Screening & Diagnosis

Screening Tests

Screening tests identify signs of breast cancer that might otherwise go unnoticed. When breast cancer is found and treated early, a woman has more treatment options and a better chance of a cure. The following tests are recommended as a routine part of every woman’s healthcare.

Breast Self-Examination (BSE)

Your health-care provider can show you how to effectively examine your own breasts.  When you are familiar with how your breasts normally feel, you are much more likely to identify lumps or other changes that may be symptoms of breast cancer.

Clinical Breast Examination (CBE)

This physical test is performed by a physician or nurse practitioner, often as a part of an annual check-up. The American Cancer Society recommends that women in their 20s and 30s have a clinical breast exam every three years.

Screening Mammogram

A mammogram uses X-rays to produce an image of the breast and to detect abnormalities in the breast that may be too small to see or feel. On average, mammograms detect 80 to 90 percent of breast cancers in women without symptoms. The American Cancer Society recommends that women age 40 and older have a screening mammogram every year. SCCA was the first in the region offer digital mammography, a techinque that captures X-ray images digitally for a more accurate diagnosis. Studies have shown that digital mammography detects up to 28 percent more cancers than traditional mammography. For more information about mammography at SCCA, check out the Digital Mammography section of our web site.

Diagnostic Tests

Once breast cancer has been suspected, the following diagnostic tests may be used.

Diagnostic Mammogram

A diagnostic mammogram is used to evaluate a woman with a breast problem or symptom or an abnormal finding on a screening mammogram. It usually includes additional views of one or both breasts. 

Ultrasound

Ultrasound uses high-frequency sound waves to form an image that is displayed on a video screen and photographed for analysis. Because of the different ways various tissue components interact with sound waves, ultrasound can often reveal whether a lump is solid or a fluid-filled, non-cancerous cyst. As a result, breast ultrasound is generally used to examine a suspicious area found on a mammogram.

Biopsy

When a screening or other diagnostic test finds an abnormality that could be cancer, a biopsy may be performed. In a biopsy, a doctor removes a sample of the suspicious area which is then examined under a microscope. A biopsy is the only way to tell if cancer is really present. There are several types of biopsies.

Fine Needle Biopsy

A fine-needle biopsy involves the extraction of fluid or cells from a lump that can be felt or seen with ultrasound or on a mammogram. A local anesthetic numbs the area before the needle is inserted. If you have a cyst, fluid will come out and the lump will disappear. If the needle extracts cells, the sample is inspected by a pathologist to determine if it is benign or malignant.

Core Biopsy

A core biopsy is virtually the same test as the fine needle biopsy, but a larger needle is used to removed a small cylinder of breast tissue.

Stereotactic Needle Biopsy

This type of biopsy is done when the lump is so small that the doctor cannot insert the biopsy needle accurately. In this procedure, you lie face down on a special table with an opening that lets the breast hang down. A mammogram shows the location of the lump and a computer guides the needle.

Surgical Biopsy

In this type of biopsy, all or part of a breast lump is removed surgically for microscopic examination to determine whether cancer is present.

Magnetic Resonance Imaging

SCCA has long been a leader in the diagnosis and care of breast cancer, most recently in the use of magnectic resonance imaging (MRI) as a diganostic tool.  According to a recent study led by SCCA's Dr. Constance Lehman, MRI scans of women who were diagnosed with cancer in one breast detected over 90 percent of cancers in the other breast that were missed by mammography and clinical breast exam at initial diagnosis. In conjunction with this news, the American Cancer Society announced new recommendations for use of MRI for women at increased risk for breast cancer. An expert panel, of which Lehman is a member, recommended annual screening using MRI in addition to mammography for women with a 20-25 percent or greater lifetime risk of the disease. For more information about the use of MRI as a diagnostic tool for breast cancer, see Magnetic Resonance Imaging in our Digital Mammography section.

Updated 1/27/2009