How Do Doctors Diagnose the Types and Stages of Breast Cancer?
Screening for breast cancer can help doctors diagnose the condition in its early stages, including before you feel a lump in your breast. Mammograms are the most common form of breast cancer screening.
According to the Centers for Disease Control and Prevention, the United States Preventative Services Task Force recommends that people assigned female at birth between 50–74 years old with an average risk of developing breast cancer have a mammogram every 2 years. People 40–49 years old can speak with their doctors about when to begin screening and how often to have a test.
If you feel a lump in your breast, your doctor may recommend a mammogram to help with diagnosis after performing a physical exam. Other diagnostic imaging tests they may use include:
- Ultrasound: An ultrasound involves high energy sound waves, or ultrasounds, bouncing off the internal breast tissues. The sound waves bouncing off the tissues create echoes. The echoes form a picture of your body tissues called a sonogram. A doctor can then evaluate this image.
- MRI: An MRI involves using a magnetic field and radio waves to create computer images of your breasts.
If the symptoms you experience or the results of imaging tests give your doctor reason to believe you may have breast cancer, they will typically recommend a biopsy.
A biopsy procedure involves a doctor removing small pieces of breast tissue so that experts can evaluate them in a lab to detect cancer cells.
The types of biopsies doctors use to help them diagnose breast cancer include:
- Fine needle aspiration: This involves a doctor attaching a thin, hollow needle to a syringe. They use it to withdraw or aspirate a small amount of tissue or fluid from the area in question.
- Core needle biopsy: This involves using a large, hollow needle to take a sample of breast tissue. It is often the method doctors prefer to use when they believe breast cancer may be present based on physical exams or imaging results.
- Surgical or open biopsy: This involves doctors removing all or part of a lump in the breast to confirm their diagnosis. They usually perform this procedure in rare cases.
- Lymph node biopsy: This involves doctors removing a portion of or an entire lymph node to check if the cancer spread involves the lymph nodes. They may choose to do this at the same time as another biopsy or during surgery.
Typically, it takes at least a few days for your biopsy results to come back from the lab after a pathologist evaluates them.
There are several types of breast cancer, including:
- Ductal carcinoma in situ: This type is also known as noninvasive breast cancer or carcinoma in situ. It involves the breast ducts and not the surrounding tissue. Doctors usually find this type of breast cancer during a mammogram, and it rarely occurs as a lump.
- Invasive ductal carcinoma: This type of breast cancer spreads from the ducts to the surrounding tissue. It is the most common type of breast cancer.
- Invasive lobular carcinoma: This type begins in the milk-producing glands called lobules. It is invasive, so it grows into surrounding breast tissue. About 1 in 10 new cases are this type of breast cancer.
- Less common: This type involves a group of relatively rare forms of breast cancer, including inflammatory breast cancer, Paget’s disease of the nipple, Phyllodes tumor, and angiosarcoma.
Once your doctor verifies the type of breast cancer present, they can then tell the cancer’s stage. This helps them to create an effective treatment plan.
The stage of breast cancer is based on the size of the tumor and if the spread involves other parts of the body. Experts generally describe the stages on a numerical system from 0–4.
The stages of breast cancer are as follows:
- Stage 0: This stage describes noninvasive breast cancers. In this stage, the cancer cells are not present beyond the area in which they begin.
- Stage 1: This stage describes invasive breast cancers. In this stage, the cancer cells are present in the surrounding breast tissue.
- Stage 2: This stage describes cancer spread involving nearby lymph nodes.
- Stage 3: This stage describes cancer spread involving other auxiliary lymph nodes.
- Stage 4: This stage describes the most invasive type of breast cancer. In this type, the cancer spread involves areas beyond the nearby tissues and lymph nodes, including other parts of the body.
Teresa Hagan Thomas, Ph.D., B.A., R.N., reviewed these questions people frequently ask about breast cancer.
What is the most common breast cancer diagnosis?
The most common type of breast cancer doctors diagnose is invasive ductal carcinoma. This type of breast cancer occurs when the cancer spreads from the breast ducts to the nearby tissues.
What are the first signs of breast cancer?
The first symptoms of breast cancer typically include:
- a new lump in your breast or underarm
- a swollen or thickened breast area
- breast skin dimpling
- flaky or discolored skin around the nipple
At what age is breast cancer usually seen?
Doctors often find breast cancer in people assigned female at birth who are 50 years or older.
How long can you have breast cancer before noticing?
A breast cancer lump can be in your body for 2–5 years before you notice it.
The diagnosis of breast cancer typically combines a physical exam, diagnostic imaging, and biopsy. Doctors can use mammograms to detect breast cancer in its earliest stages.
Other diagnostic imaging tests include ultrasound and MRI. If you experience symptoms or your imaging results make your doctor believe you may have breast cancer, they will recommend a biopsy.
In a biopsy, a doctor removes small amounts of breast tissue so that experts can evaluate them in a lab. This helps doctors determine the type and stage of breast cancer. Once they know the stage, they can work with you to create the most effective treatment plan for your circumstances.