Diagnosis and Staging

When screening detects a suspicious breast mass diagnostic examination and/or testing are needed to determine if the mass is caused by cancer or some other condition.

• Diagnostic Imaging
  Additional images of the suspected mass may be needed for diagnosis.
  • Diagnostic Mammogram
    Diagnostic mammograms are clearer, more detailed X-rays that give a sharper picture of the area identified on a screening mammogram.

  • Breast Ultrasound
    Breast ultrasound bounces sound waves off the suspected mass and uses the echoes to form a picture that helps physicians determine if the mass is solid, which may be cancer, or filled with fluid, which would be a sign of a non-cancerous cyst. Ultrasound is often used in addition to mammography to evaluate dense glandular and cystic breast tissue more completely. Ultrasound can also be used to identify a specific breast mass for biopsy.

  • Breast MRI
    MRIs are often used along with X-rays for more detailed images of breast tissue and masses.

• Biopsy
  A biopsy is the removal of cells or fluid for microscopic examination by a pathologist to determine if cancer is present.
  • Surgical Biopsy
    A surgical biopsy is a procedures in which a sample of a suspected mass is removed by a surgeon. The sample is analyzed by a pathologist while the surgery is proceeding, and all - or as much as possible - of the mass is usually removed during the operation A surgical biopsy is performed under anesthetic in a hospital operating room.

  • Fine-Needle Aspiration
    Fine-needle aspiration of a breast cyst is a minimally invasive diagnostic procedure that uses ultrasound to guide a small needle that removes fluid from the cyst. This fluid can be sent for cytology examination. Fine-needle aspiration is an outpatient procedure performed with a local anesthetic.

  • Core Biopsy
    Core Biopsy is a minimally invasive procedure which frequently eliminates the need for a surgical biopsy. In a core biopsy a fine needle is inserted into the suspected mass and a small sample is withdrawn for examination. Thompson Comprehensive Breast Center was the first area facility to offer stereotactic-guided core biopsies in 1993. Thompson now offers stereotactic- or ultrasound-guided, vacuum-assisted needle biopsy. This simple outpatient biopsy requires only a local anesthetic. There is virtually no scarring or patient discomfort, women can return to their usual activities the next day, and the cost is about half that of a surgical biopsy.

• Staging
  Determining the extent of breast cancer growth and/or spread is essential in planning treatment of the disease.
  • Stage 0
    Stage 0 breast cancer has not spread beyond either the nodule or milk duct.
    
    • Lobular Carcinoma In Situ - Lobular cancer, in the lobes or lobules, frequently does not spread to other organs or other parts of the body, but having it in one breast increases the chances of getting it in the other.
    • Ductal Carcinoma In Situ - Ductal Carcinoma, cancer in the ducts which carry milk from the lobules to the nipple, can become invasive if not treated promptly.

  • Stage I
    Stage I is early invasive breast cancer which has not spread beyond the breast. Stage one tumors are no more than ¾ inch in diameter.

  • Stage II
    Stage II breast cancer can have one of three characteristics:
    • A tumor no larger than ¾ inch which has spread to the lymph s in the armpit.
    • A tumor between ¾ and 2 inches which may have spread to the lymph nodes in the armpit.
    • A tumor of 2 inches or more which has not spread to the lymph nodes.

  • Stage III
    Stage III breast cancer is a large, locally-advanced, tumor which has not spread beyond the breast and lymph nodes under the arm.

  • Stage IIIA
    Stage IIIA cancer is either:
    • A tumor smaller than 2 inches which has spread to the under-arm lymph nodes and is attached to other body structures.
    • A tumor larger than 2 inches which has spread to the underarm lymph nodes.

  • Stage IIIB
    Stage IIIB cancer can have one of three characteristics:
    • The tumor has grown into the chest wall or the skin of the breast.
    • The cancer has spread into the lymph nodes behind the breast bone.
    • Inflammatory breast cancer, the rare breast cancer which causes the breast to become red, swollen and warm.

  • Stage IIIC
    Stage IIIC breast cancer which has spread to:
    • The lymph nodes behind the breast bone and under the arm.
    • The lymph nodes around the collarbone.

  • Stage IV
    Stage IV breast cancer is cancer which has spread beyond the chest to other parts of the body.

  • Recurrent Breast Cancer
    Recurrent breast cancer is cancer which comes back after being (or seeming to be) eliminated. Recurrent breast cancer can come back in the breast, chest wall or any other part of the body.