Personal history and clinical breast examination
The doctor will ask about the woman’s personal and family history of breast cancer and about any symptoms.
The doctor will perform a clinical breast examination. This involves a thorough physical examination of the whole breast area, including both breasts, nipples, armpits and up to the collarbone.
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
The tests used will depend on the woman’s age. For women aged 35 years or older, both a mammogram and an ultrasound will be used. For women younger than 35 years, an ultrasound is used first and a mammogram may also be used if more information is needed.
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 two types of biopsy. A woman may have one or more of these.
- 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.
- Fine needle aspiration (FNA): a thin needle is used to remove cells from the abnormal area. An ultrasound or mammogram may be used to show 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.
If more information is required, the biopsy may be repeated or the woman may have an excision/surgical biopsy. In this test 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.
