Breast Cancer
See Also:
Breast Cancer:
Overview
Breast Cancer: Breast
Cancer Types
Breast
Cancer: Causes & Risk Factors
Breast Cancer:
Signs & Symptoms
Breast Cancer: Stages
& Pictures
Breast Cancer:
Medical Tests & Diagnosis
Breast
Cancer: Treatment Options
Cancer Search Engine
Medical Tests & Diagnosis
Physical
examination and anamnesis (a personal medical
history):
The first step in the evaluation of a woman
suspected of breast cancer is a detailed and
complex medical review of the past health
problems, general health state, symptoms
displayed and medical family history, in order to
identify any risk factors that can facilitate the
development of cancer. The next step is a
detailed physical examination of (1) the breasts
in order to locate any lump or suspicious mass
and to identify the texture, size and
relationship of this lump/mass with the nearby
tissue areas and chest muscles, (2) the nipple in
order to notice any modification of the it's
appearance and shape, and (3) the general look
and appearance of the breast's skin.
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Mammography and Full-field digital
mammography (FFDM)
A mammography is one of the most common medical
techniques used to screen and diagnose breast cancer, to
examine any breast problems and for normal medical
routine check-ups. The advantage of this technique is
that it can determine the nature of the abnormal mass
tissue. The standard mammography technique uses an x-ray
to produce an image of the breast on a large sheet of
photographic film. The full field digital mammography
allows the image to be recorded, viewed and stored on a
computer. This advanced mammography allows a better
visualization of the mass or lump. Full field digital
mammography is not widely available and costs more than a
standard mammography. See our picture here:
Breast ultrasound or sonography
Ultrasound is a technique that uses high-frequency sound
waves to outline a specific part of the body. The sound
waves are transmitted into the targeted area and echoed
back by a special device and transformed into an image
format by a computer. This technique has become a
valuable tool, when used together with mammography, to
diagnose breast cancer in the last few years because it
is widely available and is less expensive than other
cancer diagnosis options. The ultrasound technique is
usually used after a mammogram has located a specific
area of concern. It's main advantage is distinguishing
between cysts and solid masses and between benign and
malignant tumors.
Ductogram or galactogram
This technique involves inserting a plastic tube in the
opening of the duct at the nipple and injecting a certain
amount of contrast substance. The contrast substance will
help outline the shape of the duct and will locate any
mass inside the duct on an x-ray image. This technique is
used to determine the cause of bloody nipple discharge.
Computer-aided detection and diagnosis (CAD)
This technique is used by a radiologist to detect
suspicious abnormalities on mammograms as a result of a
standard mammography. This technique involves a computer
device that scans the mammogram film, locating tumors or
lesions that the doctor could not identify. The advantage
of this technique is that it helps to diagnose breast
cancer while it's in the earliest stages.
Scintimammography
This technique involves the administration of a
radioactive tracer in the vein that will attach to the
cancer cells and make them detectable by a special
camera. This technique is new and is used in experimental
trials.
Magnetic resonance imaging (MRI)
MRI is an advanced technique that uses radiowaves, strong
magnets and a contrast substance to outline the image of
a certain part of the body. The cancer cells absorb a
high amount of the contrast substance and reveal the
shape and pattern of the abnormal tissue mass. This
technique is used to better examine and evaluate the mass
and lumps revealed by the mammography or in the routine
screening process of those women that have a high risk
for developing breast cancer.
Nipple discharge examination
This type of test is performed only when the patient is
displaying spontaneous nipple discharge. The secretion
eliminated by the nipple is collected and examined under
microscope in order to identify the type of cells it
contains. If the secretion is clear, green colored or
milky, the presence of cancer is very unlikely. If the
secretion is red or red-brown, it means that it contains
blood and might possibly be caused by a malignant tumor.
But a similar type of secretion can be caused by an
internal breast infection, injury, or benign tumors. Even
if the secretion has no evidence of cancer cells, a
cancer diagnosis is not completely excluded and other
types of investigation are recommended.
Ductal lavage and nipple aspiration
The ductal lavage is an experimental test developed in
order to help those women that do not have symptoms of
breast cancer, but face a high risk of developing breast
cancer, to obtain a better picture and a deep
understanding of their cancer risk. This procedure is
performed under local anesthesia. A small amount of
anesthetic cream (that numbs the skin) is applied around
the nipple and a catheter is used to withdraw a tiny
amount of liquid from the milk ducts. This ductal fluid
is collected with the help of a saline liquid that is
inserted into the duct through the catheter.
