What is a diagnostic mammogram?
A diagnostic mammogram is used to evaluate a woman with a breast problem/symptom or an abnormal finding on a screening mammogram. The diagnostic mammogram will be focused on the areas where there appeared to be abnormal tissue. It should be performed under the direct, on-site supervision of a board certified radiologist.
What is a biopsy?
A biopsy is a procedure that removes a sample of cells or tissue from the breast to be tested. The cells or tissue that have been removed are examined under a microscope to look for signs of cancer. A biopsy is generally not painful because the breast is numbed, but you may feel some discomfort. Most women who have a biopsy are not diagnosed with cancer.
What are the different types of biopsies?
There are two main types of biopsies: needle biopsy and surgical biopsy. The method you and your doctor choose depends mainly on the nature and location of the abnormality and your general health and preference.
What is a needle biopsy?
There are different types of needle biopsies:
Fine needle aspiration — A thin, hollow needle is used to remove a few cells from the breast lump. It can be done in an outpatient setting and only takes a few minutes.
Core needle biopsy — A thicker, hollow needle removes a larger amount of tissue. As with fine needle biopsy, when a core needle biopsy is done for an abnormal area found by mammogram, ultrasound imaging or stereotactic mammography is needed to accurately guide the needle to the suspicious area. The skin is nicked with a scalpel so the needle can enter. This type of needle biopsy is done in an outpatient setting.
Vacuum assisted biopsy — A thicker, hollow needle removes cores of tissue by means of a single insertion of a vacuum assisted probe. Vacuum assisted breast biopsy is done under a local anesthetic in an outpatient setting. This type of needle biopsy may be done with the guidance of stereotactic mammography or ultrasound imaging.
What is a surgical biopsy?
An open surgical biopsy is a surgical procedure that removes the abnormality from the breast. It is done in a hospital or outpatient setting with anesthetic. Most women are able to go home the same day. There are two types of open surgical biopsies:
Incisional — Only a portion of the lump is removed. It is most often done on women with advanced stage cancer whose tumors are too large to be removed by excisional biopsy.
Excisional — The entire lump plus some surrounding normal tissue are removed. This is the most common type of open biopsy and the most accurate way to diagnose breast cancer. Although the primary purpose is to diagnose cancer, a biopsy can also be a surgical treatment to remove cancer.
What is a prognosis?
A prognosis is a prediction. It is a doctor's best estimate of the chance that a woman will live free of breast cancer. In determining prognosis, doctors consider how well other patients with a similar type and stage of breast cancer have done when receiving the same treatment. However, because each patient is different, your doctor cannot say for certain what will happen to you.
What is meant by breast cancer stage?
Doctors use a rating scale to describe the seriousness of each case of breast cancer. The scale includes five stages: 0, I, II, III, and IV. The higher the stage, the more extensive and serious the cancer. The stage depends on:
- the size of the tumor
- whether the cancer has spread to the axillary lymph nodes (glands in the underarm)
- signs of metastasis (the cancer spreading to other parts of the body)
To learn more about the staging of breast cancer, please click here.
What is hormone receptor status?
Sometimes breast cancer cells have receptors for hormones and sometimes they do not. Receptors are the parts of a cancer cell that allow a hormone to attach and activate the cell. Breast cancer cells can have receptors for the hormones estrogen and progesterone together, or for either hormone alone. When this is the case, the cancer is called estrogen receptor (ER) and/or progesterone receptor (PR) positive. Women with a receptor positive cancer have a somewhat better prognosis than those without. A doctor can treat ER positive cancers with antiestrogen drugs.
What are histological grades?
Histologic grades are measures of how abnormal the cells from a tumor look under a microscope. The more the cells have changed to become cancerous (histology), or the greater the percentage of the cells that look like they are dividing, the more dangerous the cancer is likely to be. Tumors are given a histologic grade of 1 to 3. Grade 1 has the best prognosis.
What is Proliferation Rate (Cell Division)?
The rate of the cancer's proliferation is another measure of a cancer's aggressiveness. MIB-1 or S-phase fraction, terms you may see on your report, are common ways to measure proliferation. The proliferation rate describes how quickly the tumor cells are growing. When the proliferation rate is low, the cancer is growing more slowly and the prognosis is better.
Are there different types of breast cancer?
There are several different types of breast cancer. Most breast cancer occurs in the milk ducts of the breast—the tubes that carry breast milk to the nipple. This breast cancer is called ductal carcinoma. A second, but less common form of breast cancer occurs in the lobules—where breast milk is made. This breast cancer is called lobular carcinoma. Less common forms of breast cancer are inflammatory, medullary, mucinous, tubular and Paget's disease. To learn more about the types of breast cancer, please click here.
What is DCIS?
DCIS is a type of in situ (non-invasive) breast cancer that originates mainly in the milk ducts of the breast. The term "in situ" means "in place" and is used to describe this condition because the abnormal cells are still "in place" inside the ducts where they first developed. The cells involved have not developed the ability to invade tissues outside of the ducts and spread. DCIS is often referred to as a precancerous condition because it can either develop into or raise the risk of invasive cancer.
How is DCIS different from invasive breast cancer?
The term "breast cancer" describes a whole group of cancers that occur in the breast. DCIS is noninvasive, meaning that it does not spread from the breast ducts to other parts of the breast or body. Invasive breast cancers can spread to the lymph nodes or other areas of the body. You can reduce your risk of getting the more serious, invasive breast cancer by getting the proper treatment for DCIS.
What is Paget's disease?
Paget's disease of the nipple is usually, though not always, associated with in situ or invasive cancer. Symptoms of Paget's disease of the nipple include itching, burning, redness and scaling of the skin on the nipple and areola. There may also be a bloody discharge from the nipple, and the nipple may appear flattened against the breast. Treatment and prognosis for the disease is directly related to the type and extent of the underlying cancer.