Breast Cancer Exams and Tests

The earlier breast cancer is found, the more easily and successfully it can be treated. The most common methods for detecting breast cancer include:

* Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Your doctor may suggest that you have a screening mammogram, especially if you have any risk factors for breast cancer. The usefulness of mammograms may vary depending on your age; this issue is still being debated by experts.
* Clinical breast exam (CBE). During a clinical breast exam, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes.
* Magnetic resonance image (MRI) of the breast. MRI is a test that uses a magnetic field and pulses of radio wave energy to provide pictures of the inside of the breast. It may be more sensitive than a mammogram for finding breast cancer in women who have a strong family history of breast cancer. However, MRI may find small irregularities that are not breast cancer. This can lead to further testing. MRI is also more expensive and not as readily available as mammography. For these reasons, most experts do not recommend the use of MRI for screening for breast cancer. 10, 11

The type and frequency of breast cancer screening that is best for you changes as you age.

A breast self-exam (BSE) is a simple procedure to help you detect breast lumps. Medical experts disagree about the need for or the effectiveness of regular breast self-exams. Studies have failed to show that BSE alone reduces the number of deaths from breast cancer. Therefore, BSE should not be used in place of clinical breast exam and mammography.
Diagnostic tests

If your doctor thinks that you have breast cancer, you may have other tests, including:

* A mammogram, if you have not already had one.
* An ultrasound. You may have an ultrasound of the breast if a lump is found during a clinical breast exam or on a mammogram. Breast ultrasound is often used to distinguish between solid lumps and fluid-filled (cystic) lumps.
* An MRI of the breast, which is sometimes used to get more information about a breast lump or to evaluate problems in women who have breast implants. MRI of the breast may be most useful for women who test positive for the BRCA1 or BRCA2 gene. 11
* A breast biopsy. If a lump is found in your breast, your doctor will need to remove a small sample of the lump (biopsy) and look at it under the microscope to see whether any cancer cells are present. A needle biopsy is done by inserting a needle into the breast and removing some of the tissue. Tests that may be performed on any breast cancer cells that are found include:
o Estrogen and progesterone receptor status. The hormones estrogen and progesterone stimulate the growth of normal breast cells and some breast cancers. If your breast cancer tests positive for estrogen or progesterone receptors, you may be able to stop the growth of the cancer cells with hormone therapy, such as an aromatase inhibitor or tamoxifen. Estrogen or progesterone receptor-positive (ER/PR+) breast cancer also sometimes responds better to chemotherapy, which may be a less aggressive cancer than breast cancer that is not affected by estrogen or progesterone. This is an important piece of information that will help you and your doctor plan treatment.
o HER-2 receptor status. HER-2/neu is a protein that regulates the growth of some breast cancer cells. About 25% of women with breast cancer have too much (overexpression) of this growth-promoting protein.
* A lymph node biopsy to see whether breast cancer cells have spread to the lymph nodes under the arm (axillary lymph nodes). The two methods used are:
o Surgery to remove most of the lymph nodes in the underarm. This is called an axillary lymph node biopsy.
o Surgery to take a sample of just one or two of the lymph nodes that are most likely to contain cancer cells. This is called a sentinel node biopsy. Several studies have shown that sentinel lymph node biopsy is as safe and accurate as axillary lymph node dissection for staging breast cancer. Other studies are ongoing. Sentinel lymph node biopsy is less likely than axillary lymph node dissection to impair arm mobility, cause pain, or result in problems with swelling of the arm and hand. 12
* A complete blood count (CBC) to provide important information about the kinds and numbers of cells in your blood, including red blood cells, white blood cells, and platelets.
* A chemistry screen, to measure the levels of several substances (such as those involved in liver functions) in your blood.
* A chest X-ray, to provide a picture of organs and structures within your chest, including your heart and lungs, your blood vessels, and the thin sheet of muscle just below your lungs (diaphragm).

Tests if your doctor suspects that breast cancer has spread

If your doctor thinks that breast cancer may have spread to other organs in your body (metastasized), he or she may order additional testing, including a:

* CT scan to provide detailed pictures of the organs and structures in your chest, abdomen, and pelvis.
* Bone scan to detect cancer that has spread (metastasized) to the bones.
* CT scan or MRI of the brain to provide detailed pictures of your brain and to check for cancer that may have spread to your brain.

What to think about

You have an increased risk for developing breast cancer again if you have had breast cancer in one breast. Breast cancer can come back in the same breast, on the chest wall, in your other breast, or somewhere else in your body (metastatic or recurrent breast cancer). To be sure that the cancer has not returned, you will have regular checkups that include physical exams and mammograms.

If you find any unusual changes in the treated area or in your other breast, or if you have swollen lymph glands or bone pain, call your doctor to discuss these changes. For more information, see the topic Breast Cancer, Metastatic or Recurrent.
Early Detection

Early detection is an important factor in the success of breast cancer treatment. The earlier breast cancer is found, the more easily and successfully it can be treated. The three methods used for early detection are:

* Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Your doctor may suggest that you have a screening mammogram if you are older than 40, especially if you have any risk factors for breast cancer. Screening mammograms are most useful after age 50, but most experts recommend starting screening at age 40.
* Clinical breast exam (CBE). During a clinical breast exam, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes.
* Breast self-exam (BSE). A breast self-exam is a simple procedure to help you detect breast lumps. BSE should not be used in place of clinical breast exam and mammography. Although studies have not shown that BSE reduces the number of deaths from breast cancer, it may help familiarize you with your normal breast tissue. This will help you identify any new or unusual changes in your breasts. 11

source : health.yahoo.com