The diagnosis of breast cancer begins with a detailed history and physical examination. The patient’s family history, previous radiotherapy application, screening tests or complaints about the breast are taken. In the examination, both breasts are evaluated in terms of appearance, mass, etc., including the axilla and upper clavicle. If there is a suspicion of breast cancer in the findings obtained, other diagnostic tests are applied.
Diagnostic methods used in breast cancer are:
- Mammography: Mammography, which is also used as a screening test, is the imaging of the patient’s breast tissue by giving low-dose radiation. The image may not be of very good quality. Recently, better quality images can be obtained with three-dimensional mammography devices. In mammography, it is checked whether there is a mass or calcification in the breast tissue. It can also be used to follow whether previously detected masses or calcifications have grown. It also gives an idea about breast density. The risk of developing cancer is higher in breasts that are denser and have more adipose tissue. More frequent follow-up may be required.
If a suspicious image is detected on mammography, it may be necessary to evaluate the image with breast ultrasound.
- Breast ultrasound: It is the imaging of the breast tissue with high frequency sound waves. It gives better quality images than mammography. Whether the image detected by mammography is solid or liquid can be understood by breast ultrasound. It also helps to keep track of previously detected audiences. It can also be used to determine the location of the mass and the biopsy point when it is necessary to take a biopsy from the masses.
- Breast MRI: Magnetic Imaging can be used to evaluate the extent of cancer and its spread to surrounding tissues in patients diagnosed with breast cancer.
New imaging methods: Mammography and ultrasound are often sufficient for the diagnosis of breast cancer. MRI may be requested in some patients. However, developing technology also offers opportunities in terms of new and modern imaging methods. Imaging methods that have started to become widespread recently but are still in the experimental stage are as follows:
- Positron emission mammography (PEM): It is an imaging method similar to PET-CT used for staging in other cancers. The spread of cancer cells is monitored by giving a substance in the form of sugar to the patient.
- Contrast-enhanced mammography: It is the process of evaluating the image detected in standard mammography in more detail with the help of iodine-containing contrast material.
- Electrical impedance imaging: It is an imaging method based on the conductivity of the electric current passed through the breast tissue. Does not contain radiation.
Biopsy: When a mass is detected in the breast, a sample should be taken from it and evaluated in terms of pathology. A biopsy is taken from breast tissue and axillary lymph nodes. It is usually done as a fine needle aspiration biopsy. If the biopsy procedure is performed with ultrasound or breast MRI, more accurate biopsy samples can be obtained from the masses.
Biopsy material is evaluated in pathology. The report contains information in terms of the type, degree and risk of spread of breast cancer.