How we investigate breast diseases
If you discover a breast lump or breast change, make an appointment with your doctor or nurse for a clinical assessment. They will advise whether further tests are needed. Three approaches are usually involved in diagnosing your breast lump and investigating breast diseases:
1. A physical examination
The examiner will first look at your breast for changes in size or shape. Then using the pads of the fingers he/she will gently feel your breasts for lumps. The area under your arms will also be checked.
This is usually the first imaging examination that is performed in women over 40 years of age. It is an X-ray of the breast. Very low levels of radiation are used. The breast is pressed between two plates to flatten and spread the tissue. The pressure may cause some discomfort during the short while it takes to take the X-ray.
In women younger than 30 years, or depending on the results of the mammogram in an older woman, an ultrasound may be requested. The ultrasound uses high-frequency sound waves to obtain images.
Magnetic Resonance Imaging (MRI)
The MRI is of limited use in breast screening but may be indicated in woman who have a genetic mutation and are at extremely high risk for breast cancer.
The Fine Needle Aspiration Biopsy (FNA or FNAB)
This is the least invasive biopsy method. Small amounts of cells are aspirated (sucked up) into a syringe through a needle – a bit like a blood test. No stitches are needed. The procedure can be performed in your Doctor’s office and takes only a few minutes. Results are usually available later the same day or within 24 hours.
This can also be performed in your Doctor’s office, but requires a local anaesthetic to numb the area. These core biopsies provide a larger tissue sample but may not be suitable for patients with a very small or hard lump.
Biopsies could also be conducted under ultrasound guidance or stereotactic (mammographic) guidance if the area of abnormality is not in the form of an “easy-to-feel” lump.