Tests for breast cancer
You usually have a number of tests to check for breast cancer. These include:
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a breast examination
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mammogram
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taking a sample of tissue from your breast called a biopsy
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scans
Tests your GP might do
Most people with symptoms that could be due to breast cancer start by seeing their GP. Your GP might examine your breasts and feel the 
under your arms and in your neck. If you have had a telephone appointment your doctor might arrange for you to come in and see them.
Your GP might also ask about your family history. If you have a strong family history of cancer, there might be a faulty in your family that increases your risk of breast cancer.
Breast cancer screening
Some women do not have any symptoms and are referred to a breast clinic for tests if their screening mammogram shows an abnormal area.
Tests you might have during your breast clinic appointment
Depending on your symptoms, your GP might refer you to a breast clinic. This is usually a one stop clinic where you have several tests during one visit. It is also called a triple assessment.
The tests you have can diagnose breast cancer and other breast conditions. The tests you might have include:
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breast examination
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mammogram
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breast ultrasound scan
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a breast biopsy
Mammogram
A mammogram is an x-ray of your breasts. X-rays use high energy rays to take pictures of the inside of your body. It usually only takes a few minutes.
You need to remove your clothes from the waist upwards and put on a hospital gown. A health professional who specialises in taking mammograms (a mammographer) helps position your breast between the 2 plates on the machine. The plates press your breast firmly for a few moments. This is likely to be uncomfortable or painful, but it is over quickly.
Talk to your radiographer if you are nervous or embarrassed. Or if you are finding the mammogram too painful. They can stop at any time and try to make you more comfortable.
Breast ultrasound scan
A breast ultrasound is a test that uses high frequency sound waves to create a picture of the inside of the breast. A or a specialist called a sonographer puts some gel over your breast. This can feel cold. They then use an ultrasound probe to slide over the skin and give a clear picture on a screen.
A breast ultrasound usually takes about 10 to 15 minutes. You might feel a little pressure when the radiologist moves the probe over your breast.
Breast biopsy
A breast biopsy means taking samples of tissue from a suspicious area. It is the only way to find out if you have breast cancer or another breast condition. The results from your mammogram and ultrasound help your doctor know if you need to have a biopsy and where to take the biopsy. It also helps your doctor decide the type of biopsy you need.
Your doctor sends the samples to a laboratory and a looks at them under a microscope to check for cancer.
You might have a breast biopsy during your clinic appointment. There are different types of breast biopsy. These include:
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needle core biopsy
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fine needle aspiration
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skin punch biopsy
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vacuum assisted biopsy
The type of biopsy you have depends on a number of factors including how big the suspicious area is and where it is. Your doctor will tell you which type of biopsy you need. You may need more than one biopsy or different types of biopsies.
Your doctor may also suggest you have a wire guided excision. This is a type of surgical biopsy. It is done in the operating theatre.
Tests on your breast cancer cells
After a breast biopsy, a sample of tissue is sent to the laboratory. A pathologist looks at the samples under a microscope. The results usually take about 2 to 4 weeks.
The pathologist does various tests on the sample. The tests can:
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diagnose breast cancer
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show which type of breast cancer you have
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look for proteins on the surface of the breast cancer cells
The pathologist may also do other tests in the laboratory such as tests to look at cancer genes to find out how active they are. These are called tumour profiling tests such as the Oncotype Dx test.
What tests do I need after a biopsy?
If you have a biopsy that shows that you have breast cancer, you might have more tests to work out where and how big the cancer is. This is called staging the cancer.
The tests you may have include:
- checking for cancer cells in the lymph nodes in your armpit
- MRI scan
- CT scan
- blood tests
Checking for cancer cells in the lymph nodes of your armpit
Breast cancer cells can sometimes spread into the lymph nodes under the arm (the axilla). To check for this, you may have an axilla lymph node ultrasound and biopsy.
The ultrasound scanner has a probe that gives off sound waves. The sound waves bounce off the organs inside your body, and the probe picks them up. The probe links to a computer that turns the sound waves into a picture on the screen.
If there are any areas that look abnormal, doctors can use the ultrasound to guide a needle and take a sample of cells.
Breast MRI scan
MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body.
An MRI scan can tell your doctor:
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where the cancer is and how big it is
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if there are any other suspicious areas in the breast
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whether it has spread to the lymph nodes
It can also help doctors see the cancer better if it doesn’t show up well on a mammogram or breast ultrasound scan
CT scan
CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.
You may have a CT scan to find out whether the cancer has spread to other parts of the body.
Blood tests
Blood tests can check your general health, including how well your liver and kidneys are working. Doctors can also check the number of . You usually have blood tests to check that you are well enough to have treatment.
Tumour marker blood test
Tumour markers are substances that might be raised if there is a cancer. They’re usually proteins that can be found in the blood.
A tumour marker that is sometimes used in breast cancer is a protein called CA 15-3.
Doctors may use the CA 15-3, along with other tests, to check if treatment is working. A raised level may suggest that the cancer is spreading in some people with secondary breast cancer.
Tumour marker tests are not reliable enough to use on their own to:
• diagnose breast cancer
• make decisions about your treatment
This is because other non cancerous conditions can also cause the levels to rise.
Other tests you may have
You may also have other tests if doctors suspect that your cancer has spread to other parts of the body. The tests you may have include:
- liver ultrasound scan
- bone scan
PET-CT scan
Your doctor can tell you which tests you need.
Treatment
The tests you have help your doctor find out if you have breast cancer and how far it has grown. This is the stage of the cancer.
This is important because doctors recommend your treatment according to the stage of the cancer.
Coping with breast cancer
Coping with a diagnosis of breast cancer can be difficult. There is help and support available to you and your family.
