Breast Cancer

Lesson 2: Diagnosis, Tests & Staging

Tests, Tests and More Tests

The good news about most of the diagnostic test you may undergo is that they are generally non-invasive. That means that there is no surgery, minor discomfort and are usually done on an out-patient, same day basis.

Your medical team may use one, several or all of the tests described below. If you aren't scheduled for all of them, that is perfectly OK. Depending upon your diagnosis and how it was arrived at, you may not need all of the tests.

Mammogram - this is still the standard screening and diagnostic tool for breast cancer. NOTE: At most mammography facilities, you are wearing a hospital gown and your breast which is not in the mammo machine is covered. I believe this photo is just for illustrative purposes. You stand in front of the machine and the technician arranges your breast on a plate or shelf. Another plate is lowered and compresses your breast. Your arm is usually raised overhead and holds onto a resting bar. They take two or three different views of each breast - front, side and sometimes, angled.

Is it painful? I've had many "mammos" and find them to be uncomfortable, but not painful. Some have been worse than others. (The more compression, the more discomfort.) It depends on the time of the month: if your breasts are more sensitive around your period, then it will be harder to deal with. The compression lasts approximately 5 - 10 seconds. Take a deep breath and hold it (required) and count slowly or sing a song or whatever gets you through 10 seconds and you will be fine. Try to put it in perspective: This test may determine that you don't need surgery or can pinpoint exactly where the cancer is. Isn't it worth a few seconds of discomfort? Mammography has come under scrutiny lately. No, it is not perfect and yes, it does miss some lumps, but it is still the gold standard for breast cancer detection. (For the record, I found my lump and it did NOT show up on the mammogram). http://www.radiologyinfo.org/content/mam...

Ultrasound - This test is a piece of cake!

You lay on the examining table and they put some gel on your breasts and maneuver the scanner over your breasts. The imagine shows up on the computer. It is all accomplished by high frequency sound waves. Advantage: it's easy to take and MAY show some things that mammo doesn't. Disadvantage: It doesn't show everything that a mammogram can. Generally used as an adjunct (additional) diagnostic tool, along with mammography. You just lie back and let the technician do her job. Watch the blobs on the screen. Unless you know what you are looking for, it will all seem like ink blots or clouds. You have to wash the sticky gel off really well when you are done. My "lump" DID show up on my ultrasound. (I had an ultrasound after I found the lump and my doctor also felt it during a clinical exam.) http://www.howstuffworks.com/ultrasound....

MRI - Magnetic Resonance Imaging - This procedure uses radiofrequency waves and a giant magnet to see inside your body. Does it hurt? Not a bit. I’ve had it and I don’t like it. You lay in this narrow tube, which is open on both ends. The only thing you can see is the top of the tube above you. The technician talks to you and tells you when the noise is going to start again and forewarns you to stay still. The magnet makes this really loud, knocking noise. At most MRI facilities, they will give you earplugs, but it is still loud. I’m not claustrophobic, but I still get antsy in the tube. The whole process usually takes between 30 and 60 minutes, depending on what part of your body you are having examined. I’ve found that I do OK if the technician tells me how long this section will take. If they tell me 5 minutes, sometimes I sing whole songs in my head, at other times I count backwards from 1000 – anything that keeps my mind occupied and I get through it. As long as the technician talks to me in between sessions, I am fine. Some locations now have open MRIs, which are not as enclosed and I think I might like that better. Let me see around the room and I will not feel so isolated. Studies to date have shown that open MRI may not be as effective as the standard MRI.

If you are really worried, they can sedate you and then you can just float through the experience in a haze. You can't have any metal on you due to the magnets, so leave the bobby pins, jewelry and eye makeup at home. Doctors must approve an MRI for some patients with metallic implants of any type. http://www.radiologychannel.net/magnetic...

PET Scan - Positron Emission Tomography – NOTE: MRI table/tube looks almost exactly the same.

This nuclear medicine test lets the doctor assess changes in your chemical and physiological metabolism. I’ve never had a PET scan. The technician gives you a tracer, which is a radiopharmaceutical. This tracer is usually injected. You are then positioned for the scan. This procedure uses an external radiation source. This test is also non-invasive. Doctors are still analyzing how effective PET scan is in relation to breast cancer. At present, not all insurance companies cover PET scan for breast cancer, so be sure to discuss this with your doctor and insurance company. If any of you have had a PET scan, I would welcome the input on this procedure. http://www.falange.demon.co.uk/explain-p...

Other imaging techniques – There are several other tests that are used occasionally with respect to breast cancer. These include CT Scans, MIBI Scans, Thermography, Transillumination and Diaphanography. Most of these tests are inferior to mammography, but can be beneficial in certain circumstances, in conjunction with mammography.

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