The best test to identify breast cancer in the initial phase is mammography, which consists of an X-ray that allows you to see if there are lesions in the breast before the woman even has any symptoms of cancer, such as breast pain or fluid release through the nipple. See the 12 signs that may indicate breast cancer.
Mammography should be done at least every 2 years from the age of 40, but women with a history of breast cancer in the family should be tested every year from the age of 35 until the age of 69. If the results of the mammogram show any type of change, the doctor may order another mammogram, an ultrasound, MRI or biopsy to confirm the existence of a change and confirm or not the diagnosis of cancer.
In addition, laboratory tests may be required to check the concentration of some markers that may be indicative of breast cancer, as well as useful in choosing treatment and response to therapy.
Understand when breast pain may be a sign of cancer.
In addition, there are other tests that can help identify and confirm breast cancer such as:
1. Physical exam
The physical examination is an exam done by the gynecologist through palpation of the breast to identify nodules and other changes in the woman's breast. However, it is not a very precise examination, because it only signals the presence of nodules, without there being any verification that it is a benign or malignant lesion, for example. Thus, the doctor usually indicates more specific tests, such as mammography, for example.
Usually this is the first examination done when the woman has symptoms of breast cancer or has discovered changes during breast self-examination. Learn how to do self-examination at home.
Also watch the following video, which explains clearly how to perform self-examination correctly:
2. Blood Test
The blood test is useful in the diagnosis of breast cancer, because normally when there is some carcinogenic process, some specific proteins have their concentration increased in the blood, for example CA 125, CA 19.9, CEA, MCA, AFP, CA 27.29 and CA 15.3, which is usually the marker most requested by the physician. Understand what the CA 15.3 exam is and how it is done.
In addition to being important to assist in the diagnosis of breast cancer, tumor markers may also inform the physician when the response to therapy and recurrence of breast cancer, such as CA marker 27.29.
In addition to the tumor markers, it is through analysis of a blood sample that mutations in tumor suppressor genes, BRCA1 and BRCA2, that when mutated can predispose to breast cancer, can be identified. This genetic thesis is recommended for those who have close relatives who were diagnosed with breast cancer before age 50, for example. Learn more about the genetic screening for breast cancer.
3. Breast Ultrasound
Ultrasound of the breast is an examination often done after the woman has had a mammogram and the result has changed. This test is particularly suitable for women with large, firm breasts, especially if there are cases of breast cancer in the family. In these cases ultrasonography is a great complement to mammography, since this examination is not able to show small nodules in women with large breasts.
However, when the woman has no cases in the family, and has breasts that can be widely observed on mammography, ultrasound does not replace mammography. See who is at highest risk for breast cancer.
4. Magnetic Resonance
Magnetic resonance imaging (MRI) is an examination used mainly when there is a high risk of breast cancer, especially when there are changes in the results of mammography or ultrasound. Thus, magnetic resonance imaging helps the gynecologist to confirm the diagnosis and to identify the size of the cancer, as well as the existence of other sites that may be affected.
During MRI, the woman should lie on her belly downwards, supporting the chest on a special platform that prevents them from being pressed, allowing a better image of the tissues of the breast. In addition, it is also important that the woman stay as calm and quiet as possible to avoid causing changes in the images due to the movement of the body.
5. Breast biopsy
The biopsy is usually the last diagnostic test used to confirm the presence of cancer, since this test is done in the laboratory with samples taken directly from the lesions of the breast, allowing to see if there are tumor cells that, when present, confirm the diagnosis of cancer.
Generally, the biopsy is done in the office of a gynecologist or pathologist with local anesthesia, as it is necessary to insert a needle in the breast until the lesion to aspirate small pieces of the nodule or the alteration identified in the other diagnostic exams.
6. FISH Examination
The FISH examination can be done after the biopsy, when there is a diagnosis of breast cancer, to help the doctor choose the type of treatment best suited to eliminate the cancer.
The FISH test is a genetic test that allows the identification of specific genes in the cancer cells, known as HER2, which, when present, report that the best treatment for cancer is with a chemotherapeutic substance known as Trastuzumab, for example.
