Connect with others who understand.

sign up log in
Resources
About MyBCTeam
Powered By

Breast Cancer – The Path to Diagnosis

Updated on April 21, 2021
View reactions
Medically reviewed by
Todd Gersten, M.D.
Article written by
Kelly Crumrin

Breast cancer is identified in many women during a routine screening mammogram. Other women go to their doctor after they notice symptoms of breast cancer during a regular monthly self-exam. Catching breast cancer early improves the chances of treating it effectively.

Women suspected of having breast cancer are usually referred to a specialist in cancer known as an oncologist. Specialists who treat breast cancer include medical oncologists, surgical oncologists, radiation oncologists, geneticists, and plastic surgeons. Multiple specialists often work together as a team to treat breast cancer. A medical oncologist is usually the doctor who diagnoses breast cancer and manages the treatment process.

How Is Breast Cancer Diagnosed?

Breast cancer is usually diagnosed quickly after a suspicious mass is identified. Since treatment is more effective the earlier the breast cancer is diagnosed, most doctors will want to schedule tests as soon as possible.

Tests and What They Show

Imaging scans can show the shape, size, and location of potential tumors, but only a biopsy and pathology report can provide conclusive results on whether tissue is breast cancer or not. Laboratory exams, genetic tests, blood tests, and other tests help the oncologist better understand what type of breast cancer it is as well as its stage and grade.

Imaging Tests

Only about 20 percent of breast tumors are cancerous (also known as invasive or malignant). If a tumor is felt during self-exam or identified by a screening mammogram, it is not necessarily breast cancer. Imaging tests are often the first step in checking a suspicious lump. The results of an imaging test may make a diagnosis of breast cancer more likely or less likely.

The most common imaging test used for suspected breast cancer is a diagnostic mammogram. Both screening and diagnostic mammograms use X-rays to image the tissue of the breast. In a diagnostic mammogram, the technician takes many more images of the breast including more angles and views. Other imaging tests used to diagnose breast cancer can include ultrasound and magnetic resonance imaging (MRI). Imaging tests are painless.

Biopsy

If breast cancer was not ruled out by the results of imaging exams, the doctor will likely perform a biopsy. Taking a biopsy – a sample of suspected cancer cells – is the only certain way to diagnose breast cancer. There are several techniques used to biopsy breast tissue. Lymph nodes in the chest or under the arm may also be biopsied to check for any trace of cancer cells.

Needle biopsy is one of the most common and least invasive methods for breast biopsy. First, your breast will be numbed. A hollow needle will be inserted one or more times into the breast to remove tiny amounts of breast tissue. Needle biopsy may be uncomfortable, but it leaves no scar.

If needle biopsy is inconclusive, the doctor may perform an incisional or excisional biopsy. In these types of biopsy, you will receive medication to sedate you. The doctor will use a scalpel to cut into the breast. Incisional biopsy removes a smaller piece of tissue. Excisional biopsy is more involved; the doctor will remove a larger piece of cancerous tissue along with a rim of normal tissue around it. Incisional and excisional biopsies usually leave a scar.

Laboratory Testing

Biopsied tissue will be examined in the pathology lab. The pathologist will view the tissue samples under the microscope to determine whether it is cancerous, and if so, what grade the tumor should be assigned.

If the tissue is cancerous, the cells will be analyzed to determine whether they are positive or negative for estrogen, progesterone, or human epidermal growth factor receptor 2 (HER2) receptors. The results of this analysis decide the molecular subtype of the cancer.

Genomic tests such as Oncogene DX will evaluate genes in the cancer cells and provide detailed predictions about how the tumor is likely to grow, how effective some treatments will be, and the odds of the tumor returning later on.

Results of the biopsy, pathology, and Oncogene DX reports provide vital information the oncologist needs to stage the tumor and make recommendations on which treatments will be most effective.

Blood Tests

The doctor may order blood tests to check the function of your bone marrow, liver and kidneys. Blood tests may also check for hepatitis. If the test results show any problems, it may influence the doctor’s treatment recommendations.

Condition Guide

Resources

External resources

MyBCTeam resources

Updated on April 21, 2021
View reactions
All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Kelly Crumrin is a senior editor at MyHealthTeam and leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

Related articles

​Most people with breast cancer will undergo tests to determine whether their cancer is HER2-posi...

FISH and IHC Testing for HER2: 7 Things To Know

​Most people with breast cancer will undergo tests to determine whether their cancer is HER2-posi...
Metastatic breast cancer (MBC), also known as stage 4 (sometimes written with Roman numerals as s...

How and When Is Metastatic Breast Cancer Diagnosed?

Metastatic breast cancer (MBC), also known as stage 4 (sometimes written with Roman numerals as s...
Triple-negative breast cancer (TNBC) is a form of breast cancer that grows rapidly. According to ...

How Fast Does Triple-Negative Cancer Grow? 4 Reasons It’s Aggressive

Triple-negative breast cancer (TNBC) is a form of breast cancer that grows rapidly. According to ...
Some people in remission after breast cancer treatment may feel “scanxiety” — anxiety or stress a...

Scanxiety: Managing Fear About Breast Cancer Follow-Up Scans

Some people in remission after breast cancer treatment may feel “scanxiety” — anxiety or stress a...
Get Started BelowSelect a Topic

Choose Your Path

Get Started BelowSelect a Topic
Many breast cancer treatments can cause problems with fertility or even lead to permanent inferti...

Pregnancy After Breast Cancer Treatment: Know Your Options

Many breast cancer treatments can cause problems with fertility or even lead to permanent inferti...

Recent articles

The first targeted treatment for human epidermal growth factor receptor 2 (HER2)-positive breast ...

How Early-Stage HER2-Positive Breast Cancer Treatment Has Evolved

The first targeted treatment for human epidermal growth factor receptor 2 (HER2)-positive breast ...
Select a topic below to get started:

HER2-Positive Breast Cancer Treatment Journey

Select a topic below to get started:
Nurse Support | Top 3 Questions | Conversation Guide | Maintenance Therapy Breast cancer treatmen...

7 Ways Your Breast Cancer Nurse Can Support You

Nurse Support | Top 3 Questions | Conversation Guide | Maintenance Therapy Breast cancer treatmen...
Nurses are an important part of your health care team as you undergo treatment for human epiderma...

5 Ways Your Nurse Can Help During HER2-Positive Breast Cancer Treatment

Nurses are an important part of your health care team as you undergo treatment for human epiderma...
The genetic changes found in your breast tumor influence your prognosis and help your care team r...

What Is HER2? Understanding Cancer Genetics and Life Expectancy

The genetic changes found in your breast tumor influence your prognosis and help your care team r...
HER2-positive breast cancer is often treated with targeted therapies that can specifically find a...

6 HER2-Positive Breast Cancer Treatments: What To Know

HER2-positive breast cancer is often treated with targeted therapies that can specifically find a...
MyBCTeam My breast cancer Team

Thank you for subscribing!

Become a member to get even more:

sign up for free

close