Further tests for DCIS
If your mammogram shows signs that could be DCIS, you’ll have further tests.
You may have a magnified mammogram to look at an area more clearly. You may also have an ultrasound of your breast.
You’ll need to have samples of tissue removed from the micro-calcification (a biopsy). These are examined under a microscope to check for DCIS or cancer cells. The different types of biopsy are explained on this page.
An ultrasound scan uses sound waves to build up a picture of the breast. It can show if a lump is solid (made of cells) or a fluid-filled cyst.
You’ll be asked to take off your top and bra, and lie down on a couch with your arm above your head. The person doing the scan will put a gel onto your breast and move a small, handheld device around it. A picture of the inside of the breast shows up on a screen. An ultrasound only takes a few minutes and is painless.
A biopsy is needed to diagnose DCIS. A biopsy is a procedure that takes a sample of cells from your breast for testing. The biopsy is usually done at the breast screening unit. There are different types of biopsy. Your doctor or nurse will explain the procedure that you need to have.
Ultrasound guided needle biopsy
Before the biopsy, your doctor will inject some local anaesthetic into the breast to numb the area. You may feel some soreness or pressure, but this should only last for a short time.
An ultrasound scan is then used to show where the micro-calcification is and to help the doctor guide a needle through the skin into the exact area to be sampled.
You’ll have a few biopsies taken at the same time. Afterwards, your breast may be bruised and feel sore. You can take painkillers until this eases.
Mammogram guided needle biopsy
Sometimes, a mammogram is used to guide the biopsy. This is known as a stereotactic needle biopsy.
You‘ll be positioned in a mammography machine that has a special device attached. In most units, the test is done while you’re sitting down. In a few units, women are asked to lie on their front. The radiographer then takes an x-ray of your breast from two different angles to work out the exact position of the abnormal area. A needle can then be inserted into the right place to take a sample.
Vacuum-assisted biopsy (VAB)
This type of biopsy uses a special vacuum-assisted technique. It provides more tissue for diagnosis.
First, the doctor will numb the area with an injection of local anaesthetic. A small cut is then made in the skin. A tiny instrument or probe is placed through the cut into the breast tissue and guided to the correct area using a mammogram. When the probe is in the correct position, a vacuum gently draws out and collects a piece of breast tissue.
Several biopsies can be taken in this way, usually without having to remove and reinsert the probe.
Afterwards, the probe is taken out and the cut is covered with a small dressing, with no need for any stitches. The whole procedure takes about an hour and you’ll be able to go home straight after.
Side effects after a VAB are generally mild, but you may have bruising and feel a bit sore for a few days afterwards.
Wire guided biopsy
If it isn’t possible to remove enough tissue to make a diagnosis with a needle biopsy or a VAB, you may need a small operation. You’ll be referred to a specialist breast surgeon to have this done under a local or general anaesthetic.
After you’ve had a mammogram to show where the micro-calcification is, your surgeon will inject some local anaesthetic into the area to make it numb. They will then gently insert a very fine wire, which is kept in place with a dressing, into the area of micro-calcification. The wire acts as a marker to show the surgeon where to take the biopsy from. It’s removed once the biopsy is done. Occasionally, the wire is put in the day before the biopsy.
Another way of using a marker is by injecting a tiny amount of radioactive substance, which is harmless, into the area of micro-calcification. This shows up on a mammogram so that the surgeon can see the area that has to be biopsied.
Afterwards, your breast may be bruised and feel sore. You may need to take painkillers until it eases. The bruising should go away within a couple of weeks.
Examining the tissue under a microscope (pathology)
A doctor who specialises in cell types (a pathologist) will examine the tissue taken during a biopsy under a microscope.
The pathologist looks at the type of cells and how abnormal they are (the grade). All this information is reported back to your breast specialist.
Waiting for test results
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Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend. Your specialist nurse or one of the organisations you can search for, can also provide support. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.
If your biopsy results confirm that you have DCIS, you’ll be referred to a breast clinic for treatment. You’ll be seen by a specialist breast surgeon and a breast care nurse for information and support.