If the initial tests show that you have breast cancer, you may need further tests to see exactly where the cancer is and whether it has spread (the stage of the cancer). The results of all these tests help your doctors gather as much information as possible, so they can decide which is the best treatment for you.
These tests may include:
You’ll have blood taken to check your general health, the number of cells in your blood (blood count) and how well your kidneys and liver are working. Occasionally, a blood test may be used to check whether the breast cancer cells are producing certain chemicals (tumour markers). But this isn’t usually done.
This uses x-rays to take a picture of your chest, to check that your lungs and heart are healthy.
MRI (magnetic resonance imaging) scan
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MRI scans aren’t usually done but may be used if the mammogram and ultrasound don’t give enough information about the size of the cancer. They are also sometimes used when a mammogram doesn’t give a clear enough picture in women with lobular breast cancer or in women with dense breast tissue.
This test uses magnetism instead of x-rays to build up a detailed picture of areas of your body. Before the scan you may be asked to complete and sign a checklist. This is to make sure that it’s safe for you to have an MRI scan because the scanner is a powerful magnet. The checklist asks about any metal implants you may have, for example a pacemaker, surgical clips, bone pins etc. You should also tell your doctor if you have ever worked with metal or in the metal industry as very tiny fragments of metal can sometimes lodge in the body. If you do have any metal in your body it’s likely that you won’t be able to have an MRI scan. In this situation another type of scan can be used.
Before having the scan, you’ll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm, which doesn’t usually cause discomfort. This is called a contrast medium and can help the images from the scan to show up more clearly.
During the test you’ll be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless, but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It’s also noisy, but you’ll be given earplugs or headphones. You will be able to hear, and speak to, the person operating the scanner.
Some women may need other tests to check that the cancer hasn’t spread to other parts of the body.
A bone scan can show any abnormal areas of bone. It may be done to find out if the cancer has spread to the bones.
A very small amount of a mildly radioactive liquid will be injected into a vein, usually in your arm. The level of radioactivity used is very small and doesn’t cause any harm. Abnormal bone absorbs more of the radioactive substance than normal bone. This shows up on a scan as highlighted areas (known as hot spots).
You will have to wait for up to three hours after having the injection before you have a scan. This is to allow time for the bone to absorb the radioactive substance. It’s a good idea to take a book or a magazine to help pass the time. After a few hours, you’ll have a scan of the whole body.
A bone scan can show conditions other than cancer, such as arthritis. In this case, you may need to have further tests, such as an x-ray of the abnormal area.
This scan won't make you radioactive, and it's safe for you to be with other people afterwards.
CT (computerised tomography) scan
A CT scan takes a series of x-rays which build up a three-dimensional picture of the inside of the body. It may be used to identify the exact site of the tumour, or to check for any spread of the cancer. The scan is painless but takes from 10–30 minutes. CT scans use a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
You may be given a drink or injection of a dye which allows particular areas to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine or have asthma you could have a more serious reaction to the injection, so it’s important to let your doctor know beforehand.
You’ll probably be able to go home as soon as the scan is over.
Sound waves are used to make up a picture of the inside of the liver. This is done in the hospital scanning department. If you’re having an ultrasound scan you’ll be asked not to eat anything for at least four hours before your appointment.
Once you are lying comfortably on your back, a gel is spread onto your abdomen. A small device like a microphone, which produces sound waves, is passed over the area. The sound waves are then converted into a picture by a computer. This is a painless test and only takes a few minutes.
Waiting for your test results
It will probably take several days for the results of your tests to be ready and a follow-up appointment will be arranged for you before you go home. Obviously, this waiting period is an anxious time, and it may help you to talk things over with a close friend, a relative, the hospital specialist nurse or a support organisation. You can also contact one of our cancer support specialists.