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Clinical breast examination

A clinical breast examination involves a thorough physical examination of the whole breast area, including both breasts, nipples, armpits and up to the collarbone.

The doctor will also ask about the woman’s personal and family history of breast cancer and whether she has any symptoms.

Imaging tests

Imaging tests for breast cancer may involve:

  • mammogram: a way of examining the breasts using low-dose X-rays
  • ultrasound: a way of examining the breasts and/or armpit area using high-frequency sound waves
  • MRI (magnetic resonance imaging): a way of examining the breasts, armpit or chest using magnetic fields.

The tests used will depend on the woman’s age and breast density. Typically, a mammogram is used first for women aged 50 years or older and an ultrasound is used first for women younger than 35 years. For women aged 35-49, either test may be used first. MRI may be used for young women, particularly if they have a strong family history of breast cancer.

Biopsy

If the clinical examination or imaging tests show an abnormal area, a woman will have a biopsy so that cells or tissue from the area can be examined for signs of cancer.

There are three types of biopsy. A woman may have one or more of these.

  • Fine needle aspiration (FNA): a thin needle is used to remove cells from the abnormal area.
  • Core biopsy: a needle is used to remove a small piece of tissue from the abnormal area. This test is usually done under local anaesthetic. A mammogram or ultrasound may be used to show where the abnormal area is.
  • Excision biopsy/surgical biopsy: a surgeon removes some (or all) of the abnormal tissue. This test is usually done under general anaesthetic. If the abnormal area can’t be felt easily, a small wire may be inserted into the breast before the surgical biopsy (under local anaesthetic) to show the surgeon where the abnormal area is.

After any type of biopsy, the cells or tissue are sent to a pathologist. The pathologist examines the cells or tissue to find out whether the breast change is due to breast cancer.