Breast Cancer Diagnosis, Breast Cancer Screening

Breast Cancer Diagnosis

Diagnosis of breast cancer is made through a process called triple assessment, which includes

• clinical examination,
• imaging procedures (e.g., mammogram, breast ultrasound, magnetic resonance imaging [MRI scan]), and
• biopsy (surgical removal of tissue for microscopic examination) of a mass detected by physical examination or mammogram (x-ray of the breast).

Patient Information About Breast Cancer
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The American Cancer Society recommends these guidelines for women who do not have symptoms of breast cancer:

• Women at age 20 should learn about the benefits and limitations of breast self-examination (BSE). The American Cancer Society considers performing BSE to be optional.
• Women between the ages of 20 and 39 should have a clinical breast examination by a physician or other health care practitioner every 3 years.
• Women age 40 and older should have a clinical breast examination and mammogram annually.
• Older women with serious health problems should evaluate the benefit of screening with their physician.
• Women with a family history of breast cancer should discuss early detection testing with their physician, including mammogram, breast ultrasound, and MRI with computer-aided detection (CAD).

Breast self-examination should be performed about 1 week after the menstrual period ends every month. Health care practitioners can instruct patients in the correct method of performing this examination.

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During clinical breast examination, the health care provider examines the breasts (including the nipples and areola) for retractions, skin changes, and discharge. Then, the breasts and underarms are palpated (felt with the fingers). Health care practitioners often teach patients how to perform breast self-examination while doing a clinical examination.

During a mammogram, the breast is compressed between two plates for a few seconds and x-rays are taken. The procedure uses low amounts of radiation. Compression causes some discomfort.

Ultrasound may be used to determine if a mass detected by examination or mammogram is a cyst or a solid lesion. Ultrasound uses high-frequency sound waves to create an image of the breast on a computer screen. Needle aspiration may be performed if ultrasound reveals a suspicious lesion.

If a diagnosis of breast cancer is made, the cancer is staged to determine the course of treatment.

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