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Women with breast cancer may first go to see their GP because they have found a lump or another breast change that is worrying them.
When you visit your GP s/he will ask you questions about your symptoms and will look at your medical history to see what illnesses you have had in the past.
S/he will carefully examine your breasts to feel for lumps, swellings or anything else unusual.
S/he may then decide to send you to a specialist doctor at the hospital. There are cancer referral guidelines to help GPs decide who needs to see a specialist, and how quickly.
Alternatively, you may be asked to go to the hospital after a routine breast screening test.
If you need to go to the hospital it doesn't mean you have cancer… it simply means that the doctor needs to do some more tests to find out what is causing your symptoms. If you have been for breast screening, there may be something on the x-ray that needs to be checked out - but often there is nothing wrong, so try not to worry unduly.
One way of finding out whether a patient has breast cancer is to carry out three tests - clinical examination, imaging and core biopsy. Together these are called the triple assessment. In some situations a fine needle aspiration is used instead of a core biopsy.
Clinical examination
Your specialist doctor will ask you questions and then examine you.
Imaging
This will be…
- a mammogram (an x-ray of your breast)
- an ultrasound scan
This test uses sound waves to build a picture of the inside of the body. You lie on your back while a device like a microphone is passed over your breast. The sound waves then make pictures of your breast on a computer screen.
Core biopsy
For a core biopsy, you have a local anaesthetic and a small cut is made in the skin. A needle is used to take out a small piece of breast tissue.
Fine needle aspiration
For this test, a fine needle is passed through the skin and into the breast lump, to get a sample of cells. The sample is then sent to the laboratory to be looked at under a microscope.
The triple assessment correctly diagnoses breast cancer in almost all cases - but in 1 out of every 500 cases it will miss the cancer. One reason for this is that not all breast cancers can be seen on an x-ray. Another problem is that some people have dense breasts that the x-ray can't penetrate.
Your doctor may decide that you don't need to have all the tests in the triple assessment, before a diagnosis can be made. Your doctor will tell you which tests you will have.
For more information about some of these tests, go to our cancer tests section.
