Further tests for DCIS

If the mammogram shows signs of DCIS, you will have further tests to find out more. You may have more mammograms that focus on a particular area of your breast. These can be taken from different angles or by using magnification.

You may also have an ultrasound of your breast. An ultrasound uses sound waves to build up a picture of the breast tissue. It can show if an abnormal area is solid (made of cells) or is a fluid-filled cyst.

You will need to have a breast biopsy before being diagnosed. This is when the doctor takes a small piece of tissue or cells (biopsy) from any abnormal areas. A pathologist will examine the tissue or cells under a microscope to look for cancer cells. A pathologist is a doctor who specialises in analysing cells.

There are different ways of taking a biopsy. Your doctor or nurse will explain the type of biopsy you will have.

Waiting for test results can be difficult. You may find it helpful to talk to your partner, family or a close friend.

Having further tests for DCIS

If a mammogram shows changes, you will be referred to a breast assessment clinic. The clinic staff will explain why you’ve been invited back and which tests you need. You might be able to have the tests on the same day, but sometimes you have to come back for further tests.

The clinic staff will let you know how and when you’ll get your results. You’ll usually be given an appointment to return for your results.


At the breast assessment clinic

At the clinic, you’ll see a specialist doctor or a specialist nurse. They usually ask you if you have had any breast problems or if anyone in your family has had breast cancer. The doctor or nurse will examine your breasts and the lymph nodes under your arm and around your neck.

Mammogram

You may have more mammograms that focus on the area of DCIS. These can be taken from different angles or can use magnification.

Breast ultrasound

An ultrasound scan uses sound waves to build up a picture of the breast tissue. It can show whether an abnormal area is solid (made of cells) or is 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 puts a gel onto your breast and moves a small, handheld device around it. A picture of the inside of the breast shows up on a screen. They may also do an ultrasound of the lymph nodes in your armpit. An ultrasound only takes a few minutes and is painless.

Breast biopsy

A biopsy is needed to diagnose DCIS. The doctor injects a local anaesthetic and then takes a small piece of tissue or cells (biopsy) from any abnormal areas. A doctor called a pathologist, who is a specialist in analysing cells, examines the tissue or cells under a microscope to look for cancer cells.

For a few days afterwards, your breast may feel sore and bruised. Taking painkillers will help with this. Any bruising will go away in a couple of weeks.

There are different ways of taking a biopsy. Your doctor or nurse will explain the type of biopsy you will have. As DCIS can’t usually be felt, you will need a mammogram or ultrasound to guide the biopsy needle to the abnormal area.

Core needle biopsy with mammogram

A mammogram may be used to guide the biopsy. This is known as a stereotactic core 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.

Ultrasound-guided needle biopsy

Sometimes an ultrasound scan is used to show where the abnormal area is. This helps the doctor guide a needle through the skin into the exact area to be sampled. You’ll have a few biopsies taken from the area. You may feel some pressure, but this should only last for a short time.

Vacuum-assisted biopsy (VAB)

A mammogram or ultrasound helps the doctor to guide this biopsy needle to the correct area of the breast. The doctor uses a vacuum method to gently withdraw pieces of tissue into a small collecting chamber. Several biopsies can be taken without needing to remove the needle and put it in again.

Clip insertion

When a core biopsy is performed, a tiny metal clip is often placed in the area. This helps the surgeon to find the area again if you need an operation. The clip is very small and won’t cause any problems, even if it is not removed.

I went back and had further tests and a biopsy. The consultant was great when it came to telling me what we were dealing with – he gave details and diagrams.

Wendy


Other tests

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 an excision biopsy under a general anaesthetic.

Excision biopsy

The surgeon makes a cut in the skin of the breast and takes a biopsy of the breast tissue. You usually go home on the day of your operation but some people may need to stay in hospital overnight. Usually, you have stitches that dissolve and don’t need to be removed.

Wire localisation

Sometimes an x-ray or ultrasound is used to guide a fine wire into the breast. This is to mark exactly where the surgeon should take the biopsy. The surgeon removes the wire when the excision biopsy is done.

Sometimes the surgeon injects a tiny amount of a harmless radioactive substance into the area of micro-calcification. The surgeon then uses a special hand-held probe during surgery to guide them to the area that needs to be biopsied.

Examining the tissue under a microscope (pathology)

A doctor who specialises in cell types (a pathologist) will use a microscope to examine the tissue taken during a biopsy. The pathologist looks at the type of cells and how abnormal they are. All this information is reported back to your breast specialist.


Biopsy and test results

Waiting for test results can be a difficult time. You may find it helpful to talk with your partner, family or a close friend. There are organisations that can also provide support. You can 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 unit for treatment. You may also be referred to the unit if the test results are unclear. You’ll be seen by a specialist breast surgeon and a breast care nurse for information and support.

Waiting for test results was probably the most difficult time. Your mind goes like wildfire thinking about all the possible scenarios.

Pauline

Back to Tests and scans

Being diagnosed with DCIS

You may be diagnosed with DCIS after having a mammogram through the NHS Breast Screening Programme.