Diagnosing for Breast Cancer
As we know breast cancer is the most wide spread cancer in the world and if one has a symptom or their screening tests suggest possible cancer activity, a doctor must verify whether it’s cancer or something else. There has been an increase in the awareness levels about breast cancer in women in the past decade and many are undergoing the test recommended for cancer detection. This has resulted in detecting the cancer at the early stages and increase in the survival rates but it is still the most common form of cancer in the world resulting in the highest number of recorded cancer deaths in women between the age group of 45 to 55 years.
Generally, in diagnosing of breast cancer, your physician might do the following:
a) ask about family and personal medical history.
b) conduct a physical examination, mammogram or other procedures.
c) suggest further tests or biopsy. Screening for breast cancer before the appearance of symptoms is vital and in most cases treatments can work if cancer is detected early.
Probably the most common causes of breast cancer are hormonal and / or genetic factors. We have been able to develop staging systems to categorize the extent of cancerous growth and develop treatment methods accordingly. Depending on how the cancer has spread and what kind of cancer it is, various treatment options are available like surgery, mastectomy, radiation therapy, hormonal therapy and chemotherapy.
Few recommended tests by physician for breast cancer diagnosis are mentioned below:
a) Clinical breast examination:
In this examination, the physician feels both breasts for lumps and checks for other problems. If there is a lump, the physician will feel its shape, size and texture. It is also important to check for its movement. Cancerous lumps feel differently than benign ones. Benign lumps are likely to be movable, smooth, soft and round, whereas cancerous ones are oddly shaped and feel firmly attached in the breast.
b) Diagnostic Mammogram:
It is more detailed than screening mammogram where a breast x ray is conducted. Doctors normally use them for diagnosing the causes of unusual breast changes, pain, lump, nipple discharge or thickening.
c) Ultrasound:
Sound waves beyond normal human hearing range are sent in this method. The waves are bounced off tissues and fed into a computer. The computer analyses the echo and creates a picture which is viewed on a screen. The picture can show if a lump is filled with liquid or is solid. A fluid filled sac is a cyst. These are cells that do not have cancer. But a solid mass might be. This examination can be used along with a mammogram.
d) Magnetic Resonance Imaging or MRI:
To the computer a powerful magnet is attached in this method. MRI provides a complete picture. A doctor can see these pictures on the computer screen or print them. MRI can be used with a mammogram.
e) Biopsy:
It is usually done by a specialist or surgeon who is specialised in the field of breast diseases. Tissue or fluid from breast is taken out from breast to investigate for cancer. A clinical breast exam might not be able to detect few suspicious cases. In such cases the doctor might prescribe imaging procedures like ultrasound guided, stereo tactic or needle localised biopsy to remove the tissue. Following ways can be used to remove tissue from breast:
1) Fine needle aspiration:
A thin needle is used to remove fluid from the lump in the breast. If cells are found in this fluid, it is forwarded to a pathologist for microscopic examination. If it does not contain any cells it isn’t referred to a pathologist.
2) Core Biopsy:
In this type of biopsy a tissue from the breast is extracted by usage of a thick needle and then forwarded to a pathology laboratory for detection of cancer cells. This technique is also known as needle biopsy.
3) Surgical biopsy:
In this type of biopsy a sample tissue from the breast is taken out for cancer detection and sent to the pathology laboratory. There are two types of surgical biopsies, excisional and incisional. In incisional, a sample of the lump is taken and in excisional entire lump is taken for examination.
Cancers can be classified into two types based on location within tissue. If cancer cells are in the duct lining then it is known as ductal carcinoma and if it they are in the lobules then it’s called lobular carcinoma.
Additional Tests
There are few more lab tests which have to be done once cancer is diagnosed.
a) Hormones receptor test:
Estrogen and progesterone hormones help some cells grow. This test detects the presence of hormones in the cancerous tissues.
b) HER2:
In this test detection of HER2/neu gene or HER2 protein is done. Increase in this protein or excess gene copies in the tissue might increase the chances of a relapse of breast cancer post treatment.
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