If initial tests such as mammogram show that you have breast cancer, one or more tests may be done to see if the cancer has spread to other parts of your body before any treatment can be recommended.
Blood samples may be taken to check your general health and to look at your bone and liver function for signs of cancer.
Your doctor may take an x-ray of your chest to check your lungs for signs of cancer.
A bone scan may be done to see if the breast cancer has spread to your bones. A small amount of radioactive material is injected into a vein, usually in your arm. This material is attracted to areas of bone where there is cancer.
After a few hours, the bones are viewed with a scanning machine, which sends pictures to a computer. This scan is painless and the radioactive material is not harmful. You should drink plenty of fluids on the day of the test and the day after.
A CT (computerised tomography) scan uses x-rays and a computer to create detailed, cross-sectional pictures of the inside of the body. You may have to fast (not eat or drink) for a period of time beforehand to make the scan pictures clearer and easier to read.
Before the scan, you will either drink a liquid dye or be given an injection of dye into a vein in your arm. This dye is known as the contrast and it makes the pictures clearer. If you have the injection, you may feel hot all over for a few minutes.
You will lie flat on a table while the CT scanner, which is large and round like a doughnut, takes pictures. This painless test takes 30–40 minutes.
A PET (positron emission tomography) scan is a specialised test, which is rarely done for breast cancer. A PET scan uses low-dose radioactive glucose to measure cell activity in different parts of the body.
If you do have a PET scan, a small amount of the glucose will be injected into a vein, usually in your arm. You will need to wait for about an hour for the fluid to move around your body, and then you will lie on a table that moves through a scanning machine. The scan will show ‘hot spots’ where the fluid has accumulated – this happens where there are active cells, like cancer cells.
Staging and grading breast cancer
The tests described above show whether the cancer has spread to other parts of the body. Working out how far the cancer has spread is called staging. Stages are numbered from I to IV.
The grade describes how active the cancer cells are and how fast the cancer is likely to be growing.
Stage I – The tumour is less than 2cm in diameter and has not spread to the lymph notes in the armpit
Stage IIA – The tumour is less than 2cm in diameter and has spread to the lymph nodes in the armpit
The tumour is 2-5cm in diameter and has not spread to the lymph nodes in the armpit.
Stage IIB – The tumour is 2-5cm in diameter and has spread to the lymph nodes in the armpit.
Stage III is referred to as locally advanced breast cancer, and stage IV refers to advanced breast.
Grade 1 (low grade) – Cancer cells look a little different from normal cells. They are usually slow growing.
Grade 2 (intermediate grade) – Cancer cells do not look like normal cells. They are growing faster than grade 1 breast cancer, but not as fast as grade 3.
Grade 3 (high grades) – Cancer cells look very different from normal cells. They are fats growing.
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for any doctor to predict the exact course of the disease.
Survival rates for people with breast cancer have increased significantly over time due to better diagnostic tests and scans, earlier detection, and improvements in treatment methods. Most people with early breast cancer can be treated successfully.