Breast Cancer Diagnosis

A routine exam completed when there are no symptoms or concerns with the breast(s). These 2-D images are useful in discovering small lumps or abnormal areas before they can be felt or seen. This is an important tool in early detection of breast cancer; this can lead to early intervention, less invasive treatments and a better prognosis.

Ultrasound

An ultrasound uses sound waves to take a closer look at specific areas of concern. In comparison to a mammogram, an ultrasound is useful in distinguishing between a solid lump and fluid-filled cysts. If further testing is needed, like a biopsy, an ultrasound can be used to help guide the doctor to the exact location of concern.

MRI

MRI is used to take a picture of the inside of the body by using a magnetic field and radio waves. It is a valuable tool in certain circumstances (such as dense breast tissue or those with a significant family history).

Biopsy

A biopsy is a procedure performed to determine if a lump or abnormal area in the breast(s) is cancerous. A doctor will use a needle to take a small piece of tissue from the lump or suspicious area. This can be done with a thin needle, often referred to as a fine needle aspiration (FNA) or a thicker needle, which is known as a core needle biopsy.

Typically, a metal clip may be placed in the breast tissue where the biopsy was performed. The clip is

tiny, often less than 5 mm, and typically does not cause any discomfort or change of appearance to the breast(s). If a follow-up procedure such as a lumpectomy, additional biopsy or target radiation therapy are required, this clip will help your doctor locate the correct area of concern.

After the biopsy, the incision where the needle went into the breast may be a little sore and possibly bruised. It should heal within a few days to a week. If bruising occurs, this can take longer to completely resolve.

Once the biopsy is complete, the sample will be sent to the lab for review. The sample is examined under a microscope by a doctor called a pathologist to see if there are any unusual or harmful cells, like cancer cells, in the tissue. The results will be sent back to the referring doctor as a report called a pathology report. This can take a few days to a few weeks depending on what is found.

Wire and Seed Localization

This is a procedure used during breast surgery to precisely locate and mark the abnormal area in the breast(s). This can be done with a wire or a “seed” (usually a tiny magnetic marker). The radiologist will insert a fine wire or seed close to the area of concern using a mammogram or ultrasound for guidance. The seed or wire will stay in place until surgery.

During the surgery, the wire will act as a guide for the surgeon to help them locate and remove the abnormal tissue. If a seed is used, the surgeon uses a special probe to detect the seed’s location and allows the surgeon to access the abnormal tissue. This is common when having a procedure called a lumpectomy.

NOTE: A seed can be placed prior to surgery. It is recommended that you do not lift anything over 10 lbs for the remainder of the day. A wire is placed on the morning of surgery.

Radioactive Blue Dye

If you are having a sentinel lymph node biopsy, you will receive an injection that will help your surgeon locate your lymph nodes. There are two injections used, and it is common for surgeons to use both methods together.

The radioactive injection allows your surgeon to use a probe in the operating room. This will make a sound when it is placed over a lymph node, which signals the correct location to be surgically removed. This injection is typically done in the morning of surgery so that the liquid has time to travel to the lymph nodes. Sometimes, an image may be taken after the injection to help your surgeon better determine what lymph nodes need to be removed.

The surgeon may also use a blue dye that will help them visualize where the lymph nodes are located. This dye is commonly injected in the operating room by your surgeon. This blue dye can turn your urine blue or green and cause discoloration of the skin. These side effects are common and typically can last up to one week.

Understanding Your Diagnosis

Breast cancer is a disease where some of the cells in the breast can start to grow uncontrollably, which can then lead to a lump or mass. Men and women both have breast tissue, which means breast cancer can be found in both genders. It is more common in women as they typically have more breast tissue, but it is important to remember that anyone can be affected by it, no matter their gender.

Breast cancer is often a carcinoma and will be invasive or non-invasive.

Carcinoma

• abnormal cells that develop in the cells of the tissue that line your skin and organs.

Non-invasive Carcinoma

• this means the abnormal cells have not invaded outside of the duct or lobule in which it started. This is considered pre-cancer.

Invasive Carcinoma

• this means the breast cancer has spread outside of the duct or lobule, into surrounding tissue.