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Breast Cancer Diagnosis

Breast cancer diagnosis begins with screening. Regular screening for breast cancer (even if you don't present symptoms) can help you and your doctor find and treat cancer early. We'll review the three methods for breast cancer screening first and then talk about how to confirm a breast cancer diagnosis via clinical tests.

Breast cancer screening
Screening
refers to tests and exams used to find a disease, such as cancer, in people who do not present any symptoms. The goal of breast cancer screening exams is to find cancers before they start to cause symptoms. In fact, many breast cancer cases are discovered by self-exams or mammograms. Talk to your doctor about which screening tests are right for you, and how frequently you should have them.

1. Breast self-exam
You can perform monthly breast self-exams to check for any changes in your breasts. Self-exams are a systematic step-by-step approach to examining the look and feel of your breasts.  Get to know how your breasts normally look and feel to detect any signs or symptoms of change.  If you notice any changes, see your doctor as soon as possible for evaluation.

2. Clinical breast exam
A thorough clinical breast exam may take about 10 minutes during which your doctor checks your breasts. Your doctor looks for differences in size or shape between your breasts. The skin of your breasts is checked for a rash, dimpling, or other abnormal signs. Your nipples may be squeezed to check for fluid. Your doctor should also check your entire breast, underarm, and collarbone area using the pads of the finger to feel for a lump. A lump is generally the size of a pea before anyone can feel it. The exam is done on one side, then the other. Your doctor should also check the lymph nodes near the breast to see if they are enlarged.

3. Mammogram
A mammogram is a picture of the breast made with x-rays. Mammograms are the best tool doctors have to detect breast cancer early. Mammograms can show a breast lump before it can be felt.  They also help identify clusters of calcium called "microcalcifications".  These lumps or specks can be caused by cancer, precancerous cells, or other conditions. Further tests are needed to find out if abnormal cells are present.  

Mammograms are recommended for every woman when she reaches 35 years old to view the overall health of the breast and to use as a baseline photo for future comparisons.  Women 40+ years old or women with risk factors for breast cancer should have mammograms every 1 to 2 years.

Breast cancer diagnostic tests
If you notice a symptom of breast cancer or if screening test results suggest cancer, your doctor must identify potential causes and/or rule out cancer. First, your doctor may ask about your personal and family medical history followed by a physical exam. Be prepared to answer questions about possible risk factors for benign breast conditions or breast cancer as well.

Next, your doctor may order a diagnostic mammogram (more thorough breast x-ray) or other imaging procedures to take pictures of tissues inside the breast. After the tests, your doctor may suggest a follow-up exam later on. Or you may need to have a biopsy to look for cancer cells.  Doctors use the following tests to find or diagnose breast cancer:

  • Biopsy
  • Breast ultrasound
  • Diagnostic mammogram
  • Ductal lavage
  • Ductogram
  • Magnetic resonance imaging (MRI)
  • Nipple aspiration
  • Nipple discharge exam

If you have any signs or symptoms that you suspect might be due to breast cancer, please see your doctor as soon as possible. In the next section, we'll discuss the treatment of breast cancer.  Continue reading to learn more.

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