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How do you diagnose it?
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John Muir Health offers the full spectrum of advanced technology used in diagnosing breast cancer. Our comprehensive capabilities include an exceptional team of radiologists and pathologists with a broad experience base in breast cancer diagnosis. Because we understand that the time between discovery of any abnormalities and a diagnosis can be frightening and stressful for a woman, we are focused on reducing anxiety by expediting the search for answers, ensuring that each patient receives an accurate and timely diagnosis.
Patients with palpable lumps or abnormalities discovered on routine mammograms or clinical breast examinations will need to undergo several more diagnostic tests before a definitive diagnosis can be made. These include both imaging tests and biopsy procedures
Imaging Tests
Our highly skilled mammography specialists have the experience and the expertise to precisely evaluate the subtle changes and abnormalities that may indicate benign, precancerous or malignant tissue. We welcome both women who wish to schedule their regular routine mammograms, as well as those who require further evaluation of breast abnormalities discovered through breast self-examination, clinical breast exam, or mammography done elsewhere.
We are here for education, support and to help you navigate your way through your diagnosis, treatment and recovery.
Call (925) 947-3322.
Ultrasound is another imaging procedure sometimes used as a follow-up to mammography. Ultrasound technology entails the use of high-frequency sound waves, which are bounced off a specific part of the body to create an image on a computer screen. Breast ultrasound is particularly useful in discriminating between cysts and solid masses.
Biopsy Procedures
When abnormal areas are identified on a mammogram, physicians will perform a biopsy to arrive at a definitive diagnosis. A biopsy is a procedure in which tissue samples are removed from a suspicious area and examined under a microscope. Thanks to the introduction of minimally invasive biopsy techniques in recent years, most biopsy procedures can now be performed on an outpatient basis. The most current biopsy techniques are available at John Muir Health; your physician will determine the most appropriate procedure for you.
Fine needle aspiration is a biopsy procedure in which a thin needle attached to a syringe is inserted into a palpable lump. If clear fluid is drawn, the lump is most likely a cyst. If the lump is solid, small tissue samples will be removed and examined in the laboratory.
Stereotactic Core Needle Biopsy is a minimally invasive procedure that employs computer-aided imaging techniques to precisely guide a needle into the breast. The core needle is larger than that used for fine needle aspiration, allowing greater quantities of tissue to be sampled.
In certain cases, a conventional surgical biopsy procedure must also be performed to remove all or part of the lump for examination. If cancer is present, further biopsy procedures may be needed to determine if the cancer has spread to adjacent lymph nodes. We offer an innovative, minimally invasive technique known as Sentinel Lymph Node Biopsy for assessing lymph node status.
Additional testing
When cancer cells are found, additional tests are performed to determine certain complex characteristics or variables of each breast cancer, so that the most effective, individualized treatment plan can be devised. One important variable is whether or not the cancer contains estrogen or progesterone receptors. If these receptors are present, the cancer is said to be hormone-sensitive, and can be treated with hormone-blocking agents. Another example of a complex variable is the absence or presence of a certain cancer-promoting protein known as HER2. Targeted therapies are available for recurrent cancers that are HER2 positive. Pathologists will also give biopsy samples a numerical grade from 1 to 3, which define how aggressive the cancer is likely to be. Additional imaging tests may also be ordered to determine if cancer has spread to the lungs, bones, liver or other organs, including chest x-rays, bone scans, CT scans, MRI, or PET scans.
Once a definitive diagnosis of breast cancer has been reached, your physician will need to "stage" your cancer - or determine how far the tumor has spread - to devise the best treatment plan. Staging is based on information gathered from the various diagnostic tests described above, and any other tests that may have been ordered. Staging of breast cancer is based on the TNM classification system, which assesses the extent of the primary tumor ("T"), lymph node involvement ("N") and any distant metastases ("M"). Classification ranges from Stage 0 (early-stage cancer) to Stage IV (metastatic cancer). A detailed discussion of the various stages of breast cancer and the appropriate treatment options for each can be found at:www.cancer.gov/cancer_information/cancer_type/breast.
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