Staging and Detection Tests
Once a cancer has been diagnosed, it is very important to know where the cancer may have spread.
This is the "stage" of the cancer – the lower the number, the less it has spread. Knowing the stage allows your medical team to determine the best possible treatment plan for you.
Mammogram – An x-ray machine that takes a film picture of your breast tissue to look for abnormal areas inside the breast that may be cancerous. Mammograms are the best tool for finding breast cancer early. Every woman from the age of 40, or younger women who have an increased risk of breast cancer, should have a yearly mammogram.
Digital Mammogram – A newer type of mammogram that takes an electronic image of the breast and stores it directly in a computer instead of film. Digital mammography uses less radiation than film mammography, and it produces images that can be stored and sent electronically. Digital mammograms are generally more effective than film mammograms at detecting cancer in younger women, women with dense breasts, and pre-menopausal women.
3D Mammogram - Available at the end of May 2012, this technology creates three-dimensional images of the breast, finding cancers other devices might miss.
Breast Ultrasound – A machine that uses high-energy sound waves to form a picture of the breast tissue, which is displayed on a screen. The ultrasound can show if a lump is solid or a fluid-filled cyst.
Magnetic Resonance Imaging (MRI) – A machine that uses a magnet and a computer to take detailed pictures of areas inside the body. Screening trials of MRI in women with a high genetic risk of breast cancer have shown that adding an MRI to mammography is the most effective way to find breast tumors.
Biopsy – A biopsy removes tissue for a pathologist to examine under a microscope. A biopsy helps to confirm whether the lump is benign (non-cancerous) or malignant (cancerous).
Several types of biopsies are used to diagnose breast problems:
- Fine Needle Aspiration (FNA) – A pathologist removes individual cells. We are often able to provide results for this method on the same day of the clinic visit.
- Core Biopsy – Removes a piece of tissue about the size of pencil lead. Results take two to five days.
- Excisional Biopsy – Removes tissue from a questionable area. Results take five to seven days for diagnosis.
Genetic testing – A genetic counselor evaluates family history of breast cancer and performs blood tests to determine if the patient has a breast cancer gene. This testing can help women and their doctors make health care decisions that lower the risk of breast cancer. It is important to note that while finding a breast cancer gene means that a woman may have an increased risk of breast cancer, it does not mean that she will get breast cancer.
Treatments & Therapies
Treatments for breast cancer vary greatly from patient to patient. Your medical team may use a customized combination of surgery, chemotherapy, radiation, hormone therapy, or new immunotherapy to treat or control your cancer.
Surgery is often the initial treatment for breast cancer. A surgical oncologist who specializes in the removal of breast cancer via surgery will perform the operation. A plastic surgeon may then perform breast cancer reconstructive surgery.
Surgical treatments include the following:
- Mastectomy – An operation to remove one or both breasts.
- Partial Mastectomy – An operation to remove the cancer from the breast without removing the entire breast. This is also called a lumpectomy.
- Sentinel Node Biopsy and Axillary Dissection – During a full or partial mastectomy, a doctor injects dye to identify lymph nodes where the cancer is most likely to have spread. If the cancer has spread, a sentinel node biopsy removes the lymph nodes most likely to be involved. An axillary dissection removes most of the lymph nodes under the arm. A lab then tests the tissue or node for cancer cells.
- Reconstructive Surgery – An operation to rebuild the shape of the breast after a mastectomy. It can be done at the same time as a mastectomy or later, depending on the individual and the doctor’s recommendation.
- DIEP Flap Reconstructive Surgery - The DIEP flap (deep inferior epigastric perforator) is a tissue flap procedure that uses fat and skin from a patient's own tummy to create a new breast mound after a mastectomy.
Chemotherapy involves using drugs that slow down, damage or kill cancer cells. It may involve single drugs or combinations of drugs taken intravenously or by mouth. Chemotherapy is often used in cycles lasting three or four weeks. Your medical team may also prescribe other drugs and treatments to reduce or eliminate the side effects associated with chemotherapy.
Radiation Therapy ("Radiotherapy")
Radiation therapy involves using X-rays and other types of medical radiation that targets specific parts of the body. Radiation is used to kill cancer cells, prevent them from developing or recurring, and to ease many of the symptoms caused by cancer. It can be used together with chemotherapy for certain cancers ("chemo-radiotherapy").
Some hormones can cause certain cancers to grow. Hormone therapy removes these hormones or blocks their action, which stops cancer cells from growing.
Doctors may prescribe the following medications to block the production or binding of estrogen to treat and prevent breast cancer:
- TamoxifenTM – A drug that has been shown to be effective in preventing breast cancer from returning in women who are in remission (have had treatment and show no sign of remaining cancer). It is also used to help women who are at high risk avoid developing breast cancer.
- Aromatase Inhibitors – Medicines that interfere with how much estrogen is produced after menopause. This limits the amount of estrogen that can cause growth of breast cancer tumors.
Your medical team may recommend that you participate in a clinical trial.
University of Colorado Hospital and UCCC conduct hundreds of clinical trials in an ongoing effort to discover and deliver more effective treatments. Participants in clinical trials often have access to the latest drugs and vaccines years before they are widely available.
Other types of treatments being tested through clinical trials include:
Biologic therapy (biotherapy or immunotherapy) – A treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer.