Breast cancer is diagnosed by Triple Assessment which means Assessment is done by the following components namely
After clinical assessment, few investigations are done for further treatment. The investigations done can be broadly divided into*
*All the above tests will not be done for everyone. We have only enumerated all the tests. Tests that are needed for the patient only will be done.
Mammogram is X ray imaging of the breast. It is mainly used for screening purposes as well as to find out the presence of non palpable breast lesions. With the advent of digital mammogram It helps us to find out the presence of small non palpable lesions better and also helps to rule out false positive lesions in the breast.
Ultrasound is an imaging device wherein sound waves are transmitted from the probe and depending upon the reflected sound waves we get an image which helps us to find out where the breast lesion is, whether the lesion is a cyst and helps us to find out non palpable breast lesions better. Using an ultrasound we can also guide the core needle to take biopsies.
A 2 mm small incision is made over the breast. Under ultrasound guidance, a core needle is inserted into the breast and a small amount of tissue is taken along with the needle. This tissue taken out is then sent for biopsy. The biopsied tissue is analysed by a pathologist who sees the tissue under a microscope and sees whether the tissue is a cancer or not. If there is cancer, further immunohistochemical markers such as hormone receptors like estrogen receptor and progesterone receptors are looked for in the tissue biopsied. This gives us a lot of information for further treatment. This is a office procedure and can be done in the clinic.
In this a needle is injected multiple times into the tumour or the lymph nodes in the axilla under negative pressure and few cells are aspirated into the syringe. If the tumour or the lymph node is not easily palpable, it can be done under ultrasound guidance.These cells are analysed by the microscope to look out whether the tumour is benign or malignant. This is an office procedure and this can be done in the clinic.
BRCA 1 and BRCA 2 gene testing is used to test whether a person has a gene which predisposes a person to breast cancer. This is a blood test and is done for women who present with breast cancer at an early age and have a strong family history of having breast cancer and ovarian cancer.
