If you have a symptom or an abnormal imaging study (i.e. abnormal mammogram), your doctor will evaluate this further using additional tests, such as:

  • Diagnostic Mammogram - Like screening mammograms, diagnostic mammograms are X-rays of the breast, but they may involve different techniques and more views than screening mammograms. They take more detailed images of abnormal areas found on screening mammograms and to learn more about lumps or abnormalities in the breast. They are typically analyzed right away by a radiologist and then he or she explains the findings and action plan to the patient.
  • Ultrasound - Sound waves and a computer are used to create a picture of the breast, which can show whether a lump is solid or filled with fluid. Cysts, or fluid-filled sacs, are not cancerous. Solid masses may be.
  • MRI - Magnetic Resonance Imaging uses magnets and radio waves to produce detailed images of the breast. MRIs are often used to screen high-risk women and to gather more information about a suspicious finding on a mammogram. Because MRI does not expose a woman to radiation, it may be helpful for the evaluation of a breast lump during pregnancy.
  • Biopsy - A pathologist looks at a sample of tissue under a microscope to check for cancer cells. It can be done several ways:
    - Fine needle aspiration - A thin needle is used to remove fluid from a breast lump.
    - Core Biopsy - Also called needle biopsy, a thick needle is used to remove a sample of breast tissue.
    - Surgical Biopsy - A surgeon makes an incision and removes a sample of tissue from the lump or lump area in the operating room using some form of sedation or anesthesia.

The doctor will run several tests on the breast cancer cells to learn what treatments may or may not work, how quickly the cancer may grow and spread and the likelihood that the cancer may return.

Doctors will also test breast cancer cells to find out several things about the breast cancer cells:

  • ER- and PR-positive: If the cancer cells have more hormone receptors—estrogen receptors (ER) or progesterone receptors (PR) – than a normal cell, the breast cancer will be classified as estrogen receptor-positive or progesterone receptor-positive. A treatment to block these receptors may be recommended.
  • HER2: Like ER/PR receptors, some cancer cells have too many HER2 receptors. These are called HER2-positive cancers. HER2 receptors tell the cell to grow and divide. Therefore, cancers that are HER2-positive are more likely to grow and spread more rapidly. HER2-positive breast cancers can be more aggressive, but also respond to targeted drugs.
  • Triple Negative: This cancer tests negative for additional estrogen receptors, progesterone receptors and HER2 receptors and is treated with a combination of surgery, chemotherapy and radiation.

Updated June 3, 2015