Evaluation for breast cancer includes review of imaging exams, medical history and a clinical exam including a breast exam. Breast tissue must be evaluated to obtain a diagnosis of breast cancer. Palpation or image-guided needle biopsies allow for treatment planning prior to surgery and have been shown to decrease re-excision rates. Types of biopsies include:
- Core needle biopsy: Insertion of a hollow needle into a suspicious area, where a small tissue sample is taken to be visualized for abnormalities under a microscope. If a lump cannot be felt, an image guided biopsy is performed with either mammogram, ultrasound or MRI
- Fine needle biopsy/aspiration: Uses a smaller needle to remove some of the fluid or cells from a lump so they can be tested for the presence of cancer.
- Excisional or open biopsy: A procedure performed under local anesthesia, sometimes with sedation, involving removal of the entire abnormal area along with some of the surrounding tissue. This is more invasive and is generally only used when the tumor cannot be sampled by the above modalities.
- Other tests used during a diagnostic workup are typically reserved for most advanced breast cancers. These may include:
- PET/CT scan: A form of 3-D imaging that can offer more definitive information about cancerous tumors and other lesions located throughout the body. This test is not used in early stage breast cancer.
- Bone scan: An imaging test that uses a small amount of radioactivity to diagnosis problems in the bones.
Specialists in the critical evaluation and diagnosis of diseases, our board-certified pathologists and cytopathologists work closely with the medical and surgical team in the diagnosis of cancer. Our accredited laboratory is committed to the latest and most trusted methods of testing to ensure the accuracy and quality of each analysis for a cancer diagnosis in the shortest time possible.
Breast cancer pathology review includes:
- Histopathologic evaluation of all breast diagnostic and surgical specimens, including intraoperative consultation (frozen section) when appropriate.
- Immunohistochemical (IHC) testing of breast cancer tissue for estrogen (ER) and progesterone (PR) receptors.
- Fluorescence In-Situ Hybridization (FISH) testing of breast cancer tissue for Her-2 neu gene amplification.
- Availability of comprehensive molecular testing of breast cancer tissue
- Second pathologist review for every diagnosis.