When a lump is discovered or a screening mammogram shows an area of concern, additional tests will be performed to get more detailed information. In many cases, these tests show that everything is fine. However, if cancer is present, the additional information that is gathered can be valuable in planning treatment. These additional tests may include:

  • Diagnostic Mammogram: For people who are experiencing current breast problems or who have had an abnormal screening mammogram, a diagnostic mammogram is the next step. As many as 10 percent of women who have screening mammograms may be called back for a diagnostic mammogram. A diagnostic mammogram uses the same technology as a screening mammogram, but may involve additional images such as magnification views. This allows the radiologist to get a more detailed look at the areas of concern. More often than not, these additional images eliminate any further cause for concern.
  • Ultrasound: Another imaging method that uses sound waves instead of radiation to produce an image. Ultrasound is often used along with mammography to provide additional information about a lump or an area of concern. It is useful in telling the difference between normal or benign areas and those that need further evaluation.
  • MRI: Although not as commonly utilized as ultrasound, MRI can be another tool used in selected situations where the mammogram or ultrasound may be of limited use.
  • Nipple-Discharge Procedures: When nipple discharge is present, a sample of the fluid may be collected and examined for cancer cells under a microscope. Another way to determine the cause of nipple discharge is to take a special kind of X-ray called a galactogram or ductogram.
  • Needle Biopsy: There are two non-surgical ways in which a doctor can further examine an area of concern. These are called fine needle aspirate and needle core biopsy. The tissue sample removed in either of these tests is examined in a laboratory to check for signs of cancer.
  1. A fine needle aspirate is a simple procedure in which a thin, hollow needle is inserted into the breast. Once the needle is in the appropriate place, suction is used to help collect a few cells for study. A local anesthetic may be used to numb the breast tissue during the procedure. Often ultrasound is used to help guide the needle.
  2. In a needle core biopsy, the needle is larger, which allows the doctor to remove a larger tissue sample. For this procedure, doctors may use special images to help guide the needle precisely to the area of concern. These images are created by either X-rays and computers (known as a stereotactic biopsy) or by ultrasound.
  • Surgical Biopsy: A surgical, or excisional, biopsy is what most people think of when they hear the word biopsy. The procedure, performed by a surgeon, is used to collect a tissue sample from the suspicious area. The sample is then studied under a microscope to confirm or rule out a breast-cancer diagnosis

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