Exams and Tests

Early detection

You may have a screening test to look for breast cancer. (Screening tests help your doctor look for a certain disease before any symptoms appear.) The earlier breast cancer is found, the more easily and successfully it can be treated.

The type and frequency of breast cancer screening that is best for you changes as you age. The most common ways to find breast cancer early include:

• Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel.

  Breast Cancer Screening: When Should I Start Having Mammograms?

• Clinical breast examination (CBE). Your doctor may do this exam during your routine physical exam.
• Magnetic resonance imaging (MRI) of the breast. MRI is a test that uses a magnetic field and pulses of radio wave energy to provide pictures of the inside of the breast. It may be used as a screening test for women who are at high risk.

Diagnostic tests

If your doctor thinks that you have breast cancer, you may have other tests, including:

• More mammograms.
• An ultrasound. You may have an ultrasound of the breast if a lump is found during a clinical breast exam or on a mammogram.
• An MRI of the breast. This is sometimes used to get more information about a breast lump or to evaluate problems in women who have breast implants.
• A breast biopsy. If a lump is found in your breast, your doctor will need to remove a small sample of the lump (biopsy) and look at it under a microscope to see whether any cancer cells are present.
• Other tests may be done to help with treatment decisions. These include:
  • Estrogen and progesterone receptor status. The hormones estrogen and progesterone stimulate the growth of normal breast cells as well as some breast cancers. Hormone receptor status is an important piece of information that will help you and your doctor plan treatment.
  • HER-2 receptor status. HER-2/neu is a protein that regulates the growth of some breast cancer cells. About 20 out of 100 women with breast cancer have too much (overexpression) of this growth-promoting protein.⁵
  • Gene tests for postmenopausal women with hormone-receptor-positive breast cancer. These tests can show your chances of the cancer coming back. This can help your doctor tell whether chemotherapy is likely to work for you.
• A complete blood count (CBC) to provide important information about the kinds and numbers of cells in your blood.
• A chemistry screen, to measure the levels of several substances (such as those involved in liver functions) in your blood.
• A chest X-ray, to provide a picture of organs and structures within your chest, including your heart and lungs, your blood vessels, and the thin sheet of muscle just below your lungs (diaphragm).

Tests if your doctor thinks that breast cancer has spread

If your doctor thinks that breast cancer may have spread to other organs in your body (metastasized), he or she may order additional testing, including a bone scan or CT scans.

Follow-up tests

If you have had breast cancer in one breast, you have an increased risk for developing breast cancer again. Breast cancer can come back in the same breast, on the chest wall, in your other breast, or somewhere else in your body. You can expect to have:

• Physical exams. The frequency of your physical exams depends on your general health and the type of breast cancer you have. In general, you will see your doctor every 3 to 6 months for 3 years and then every 6 months until 5 years have passed since your diagnosis of breast cancer. Then you may see your doctor once a year.
• Mammograms to screen for breast cancer and to investigate lumps that can be felt during a breast exam.

If you find any unusual changes in the treated area or in your other breast, or if you have swollen lymph glands or bone pain, call your doctor to discuss these changes. For more information, see the topic Breast Cancer, Metastatic or Recurrent.

It is important to know what your breasts normally look and feel like. When you know what is normal for you, you are better able to notice changes. Tell your doctor right away if you notice any changes in your breasts.