Diagnostic Techniques
Imaging techniques
Mammography – an x-ray of the breast that is still the gold standard in detecting breast cancer. It is recommended routine screening for women ages 40 and older, but those who have a family history of breast cancer may begin getting mammograms at an earlier age. A diagnostic mammogram examines breast tissue more closely when a suspicious area is noted on a screening mammogram.
To read an explanation of mammography, and an “Ask the Doctor” question on the subject, take a look at the fall 2002 issue of Lifeline.
CT scan, or CAT scan (Computerized Axial Tomography) – uses x-rays and a rotating system to get detailed images of the body.
MRI (Magnetic Resonance Imaging) – uses a combination of magnetic energy and radio waves.
Miraluma – FDA approved for use in addition to mammography. Injection of nuclear dye into ankle, then a camera is used to examine breast tissue.
Nuclear Bone Scan – intravenous radioactive substance that concentrates in blood vessels (hot spots) that may be cancerous.
PET scan (Positron Emission Tomagraphy) – can show the metabolism and activity of the cancer.
Ultrasound – uses high frequency sound waves. May also be called a sonogram.
To read a comparison of the different breast cancer diagnostic tests available, take a look at the “Ask the Doctor” question in the summer 2005 issue of Lifeline.
Other Diagnostic Techniques
Breast Self-Exam (BSE) is a physical breast exam performed by you. While experts disagree about how effective BSE is in detecting breast cancer, it’s a good idea to perform BSE once a month so you become familiar with what’s normal for your breasts.
Clinical Breast Examination (CBE) is performed by a physician or nurse. Beginning at age 20, women should have a clinical breast exam every two to three years. Women age 40 and older should have a CBE every year.
Ductal Lavage – relatively new procedure; suction draws fluid out of nipple before the milk ducts are flushed with a liquid that is sent to a laboratory for testing. May be used in combination with an imaging technique.
Oncotype DX™ –Multiple studies of the Oncotype DX(tm) Recurrence Score Assay have demonstrated that the test not only quantifies the likelihood of breast cancer distant recurrence in women with node-negative, estrogen receptor (ER) positive, Stage I-II breast cancer, but also predicts the magnitude of benefit from tamoxifen and chemotherapy. The recurrence score is based on the expression of 21 genes, including ones related to proliferation, invasion, HER-2 and ER. Recurrence is scored on a scale from 0 to 100: 0-17 is considered low risk, 18-30 intermediate risk, and 31-100 high risk. The cutoff points were chosen on the basis of the results of a National Surgical Adjuvant Breast and Bowel Project (NSABP) trial.
