If breast cancer is suspected because of an abnormal screening, symptoms or family history, getting the right tests is the first step. At Banner MD Anderson Cancer Center, we use advanced imaging and laboratory testing to give you accurate answers quickly. The sooner you know if you have breast cancer, the sooner your care team can create the best treatment plan for you.
Many types of breast cancer have a high survival rate and the number of women surviving breast cancer is increasing every year.
Why testing matters
Early and accurate diagnosis is important because it gives you more treatment options and better outcomes. Two types of tests look for breast cancer:
- Screening tests: These routine screenings, like mammograms, are tests you have even though you don’t have any symptoms.
- Diagnostic tests: These tests look for breast cancer after you notice a change in your breast health or you need more detailed information after an abnormal test result.
Initial evaluation
Before ordering tests, your provider may:
- Review your medical history: They will ask about your family history of breast or ovarian cancer, genetic risks and past medical treatments like radiation.
- Perform a physical exam: They will check your breasts, chest and underarms for lumps, swelling or changes.
Screening tests
Routine cancer screenings are the most important thing you can do to detect breast cancer early. Screening can find cancer before you have symptoms. Most health insurance plans cover the cost of breast cancer screenings, including mammograms.
Common screening tests include:
- Clinical breast exam: A provider carefully checks your breasts for lumps or other changes
- Mammogram: An X-ray of the breast, available in 2D and 3D (tomosynthesis)
- Breast MRI: This exam is sometimes recommended if you are at higher risk
Screening guidelines for average-risk patients
Banner MD Anderson recommends that most women follow breast cancer screening guidelines from the National Comprehensive Cancer Network.
For women at average risk of breast cancer:
- Talk to your provider about having clinical breast exams every one to three years from age 25 to 39 and yearly beginning at age 40.
- Begin annual mammograms at age 40.
- Continue yearly screening as long as you are in good health.
- Be aware of changes in your breasts between screenings and report them to your doctor.
Screening guidelines for high-risk patients
Some people need screening earlier or more often. You may be considered high risk if you have:
- A strong family history of breast or ovarian cancer
- A known inherited genetic mutation, such as BRCA1 or BRCA2
- Radiation therapy to the chest before age 30
- Dense breast tissue
For high-risk patients, your provider may recommend:
- Mammograms before age 40
- Additional imaging such as breast MRI or ultrasound
- Referral to genetic counseling and testing
Diagnostic imaging tests
A breast cancer diagnosis usually begins with an imaging exam. If a screening test finds something unusual or if you have symptoms, you may need more imaging studies:
- Diagnostic mammogram: More detailed X-rays after symptoms or an abnormal screening
- Breast ultrasound: Uses sound waves to tell if a lump is solid or fluid-filled or to guide a biopsy
- Breast MRI: Offers detailed images, which are useful for dense breasts or in complex cases, or for planning treatment
- Contrast enhanced mammogram: Combines a standard diagnostic mammogram with an injection of iodine-based contrast to highlight areas of increased blood flow, helping to detect abnormalities that may not be visible on regular mammograms
Biopsy procedures
If imaging shows an area of concern, your provider may recommend a biopsy to see whether it is cancer. A biopsy involves taking a small sample of tissue for testing in a lab where a pathologist checks the tissue sample under a microscope to look for cancer cells.
Your provider may recommend one of these types of breast cancer biopsies, depending on your imaging test results and any symptoms:
- Fine needle aspiration: Takes a sample from a lump or suspicious area with a needle and syringe
- Core needle biopsy: Uses a hollow needle to take a sample of breast tissue
- Surgical biopsy: Removes a sample of tissue by cutting through the skin (only used in certain cases)
Lab and pathology testing
If a biopsy shows signs of cancer, laboratory tests can show:
- Type and grade: How abnormal the cells look and how quickly they may grow
- Hormone receptor status: Estrogen receptor (ER) and progesterone receptor (PR)
- HER2 status: Whether the cells show human epidermal growth factor receptor 2
- Molecular or genetic markers: These may guide targeted or immunotherapy treatment
Advanced and special situations
Additional or specialized testing can help with:
- Dense breast tissue: You may need more imaging for an accurate diagnosis
- High-risk: Genetic counseling and testing can help guide prevention and treatment
- Molecular profiling: Tumor samples may be tested for specific biomarkers to match you with targeted therapies or clinical trials
Understanding your results
Your results will include details about:
- The tumor size and location
- Whether it has spread to nearby lymph nodes
- The tumor grade and stage
- Biomarker status (ER, PR and HER2)
This information helps your care team create your personalized treatment plan.
What happens after diagnosis
If breast cancer is confirmed, your care team will:
- Review your test results
- Determine the stage of the cancer (from Stage 0 to Stage 4)
- Develop a treatment plan based on your type, stage and overall health
- Connect you with support services, including nurse navigators, counseling and survivorship resources
Stages of breast cancer
Breast cancer staging helps doctors understand your treatment options and prognosis.
- Stage 0: Cancer is only found in the breast milk ducts
- Stage I (1): Cancer is small but has started to spread to other breast tissue
- Stage II (2): Cancer has grown or spread to nearby tissue or up to three lymph nodes
- Stage III (3): Cancer has grown or spread to nearby tissue, the chest wall or four to nine lymph nodes
- Stage IV (4): Cancer has spread to other parts of the body like the bones, lungs, liver or brain
Should I consider genetic testing?
If your family has a strong history of breast or ovarian cancer, you may have a gene that puts you at higher risk. Genetic counseling can help you decide if you want to get a genetic test, which uses a blood or saliva sample to find gene abnormalities.
Why choose Banner MD Anderson for breast cancer testing and diagnosis
At Banner MD Anderson, we work to improve outcomes for people with breast cancer. Our personalized treatment plans include:
- Advanced imaging and pathology labs
- A multidisciplinary team of radiologists, pathologists, oncologists and surgeons who focus on breast cancer
- Fast results, so you can begin treatment sooner
- Access to clinical trials and innovative diagnostic tools
- Nurse navigators and counselors to help make the diagnosis and treatment process easier
Next step: Treatment and support
Testing is the first step to getting care for breast cancer. After a diagnosis, your care team will guide you through treatment and recovery.
Banner MD Anderson offers advanced screening and diagnostic tests for breast cancer.
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