How We Diagnose Breast Cancer

An accurate and thorough diagnosis is important so that your breast cancer team can develop the best treatment plan for you. Early detection and ongoing management of your treatment are our priority. Your highly skilled team will use the most advanced and powerful breast imaging technologies and laboratory techniques to plan your personalized treatment.

Breast Imaging

Imaging studies give your breast cancer team important information about changes that may be occurring in your breast tissue. Breast imaging is an important part of a woman’s health care, so that problems can be detected when they are most treatable.
A mammogram is a safe and reliable low-dose X-ray exam that provides a view inside breast tissue. Mammography is appropriate for women who have a current symptom or women with a history of previous breast cancer.
Screening mammography: A specially licensed radiologic technologist will administer the mammogram. First, a compression paddle is lowered slowly onto the breast. This prevents any movement and allows the maximum amount of tissue to be examined. There may be some brief discomfort from the compression. A series of images is taken and checked for quality.

Diagnostic mammography: During a diagnostic mammogram, a number of X-rays are taken to obtain views of the breast from several angles. Areas may be magnified to produce a detailed picture that can help the doctor make an accurate diagnosis. A diagnostic mammogram takes longer than screening mammogram because more X-rays are needed to obtain varying views of the breast.

Digital mammography: This specialized form of mammography uses digital receptors and computers instead of X-ray film to help examine breast tissue for cancer. The electrical signals can be read on computer screens, permitting more manipulation of images to allow your doctor to more clearly view the results.
Breast MRI
Women who are at extremely high risk for developing breast cancer because of family history, genetics or prior treatment may require closer screening with a breast MRI (magnetic resonance imaging). MRI technology combines magnetic fields, radio waves and a computer system to obtain cross-sectional three-dimensional images. Breast MRI is especially useful for women with breast implants, as well as women with dense breast tissue that can be difficult to image with regular mammography. It can also detect small lesions that may not be visualized with mammography. The test does not use radiation.

Diagnostic ultrasound: An ultrasound uses high-frequency sound waves to create an image of the breast tissue on a viewing screen. An ultrasound may be used to distinguish between a solid mass, which may be cancer, and a fluid-filled cyst, which is usually not cancer.

A biopsy is a test in which a sample of breast tissue is obtained through a needle or by removing a piece of tumor, which is then examined using a microscope. The examination can answer questions about the specific composition of a breast lump or other abnormality.

Fine needle aspiration biopsy: In this minor surgical procedure, a thin, hollow needle is inserted into a breast lump to take a small sample of cells that are examined under a microscope.

Needle-localized open surgical biopsy: This type of biopsy is performed when you have an abnormality that cannot be felt but is visible on a mammogram. After a local anesthetic is administered, a small needle is inserted into the breast to mark the 
area to be sampled, and then mammogram images are taken to confirm the needle is correctly positioned. A guide wire is then inserted through the needle to show the surgeon exactly where to take the biopsy. The tissue biopsy is obtained in the operating room and the wire removed.
Stereotactic biopsy: This type of biopsy uses a computer and X-rays to locate the abnormal breast tissue. A sample of tissue is then removed using a fine needle aspiration biopsy.

MRI-guided biopsy: MRI (magnetic resonance imaging) uses magnetic fields and radio waves, and a computer system to generate three-dimensional cross- sectional images of the body. MRI-guided biopsy is used when an abnormal area cannot be visualized well by mammogram or ultrasound. Sometimes, an MRI-guided biopsy is used when an abnormality can only be visualized on an MRI scan.

Ultrasound-guided biopsy: During ultrasound-guided biopsy, your doctor will use ultrasound to guide the needle to the appropriate area. The sample of tissue or fluid then is evaluated in the laboratory.