with women automatically suspecting doom when they feel a breast lump. Conversely, women with a negative family history tend to feel bullet proof. Both concepts are incorrect, as the status of the family history is an important factor, but breast cancer is multifactorial and family history is only one of many risk components. Ultimately, most breast cancer patients have a negative family history of breast disease and the majority of patients with breast cancer (60 percent) have no identifiable risk factors.

    This content originally appeared on the HCA Virginia Physicians blog.
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    A , Health Education, answered

    The types of breast cancers are categorized according to how they look under the microscope. Many breast cancers are actually combinations of different types of coexisting cancer cells. It’s possible for your biopsy results to come back as one type and a follow-up mastectomy or lumpectomy to show that other types are present in the same tumor. Keep in mind that for now, you and your doctor may not know the whole story.

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    A , Cardiology (Cardiovascular Disease), answered
    Screening breast cancer
    Many women fear talking to their doctor about breast cancer. In this video, Dr. Oz simulates a breast cancer screening dialogue between a patient and an OB/GYN.

     
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    A answered
    Tubular carcinoma is characterized by tubular structures ringed with a single layer of cells. Only 2% of all breast cancers fall into this category. The prognosis is usually good. 
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    Invasive mammary carcinoma (IMC) is an aggressive and fast growing cancer that appears where the breast lobe and breast duct meet. The breast lobe produces milk and the breast duct carries milk to the nipple.

    To diagnose any breast abnormality, your doctor may perform any of the following tests:

    • Clinical breast exam - In this exam, your doctor manually checks your breasts for changes or abnormalities.
    • Mammogram - This is an image of the inside of your breast captured either on film like an X-ray or as a computerized digital image.
    • Ultrasound - In a breast ultrasound, high frequency sound waves exposed to breast area produce pictures of the inside of the breast, similar to an X-ray. This allows your radiologist to distinguish between a solid mass (benign, meaning non-cancerous, or malignant, meaning cancerous, tumors) and a liquid mass (cyst).
    • MRI - MRI stands for magnetic resonance imaging. An MRI uses a magnetic field and radio frequency waves to project a very detailed picture of the inside of your breast onto a computer.
    • Biopsy - For a biopsy, your doctor removes tissue from the inside of your breast to examine under a microscope. There are a variety of methods your doctor can use to obtain this tissue sample.
    • Pathology - After your doctor draws a sample of your affected breast tissue, a pathologist examines the tissue under a microscope to make a diagnosis. A pathologist will examine and classify your tissue sample.
    • Staging Workup - Breast cancer staging is a system that describes the size, growth and type of your tumor and location of the tumor cells.