Being diagnosed with breast cancer

Your GP will examine you and refer you to a breast clinic to see a specialist. You may also be referred through an NHS breast screening programme if you’ve had a mammogram (a breast x-ray) which shows changes.

At the breast clinic, you’ll see a specialist breast doctor and sometimes a specialist breast nurse. They will ask you about your general health and if anyone in your family has had breast cancer.

The doctor will examine you and arrange some tests, including mammograms. You will usually have an ultrasound of your breast and armpit. Samples of cells (biopsies) may also be taken from any lumps or abnormal areas. There are different ways of taking a biopsy.

Some women get their results on the same day as the tests, but sometimes it can take a couple of weeks. Waiting for test results can be difficult. You may want to talk to someone close to you or one of our cancer support specialists.

How breast cancer is diagnosed

You usually start by seeing your GP, who will examine you and refer you to a breast clinic to see a specialist. You should receive an appointment for the breast clinic within two weeks.

Some women are referred through national breast screening programmes because there are changes on their mammogram. Breast screening is a way of picking up breast cancer at an early stage when it’s too small to be felt or seen.


At the breast clinic

Most hospitals have a special breast clinic. At the clinic, you will see a specialist breast doctor. You may also see a breast care nurse or advanced nurse practitioner. They usually ask you if you have had any other breast problems and if anyone in your family has had breast cancer.

The doctor will examine your breast, and the lymph nodes in your armpits and around your neck. After this, they will explain the tests you need.

You may have all the tests on the same day, as well as the results. Although you might have to wait up to a week for some results. You may also need to come back to the hospital afterwards for further tests.


Mammogram

A mammogram is a low-dose x-ray of the breast. You will need to take off your top and bra for the mammogram.

The radiographer will position you so your breast is against the x-ray machine and gently but firmly compressed with a flat, clear, plastic plate. You’ll have mammograms of each breast taken from different angles.

The breast tissue needs to be pressed down to keep the breast still and to get a clear picture. Most women find this uncomfortable, and for some women it’s painful for a short time.

Mammograms to detect breast cancer are usually only used for women over the age of 35. In younger women, the breast tissue is more dense (has less fat), which makes it difficult to detect any changes on the mammogram. Women under 35 are usually offered an ultrasound of the breast.

But if you are under the age of 35 and are diagnosed with breast cancer, your specialist will arrange for you to have a mammogram.


Breast ultrasound

An ultrasound uses sound waves to build up a picture of the breast. It can show if a lump is solid (made of cells) or if it’s a fluid-filled cyst.

You will be asked to take off your top and bra, and lie down on a couch, often with your arm above your head. The person doing the scan puts a gel on to your breast and moves a small hand-held device around the area. A picture of the inside of the breast shows up on a screen. An ultrasound only takes a few minutes and is painless.


Ultrasound of the lymph nodes

You will also have an ultrasound of the lymph nodes in the armpit. If any of the nodes feel swollen or look abnormal on the ultrasound, the doctor will take a biopsy  of the node or nodes.


Breast biopsy

This is when the doctor removes a small piece of tissue or a sample of cells from the lump or abnormal area. A pathologist (a doctor who specialises in studying cells) looks at the tissue or cells under a microscope to check for cancer cells.

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

For a few days after the biopsy, your breast may feel sore and bruised. Taking painkillers and wearing a supportive bra will help with this. Any bruising will go away in a couple of weeks.

Needle (core) biopsy

This is the most common type of biopsy. It’s a quick test where the doctor uses a needle to take small pieces of tissue from the lump or abnormal area. Before taking the biopsy, they inject some local anaesthetic into the area to numb it. You may feel uncomfortable and have a feeling of pressure for a short time during the biopsy.

Fine needle aspiration (FNA)

This is a quick, simple test. The doctor puts a very fine needle into the area and withdraws a sample of cells into a syringe.

The following tests aren’t usually done at your first visit to the breast clinic. You usually have to go back to have them done.

Vacuum-assisted biopsy (VAB)

This is a way of taking needle biopsies using a vacuum-assisted method. The doctor gives you an injection of local anaesthetic into the skin to numb the area. They then make a small cut and put a needle through it into the breast. A mammogram or ultrasound picture helps them guide the needle to the right area. The doctor uses the vacuum to gently withdraw a piece of breast tissue into a small container. They can take several biopsies without needing to remove the needle and put it in again.

Excision biopsy

Occasionally, the doctor makes a cut in the skin of the breast and removes the lump or abnormal area. This is usually done under a general anaesthetic but can sometimes be done using local anaesthetic. 

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 to mark exactly where the surgeon should take the biopsy. This is usually done when a mammogram or ultrasound shows an abnormal area, or when a lump is too small for the doctor to feel. The surgeon removes the wire when the excision biopsy is done.

Sometimes the surgeon leaves a tiny metal marker clip in place, which is permanent. The clip shows up in mammograms and marks the area where the biopsy was taken. This helps the surgeon find the exact area if you need to have more breast tissue removed later on. The clip doesn’t cause you any harm or discomfort.


Waiting for test results

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 listed on our database, can also provide support. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.

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