Breast cancer tests
This page tells you about the tests you may have if you have symptoms of breast cancer. There is information about
Breast cancer tests
You usually start by seeing your GP. Your GP will examine you and if necessary refer you to a specialist breast clinic.
At the breast clinic
The doctor will take your medical history and examine your breasts. They will also feel for any enlarged lymph nodes under your arms and at the base of your neck. You may also need some of the following tests.
Mammogram or ultrasound
A mammogram is an X-ray of the breasts. If you are under 35, you are more likely to have an ultrasound scan instead.
Having a biopsy
This means taking a small sample of cells or tissue from your breast and looking at them under a microscope to see if they are cancerous. Often your biopsy can be done with a local anaesthetic. But sometimes the doctor needs to do a small operation under general anaesthetic. On the full version of this page, we have information about the different types of biopsy you may have.
Waiting for results
It is always an anxious time waiting for test results. While you are waiting it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience.
You can view and print the quick guides for all the pages in the Diagnosing breast cancer section.
If you have changes in your breast that worry you, you usually start by seeing your GP (family doctor). Your GP will examine you and if necessary refer you to a specialist breast clinic for advice or treatment. In some situations the GP may ask you to come back again in a couple of weeks time. This is because some non cancerous breast tissue changes naturally disappear after a menstrual period. Waiting a couple of weeks may make you anxious. But your GP wouldn't suggest this if there were any obvious signs of cancer. And even if it is cancer, waiting a week or two will not be harmful, as cancer develops very slowly.
The doctor or breast nurse will take your medical history before doing a physical examination. Your doctor will
- Examine your breasts
- Feel for any enlarged lymph nodes under your arms and at the base of your neck
Once you've had your examination, you may need some tests. The tests that doctors use to diagnose breast cancer are described below. You may have these tests on your first visit to the hospital or breast clinic. Or you may have appointments arranged to come back for them.
A mammogram is an X-ray of the breasts. Mammography is useful for finding early changes in the breast, when it may be difficult to feel a lump. It isn't as helpful in younger women though. If you are under 35, your specialist is more likely to suggest you have an ultrasound instead.
Mammography can be painful because the breasts are put between two metal plates and a little pressure is applied. But most women describe this as mild to moderate discomfort. And it only lasts a few minutes. It is not harmful to the breasts.
There is more information about having a mammogram in the breast cancer screening section. You may also be interested in the questions for your doctor page for ideas about what to ask about mammography.
Breast ultrasound is painless and takes just a few minutes. Ultrasound uses sound waves to make a picture of the inside of the body. It is usually used for women under 35 whose breasts are too dense or solid to give a clear picture with mammograms.
It is also used to see if a breast lump is solid, or if it contains fluid. A fluid filled lump is called a 'cyst'.
There is more about having an ultrasound scan in the about cancer tests section of CancerHelp UK.
A breast biopsy means taking a small sample of cells or tissue from your breast and looking at the sample under a microscope. A specialist doctor examines these samples (a pathologist) and can see if they contain areas of cancer. There are different ways of taking these biopsies. These are
- Needle aspiration
- Needle biopsy
- Excision biopsy (surgical)
- Wire guided biopsy
- Mammotome biopsy
- Punch biopsy
Needle aspiration
You may hear this called 'fine needle aspiration cytology' or FNAC. This quick test is done in the outpatient clinic. The doctor uses a fine needle and syringe to take a sample of cells from the breast lump. The sample is sent to the lab to see if it has cancerous cells. If the doctor can't get a sample of cells with this method, you will need to have a needle biopsy or excision biopsy. This test might also be used to drain fluid from a benign cyst.
Needle biopsy
Needle biopsy is also called a 'core biopsy' or Tru-Cut biopsy. It is used more often than a fine needle aspiration. A core needle biopsy uses a slightly bigger needle than the one used for aspiration. You may have this test under a local anaesthetic. The anaesthetic numbs the area and allows the doctor to take a biopsy - a core of tissue from the lump.
As with the other types of biopsy, the pathologist looks at the sample in the lab to check for signs of cancer. This type of biopsy is useful because the pathologist can see the cells in place within the piece of breast tissue that has been removed. So it is possible to tell a non-invasive cancer (DCIS) from invasive breast cancer with this test. You can't do this with needle aspiration because you are only looking at cells that have been sucked out.
Excision biopsy
Excision biopsy is also called a surgical biopsy. In this biopsy, you have a minor operation to remove the whole lump under general anaesthetic. It is sent to a lab for examination. Most hospitals will do the biopsy as a day case. In others, you may need to stay overnight in the hospital.
Wire guided biopsy
A wire guided biopsy is also called a wire localisation. Doctors usually use this technique if you have calcium specks showing up on your mammogram, but no clear lump. In these cases, the surgeon can't really see or feel which area needs to be removed. So during a mammogram or ultrasound, the doctor puts a fine wire into the suspicious area. The doctor makes sure the tip of the wire is right in the centre of the suspicious tissue and then secures the wire firmly. The wire stays in until you have your surgical biopsy, which is usually the same day. Your surgeon then knows that where the wire ends is where they need to take a biopsy of the tissue. The tissue sample is then sent to the lab to be examined for cancer cells.
Mammotome biopsy
A Mammotome test uses an instrument called a Mammotome to take a biopsy from the breast. After giving you a local anaesthetic, the surgeon makes a small cut in your breast tissue. Guided by an ultrasound or X-ray, the surgeon uses a small vacuum assisted probe to take a biopsy from the suspicious area. A mammotome biopsy removes a slightly larger sample of breast tissue than a needle biopsy. Your doctor might use this test if a needle biopsy did not give a clear result.
Punch biopsy
A punch biopsy is when the doctor removes a small circle of tissue to biopsy. You might have this type of biopsy done if your doctors thinks you could have Paget's disease of the nipple.
Waiting for test results is always an anxious time. Some breast clinics now offer a same day service for the basic result - whether there are cancer cells there or not. Others take 24 hours, 48 hours or even longer. Specialised tests to find out the type of cancer can take quite a few days to carry out. So you may have to wait longer for these results. Each clinic has a standard for waiting times. You can ask the breast specialist or breast care nurse when you should expect your results. While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience.
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