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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  • 1 Answer
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    A Surgery, answered on behalf of
    Are there any additional risks in 3D mammography?
    Overall exposure to radiation from a mammogram is very minimal, especially when compared to the benefit it provides in screening for breast cancer. Watch as Jamie Caughran, MD, FACS, of Mercy Health, explains the risks of both 2D and 3D mammograms.

    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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    During digital breast tomosynthesis (3D mammography), the mammogram is similar to a traditional (2D) digital mammogram. The technologist will position you, compress your breast and take images from different angles. The x-ray arms sweep in an arc over your breast taking multiple breast images to produce the 3D images of your breast. The duration of the exam is similar to that of traditional digital mammography. The technologist will send the images of your breast to the radiologist to be read. The results will be reported to you and your doctor.

    Breast tomosynthesis is available to all women who are due for their annual screening mammogram. Detection benefits have been demonstrated in all types of breast tissue. Diagnostic exams may also be performed with a doctor`s order.

    This content originally appeared on http://www.livehealthyaustin.com/
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    Whenever I see a woman who is 35 or younger with breast cancer, one of the first things that I want to know is her family history. Women under age 35 who are diagnosed with breast cancer are more likely to have a genetic mutation. So, it's very important to undergo genetic testing. The results of the genetic testing could impact treatment decisions and determine the risk of developing another breast cancer in the future. 
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    Women under the age of 40 are usually not screened for breast cancer with mammograms and ultrasounds. In general, we don't recommend such screening unless these young women have a very strong family history of other personal risk factors that put them at a very high risk of breast cancer at a young age.

    Only 2% of all breast cancers are diagnosed in women age 40 and younger. However, the leading cause of cancer death in women under the age of 40 is actually breast cancer. Many young women with breast cancer are not diagnosed until the late stages of the disease and often have a more aggressive type of cancer.
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    A Surgery, answered on behalf of
    After intake of a patient’s history and a physical exam, a diagnostic mammogram is the next tool for patients aged 35 and older who have found a lump. If less than 35 years of age, the accuracy of a diagnostic mammogram significantly decreases due to the natural breast density of a young woman, as breast density naturally decreases with age. For those under 35, a solid lesion can best be diagnosed with an ultrasound-guided needle biopsy. At this young age, the high percentage diagnosis is a benign fibro-adenoma.

    For those over 35, the diagnostic mammogram will yield important information concerning the nature of the mass. Is it smooth or are the borders irregular? Does it create architectural distortion? Are there any other lesions present that are too small to be palpated? The recent introduction of 3D tomosynthesis with mammography adds detection sensitivity. Needle biopsy using mammogram imaging is called a stereotactic biopsy. Imaging with breast magnetic resonance imaging (MRI) is very sensitive in detecting breast abnormalities and is especially helpful in patients with dense breasts. If a lesion is not visualized on mammography, 3D tomosynthesis or ultrasound, then a needle biopsy using MRI image guidance is the preferred diagnostic option.

    Multiple well-controlled, large, randomized studies document that annual screening mammography saves lives. As a cancer is evolving, mammography leads to early detection. If the malignant process is diagnosed earlier in its natural history, there are higher cure rates and less severe treatments. Despite some controversy, mammography lowers the risk of dying from breast cancer and should be a mandatory component of every woman’s healthcare plan.

    This content originally appeared on the HCA Virginia Physicians blog.
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    A answered
    There are many available options to pursue if unfavorable results are found after mammography or other screening activities. If a malignant tumor is found, and the breast cancer was one of several types (early onset, two separate breast cancers, male breast cancer, ovarian cancer or multi-generational), a doctor will consider whether there is an inherited mutation in the family. Although this is present in only five to 10 percent of individuals, the breast and ovarian cancer risk is as high as 87 percent and 44 percent, respectively, in the patient’s lifetime, depending on many factors.

    Fortunately, there are many options for treatment and future preventive activity. Preventive mastectomy and removal of ovaries is the choice of many, but not all, women. This reduces the risk of breast and ovarian cancer, but not to zero. This prevention, one form of risk management, was chosen by Angelina Jolie after she discovered she carries a mutated copy of the BRCA1 gene, with wide media coverage after the announcement. This is a personal decision, to be made with all facts in place and with information from a healthcare provider with extensive knowledge in this area. For those at a lesser risk, at the opposite end of the continuum, one would start with lifestyle changes and medication.

    This content originally appeared on the HCA Virginia Physicians blog.
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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 Surgical Oncology, answered on behalf of
    The majority of breast cancers found by screening mammography are small and non-palpable. In contrast, breast cancers that are not detected by screening mammography tend to be much larger and usually are palpable. Breast cancer on mammography usually appears as a suspicious microcalcifications, a super-density with irregular borders, or an asymmetrical density compared with the other breast or the previous annual mammogram. On an ultrasound, breast cancer appears as a solid mass that is taller than wide with irregular borders or an angular or lobular borders. There is frequently increased vascularity within the solid mass and a shadow cast behind the mass.
     
    Magnetic resonance imaging (MRI) is another modality for breast imaging. Breast cancer usually presents on MRI as a contrast-enhanced lesion. Breast MRI probably gives the best three-dimensional assessment of the tumor mass and also allows doctors to evaluate whether there are satellite lesions. MRI is significantly better than mammography for evaluating the lymph nodes in the armpit, behind the muscle and along the internal mammary chain. And MRI screening usually is restricted to women with high risk conditions for developing breast cancer.
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    You do need a mammogram if you have small breasts. Breast cancer can occur in small breasts. The mammogram is a test used to help detect breast cancer at an early stage, and women with breasts of any size are at risk for breast cancer.
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    A Diagnostic Radiology, answered on behalf of
    Why is 3D mammography showing promise?
    One advancement in breast cancer screening is 3D mammography, which allows for more accurate screenings and fewer callbacks. In this video, Michael Paciorek, MD, of Mercy Health, explains why he believes 3D mammography will soon be the new standard.

    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.
    See All 5 Answers