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How Is Breast Cancer Diagnosed?

Medical professionals now have an extensive array of tools at their disposal to make diagnosis of breast cancer more reliable, especially in the early stages. That's great news, since it considerably increases the odds of keeping breast cancer down to the level of 'serious but not permanently scarring or life-threatening'.

Diagnosis will usually start with a clinical exam. The physician will perform a hands-on breast examination similar to the self-exam that is recommended for all women over age 19. Cancerous lumps generally feel harder and less mobile than benign cysts. Cancer tumors are frequently irregular while non-cancerous lumps tend to be round. A trained professional can often tell the difference.

A mammogram will help confirm the diagnosis. Modern digital mammograms are often computer assisted. Detection of tumors is aided by complex algorithms that do a good job of differentiating suspect image sections. This new tool greatly enhances the ability to eliminate false positives and to detect smaller, less obvious problems in the early stage of development.

Ultrasound is another modern tool that has been improved since its introduction. They're excellent at helping to distinguish between a benign cyst and a cancer tumor. Since cysts are harmless, fluid-filled sacs they react to sound waves differently than do the harder, denser cancer cells.

MRI (Magnetic Resonance Imaging) is another diagnostic tool coming to be used more and more often. Years ago, insurance companies would never pay for this highly expensive test. But as costs have come down and coverage has expanded, it's more common. As a powerful magnetic field is swept over the breast, it excites molecules in a way that is harmless but produces distinctive effects. That allows professionals to use images generated by MRI to detect very small anomalies.

When other tests suggest that a closer look is warranted, a biopsy is often performed. Some may be as simple as a fine-needle aspiration. A small amount of fluid is removed via a needle from the detected breast lump. That fluid can be examined for cells that are associated with or constitute cancer.

A deeper or core biopsy may be called for in certain cases. That too uses a needle, but one that's thicker and removes tissue. Still more tissue is removed in a surgical biopsy. The sample is then examined by an oncologist for the presence of cancer cells.

A new test developed at John Hopkins offers promise for even more accurate early diagnosis. Called a QM-MSP (quantitative multiplex methylation-specific PCR), it relies on fluid drawn from the breast. That fluid is then chemically analyzed. When abnormally high levels of certain molecules are detected it indicates the presence of cancer cells. Some studies suggest that clusters with as few as 50 cancer cells can be detected in this way. It was able to detect cancer in 84% of breast tumor samples used.

With modern tests and techniques, diagnosis can be done early and with far greater reliability than in the past. That's key to treating breast cancer at the earliest possible stage. That greatly improves the odds of keeping it from becoming a more serious matter than it has to be.