At Scripps Cancer Center, a breast cancer diagnosis may involve several types of tests, starting with a physical exam or screening mammography, to look for breast abnormalities. If something unusual is found, the next step will be diagnostic testing to see whether the abnormal finding is in fact breast cancer. Diagnosing breast cancer also involves determining the type of cancer and its stage, or how far it has spread.
For many women, the first sign of cancer is a lump or mass in the breast found during a self-exam, a clinical exam or a breast cancer screening mammography. These early detection methods can help find breast cancer at its earliest stages, when treatment is most likely to be successful.
If a breast cancer screening exam finds something unusual, or a physician recommends further testing for other reasons, the next step is usually additional tests to confirm the diagnosis, such as a diagnostic mammogram or ultrasound exam. A biopsy may be performed as well.
Depending on the results, a patient may be referred to an oncologist or other cancer specialist for further diagnosis and staging to determine how far the cancer has spread and the most appropriate cancer treatment plan.
Scripps offers the most advanced testing for breast cancer diagnosis.
- All Scripps locations provide state-of-the-art digital mammography, which uses lower doses of radiation than conventional mammography and produces clearer, high-resolution images of breast tissue to detect potential abnormalities at their earliest stages.
- All diagnostic mammograms are read by physicians specializing in breast imaging.
- Every mammogram is double-checked by a computer-aided detection system for ensured accuracy.
- Scripps mammography centers are accredited by the American College of Radiology.
In addition to mammography, Scripps offers screening MRI, ultrasound and other exams.
The breast cancer stage defines how far cancer may have spread inside the breast or to other parts of the body. Diagnostic imaging and testing help physicians determine the stage of cancer, as well as how best to plan breast cancer treatment. In some cases, the stage will be determined after the tumor and often a few lymph nodes from the underarm area have been surgically removed. This tissue is evaluated by the pathologists with a microscope. Generally, the lower the stage, the better the breast cancer prognosis.
Breast cancer staging is determined by:
- The size of the tumor
- Whether the cancer has spread to the breast tissue, meaning it has broken through the wall of the lobule of milk duct (invasive) or is confined to the lobules that produce breast milk or ducts that carry milk to the nipples (non-invasive)
- Whether the cancer has spread to the lymph nodes
- Whether cancer has spread to other parts of the body
Doctors also may describe breast cancer as:
- Local when the cancer has not spread beyond the breast tissue
- Regional when the cancer has spread to the lymph nodes in the armpit or nearby
- Distant when the cancer has spread to other parts of the body
Because inflammatory breast cancer affects the lymph vessels and the skin, all cases start at stage IIIB.
No one wants to hear that they have breast cancer. You may feel frightened, overwhelmed, anxious or sad. All of these feelings are perfectly normal. The more you learn about your diagnosis and next steps, the sooner you can begin to make informed decisions about your treatment.
Questions and considerations
Here are some questions you may want to ask your doctor or health insurance provider regarding your breast cancer diagnosis:
- Should I get a second opinion?
- How do I find a specialist?
- What is my cancer treatment plan?
- Will I have to miss work/school?
- What are the side effects of breast cancer treatment?
- How successful is my treatment likely to be?
- What costs will be covered by insurance?
- Which costs will I be responsible for?
Your Scripps cancer care team will be with you every step of the way, ensuring that your care revolves around your medical, personal and practical needs. From your diagnosis through your breast cancer treatment, your nurse navigator will coordinate your care, answer questions and provide support. In addition, Scripps offers many resources for our breast cancer patients, from education and support groups to integrative programs, such as yoga and meditation. For more information, visit our cancer patient resources section.