Treatments

You will probably begin by seeing your family doctor (General Practitioner) who will examine you and arrange any tests and X-rays you may need. Your GP may need to refer you to a specialist breast clinic where triple assessment is available. At the hospital, the doctor will take your medical history before doing a physical examination. He or she will examine your breasts and feel for any enlarged lymph nodes under your arms and at the base of your neck. A chest X-ray and blood test may also be taken to check your general health. The following tests are all used to diagnose cancer of the breast and your doctor may arrange for you to have one or more of them at the hospital:

Mammography

Mammograms (breast X-rays) are important tests in the diagnosis of breast cancer. A mammogram is a low-dose X-ray of the breast which can pick up small changes that cannot be felt. Each breast is placed between two special plates and pressure is applied to get the best possible picture. Some women find mammography uncomfortable or even painful. However, it only lasts a few minutes and is not harmful.

Ultrasound

This test is painless and takes just a few minutes. Ultrasound uses sound waves to build up a picture of the inside of the body. It is generally used for women under 35 whose breasts are too dense to give a clear picture with mammography. It is also used to see if a lump is solid or contains fluid (a cyst). Ultrasound is often used with mammography in specialist breast clinics. A special gel is spread onto the breasts and a small device like a microphone, which emits sound waves, is passed over the area. The echoes from the soundwaves are converted into a picture by a computer.

Needle aspiration

This is a quick procedure which is done in the out-patient clinic. Using a fine needle and syringe, the doctor takes a sample of cells from the breast lump and sends it to the laboratory to see if it contains any cancer cells. This technique may also be used to drain a benign cyst.

Needle biopsy (core biopsy)

This test is done in the outpatient clinic. A slightly larger needle than the one used for aspiration is used. The doctor takes a small piece of tissue (biopsy) from the breast lump after the area has been numbed with a local anaesthetic. The sample is then sent to the laboratory for examination under a microscope.

Excision biopsy

The whole lump is removed under a general anesthetic and sent to a laboratory for examination. This may mean an overnight stay in hospital but is more often done as a day case.

Further tests

If the tests show that you have breast cancer your doctor may want to do some further tests to see if the cancer has spread to other parts of the body. This is called staging. These tests will help the doctor to decide on the best type of treatment for you. The tests may include any of the following:

Liver ultrasound scan

Ultrasound can be used to check the health of your liver. It is a painless test and only takes a few minutes. It will probably be done in the hospital X-ray department. You will be asked to lie on a couch. A gel will be spread on your abdomen and a small device like a microphone will be passed over the area. The echoes are converted into a picture using a computer.

Bone scan

Bone scans are very sensitive and can detect cancer cells before they show up on X-ray. For this test a very small amount of mildly radioactive substance is injected into a vein, usually in your arm. A scan is then taken of all the bones in your body. As abnormal bone absorbs more of the radioactive substance than normal bone, the abnormal bone shows up on the scan as highlighted areas. After the injection you will have to wait for up to three hours before the scan can be taken, so you may want to take a book or magazine with you, or a friend to keep you company. The level of activity used in these scans is very low and is not harmful. The radioactivity disappears from the body within a few hours. Before you leave hospital you may not have the results of all your tests. An appointment will be made for the breast clinic within a short time. Obviously the waiting period will be an anxious time for you and it may help to talk about your worries with a partner, close friend or relative.

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