Nipple aspiration is another cancer test used to
detect the breast cancer risk and involves a simple
procedure performed to collect abnormal cells from the
duct. This procedure is not an intrusive technique. It
uses two small cups that are placed on the breast. This
device warms the breast, gently compresses them and
performs a slight suction in order to bring duct fluids
to the surface of the breast skin for collection and
later examination.
Biopsies
A Biopsy is the next step after the previous
investigations (mammography, ultrasound and physical
examination) find abnormal mass tissues suspected of
being cancerous. The role of a biopsy is to remove a
certain amount of tissue sample for microscopic
investigation. There are several types of biopsies: (1)
fine needle aspiration biopsy, (2) core (large needle)
biopsy, and (3) surgical biopsy. The decision as to which
biopsy type is necessary depends on the characteristics
of the suspected cancerous mass (lesion's level of
suspicion, the mass/lump size and location, the presence
of other symptoms of lesions).
(1) Fine needle aspiration biopsy (FNAB) : This
procedure involves using a thin needle attached to a
syringe to remove a cell sample from the breast lump or
mass. This procedure is easily performed when the lump is
located at the surface of the breast tissue. When the
tumor is deep within the breast, this procedure will be
performed under ultrasound. Another method used in these
circumstances is a stereotactic needle biopsy.
This procedure is performed with the help of a computer
device that analyses two mammograms taken from 2 angles
to indicate the precise location of the tumor. Fine
needle aspiration biopsy can sometimes miss the tumor and
withdrawn cells from a nearby area.
(2) Stereotactic core needle biopsy:
This procedure is performed under local anesthesia and
involves removing a small cylinder of tumor tissue. There
are two new sterotactic methods that remove more tissue
than a core biopsy: mammotome or vacuum-assisted biopsy
and advanced breast biopsy instrument (ABBI).
The mammotome procedure involves taking a consistent
sample of tumor tissue (twice as much tissue that is
removed through a core biopsy) using a cylinder inserted
into the breast tissue. This cylinder contains a special
rotating knife that removes the tissue sample when
inserted into the breast tissue .
(3) Surgical biopsy : This is a procedure where
the whole tumor or a part of the tumor is removed for a
detailed lab examination. There are two types of this
procedure: incisional biopsies, when a
small piece of a big tumors is removed for examination
and excisional biopsies, when the whole
tumor with the surrounding margin of normal-appearing
breast tissue is removed completely for a detailed lab
examination.
These biopsies are performed under local anesthesia.
Sometimes, if the lump is hard to locate by touch or the
surrounding area looks suspicious, these biopsies are is
used in conjunction with another procedure called wire
localization. Wire localization is performed under
imaging techniques used to help the doctor guide the
needle in the target area. A thin wire is inserted into
the tissue through the center of the needle and is used
to locate the area that needs to be removed.
Chest X-rays:
This type of x-ray is used to determine if the cancer has
spread.
Bone Scan:
This method is performed only when there is a suspicion
that the cancer has spread to the bones. The procedure
uses a radioactive substance that once injected, will be
absorbed by the problematic bone tissue and can be
visualized on the image scan.
Computed Tomography (CT):
The CT scan is an advanced x-ray procedure that produces
a more detailed cross-sectional image of the body. The CT
scan procedure involves two phases: in the first phase, a
set of pictures will be taken and in the second phase the
patient will receive an intravenous injection (IV) of a
radiocontrast agent in order to better outline the
structure of the body and a second set of pictures will
be taken.
Positron Emission Tomography (PET):
This technique uses an injectable glucose substance that
contains a radioactive atom. Cancer cells absorb a high
level of this substance, making them easier to be
detected by a special camera device. This technique is
used when there is suspicion that the cancer has spread
to other areas of the body.
See Also:
Breast Cancer:
Overview
Breast Cancer: Breast
Cancer Types
Breast
Cancer: Causes & Risk Factors
Breast Cancer:
Signs & Symptoms
Breast Cancer: Stages
& Pictures
Breast Cancer:
Medical Tests & Diagnosis
Breast
Cancer: Treatment Options
Cancer Search Engine

Article by Alina Morrow, MS
Medical Writer,
OmniMedicalSearch.com
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