Breast Cancer Detection and Diagnosis

 

Visualizing your breast tissue is a vital component to detecting and evaluating the extent of breast cancer. Aurora invests in research to explore new ways of diagnosing breast cancer. Examples of procedures used in our program include:

Mammography: Mammography is the primary tool used in breast cancer diagnosis. While its value is important, other diagnostic methods sometimes help our physicians pinpoint and characterize breast cancer more precisely.

The United States Preventive ServicesTask Force (USPSTF) recommends that women aged 50 and older have mammography every two years. Other organizations recommend screening every year starting at age 40. Aurora recommends average risk women have mammography at least every two years beginning at age 40. Women who are at high risk for breast cancer (i.e. have a family history) may need to have mammograms starting at an earlier age and more often, or other studies. Talk to your doctor about what is best for you.1* 

Breast Ultrasound: Ultrasound does not employ radiation to create clinically useful images of breast tissue. is. It’s often used to position biopsy needles precisely and to determine if abnormalities, found on a mammogram, are solid or fluid-filled.

Magnetic Resonance Imaging (MRI): MRI uses a magnetic field and radio waves to image your breast without exposure to radiation. MRI may be used with mammography for improved breast cancer detection, to determine the extent of the disease and to monitor breast cancer therapy. MRI can also capture improved images if you have dense breast tissue or breast implants.

PET/CT: The combination of Positron Emission Tomography (PET) with Computed Tomography (CT) represents the frontier of diagnostic cancer imaging. The technology provides physicians with two sets of information from a single scan: the anatomical data yielded by a CT scan and the metabolic information provided by PET.

This technology is helpful in localizing smaller cancers and in defining areas where breast cancers have metastasized.

Ductoscopy: A procedure that involves inserting a very small video scope into your breast, ductoscopy allows our physicians to examine the affected duct in real time and to biopsy suspicious areas. This can be done to evaluate you if you’re at high risk for breast cancer, with precancerous or cancerous cells.

Our physicians use ductoscopy when atypical cells have been detected in your milk ducts (where 90 percent of breast cancers begin). It’s also used to evaluate women with abnormal nipple discharge whereby ductal lavage and visualization of the duct can be done at the same time.

Breast Cancer Diagnosis

Because of the complexity of breast cancer, your physician may also request the following tests to further identify your particular type of breast cancer:

Breast Cancer Tests

Hormone receptors
Estrogen and progesterone are hormones that are produced by your ovaries. These hormones help your normal breast cells grow and can help some cancer cells grow. It’sigood if your breast cancer cells have hormone receptors. We can treat these cells with medicine that reduces estrogen in your body and they can be treated with medicine that keeps estrogen away from receptors. Different treatment is available if the cancer has no receptors.

  • ER Positive: It has receptors for the hormone estrogen
  • ER Negative: It does not have estrogen receptors
  • PR Positive: It has receptors for the hormone progesterone
  • PR Negative: It does not have progesterone receptors

HER-2 Status (sometimes referred to as C-erbB-2)
HER-2 is a gene that helps control how cells grow, divide and repair themselves. About one out of four breast cancers have too many copies of the HER-2 gene. These cancers tend to grow fast. They also respond very well to anti-HER-2 antibody therapy. There are two tests for HER-2.

  • IHC Test (ImmunoHistoChemistry): The IHC test uses antibodies to identify HER-2. The tumor can be scored as (negative), 1+ (negative), 2+(borderline), or 3+ (positive) on the IHC test.
  • FISH Test (Fluorescence In Situ Hybridization): The FISH test is good for all kinds of tissue: fresh, frozen and those kept in wax. The results are 0 (negative) or positive on the FISH test.

Only tumors that test IHC "3+" or FISH "positive" will respond well to antibody therapy.

Your doctor will use all the information provided in your biopsy pathology report to plan your breast cancer treatment options.

1*. Resources: United States Preventive Task Force, American Cancer Society