Diagnosis
If you or your doctor detect a breast abnormality during a self-breast exam or routine physical, the doctor will likely order imaging tests followed by biopsies to determine if the abnormality is in fact cancer. After determining that the abnormality is cancerous, the doctor will order additional tests to determine if the cancer has spread to distant organs. These tests include:
Blood tests
Also called tumor marker tests, these measure the levels of breast cancer markers (CEA, CA 15-3, CA 27-29). These tests are not recommended to be used by themselves to guide treatment decision-making, but are used along with other tests and your oncologist’s clinical experience. Women with breast cancer might have an elevated level of these markers. These tests are not as useful for earlier stage cancers.
- Please see Understanding Tumor Markers for more information
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Bone scan
A bone scan uses a radioactive substance to identify cancerous areas in the bones. A bone scan provides a picture of all the bones in the body, and allows doctors to detect small areas of cancer cells that may not be visible on standard X-rays. The radioactive substance collects in these areas and illuminates them on the skeletal X-ray.
Chest X-Ray
This test may be done to see whether the breast cancer has spread to your lungs or ribs.
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Computed Tomography (CT) scan
A CT scan takes many pictures as it rotates around your body while you lie on a table. It produces detailed cross-sectional images of your body and allows doctors to study specific areas.
CT guided needle biopsy
If a CT scan identifies an abnormality, your doctor may perform a biopsy using the CT scan to precisely guide a needle into a suspected area of cancer that has spread as you lie on the scanning table.
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Magnetic Resonance Imaging (MRI) scan
MRI scans are also used to look for cancer that has spread to various parts of the body, just like CT scans. An MRI is very helpful in looking at the brain, spinal cord, bones, and liver. MRI is also very good for evaluation of whether a tumor may have grown into the underlying muscle or bones of the chest wall. This test may be ordered after a CT scan to further evaluate a possible lesion or area of concern not well seen on the other diagnostic tests.
Ultrasound
Ultrasound can also be used to look for cancer spread in some areas of the body such as the lymph nodes or liver. Ultrasound is also useful in people who cannot get a CT scan or MRI scan because of an allergy to the dye that is required for the other tests. For example, doctors commonly use abdominal ultrasounds to look for tumors in your liver or other abdominal organs.
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Positron Emission Tomography (PET) scan
Doctors use PET scans when they think the cancer might have spread but do not know where. The picture often does not have as much detail as a CT or MRI scan; therefore, many cancer centers combine a PET scan with a CT scan. PET scans can provide helpful information about your whole body.
