Understanding Your Diagnosis

What Happens When You Are Diagnosed?

The doctor will ask about your symptoms and medical history. A physical exam will be done. It will include a breast exam and blood tests. Imaging tests can help diagnose and evaluate the extent of the cancer. Imaging tests include:
• Mammography
• Ultrasonography
• CT scan
• PET/CT scan

Your doctor may need to test your breast tissue and adjacent lymph nodes. A sample will be removed and sent to a lab to look for cancer cells.
This can be done with different biopsy types, including:
• Fine-needle aspiration: Removal of fluid and/or cells from a breast lump using a thin needle.
• Needle biopsy: Removal of tissue with a needle from an area that looks unusual on a mammogram, but cannot be felt.
• Surgical biopsy:
       — Incisional biopsy: Cutting out a sample of a lump or suspicious area.
       — Excisional biopsy: Cutting out all of a lump or suspicious area and an area of healthy tissue around the edges.

If cancer is present, your doctor may order tests to learn about the type of cancer. These may include:
• Blood tests: To look for tumor markers or genetic mutations.
• Tissue evaluation: To look for estrogen and progesterone receptors, and the presence of HER2/neu and Oncotype DX. These are used for developing a treatment plan.

The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, breast cancer is staged from 0-IV. Stage 0 is a very localized cancer, while stage IV indicates a spread to other parts of the body.

Types of Breast Cancer Found in Women

• Ductal carcinoma situ: Early stage cancer confined to the ducts. This type has a high cure rate.
• Infiltrating ductal carcinoma: A cancer that starts in the ducts of the breast and spreads into surrounding tissues. This is the most common type of breast cancer in women.
• Infiltrating lobular carcinoma: A cancer that starts in the lobules of the breast and spreads into surrounding tissues.
• Medullary, mucinous, and tubular carcinomas: These are three relatively slower-growing types of breast cancer.
• Inflammatory carcinoma: A rare and aggressive form of breast cancer that can be difficult to treat. This cancer invades the lymphatic vessels of the skin and can be very extensive. It is very likely to spread to the local lymph nodes.
• Paget’s disease: A very rare cancer of the areola and nipple. Although Paget’s does not arise from glandular tissue in the breast, it can be associated with both in situ and infiltrating breast cancers.