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This information has been reviewed by:
Dr Meron Pitcher (Chair VCOG Breast Cancer Committee), Surgeon, Western Hospital
How can I find out if I have breast cancer?
Doctors and other health professionals you may see
How breast cancer is diagnosed
Women's breasts change throughout their lives. Normal changes can occur during the menstrual cycle. However, some breast changes may be signs of breast cancer. They include:
If you have not been diagnosed with breast cancer and are just looking through this booklet, please be aware that some of these
symptoms occur without any serious disease being present. Nine out of ten breast changes are not cancer. However, any unusual breast change should be checked by a doctor.
Men's symptoms are similar to women's, although men are often diagnosed at a later stage. Many early breast cancers are now found by screening mammogram, before any breast change is noticed.
Your doctor will examine you and refer you for tests to find the cause of your symptoms. This can be a worrying and tiring time, especially if you need to have several tests. If the tests show you have or may have cancer, your doctor will refer you to a specialist who will advise you about treatment options.
You should expect to be cared for by a team of health professionals from the relevant major disciplines (see following list). Ideally, your hospital will have all means of diagnosis and treatment. This may be possible in regional centres.
Specialists and other health professionals who care for people with breast cancer include:
Sometimes an unusual breast change is found if you have a screening mammogram. You may notice a breast problem or change yourself. You will have some of these tests to find out if your breast change is due to breast cancer.
‘In the time between the diagnosis and going in to hospital I was in an absolute dream. The night
before the surgery all of the family visited me in hospital and only then did the realisation that I had
breast cancer come to me.'
The doctor will look at and feel your breasts. They will look for anything unusual and feel the lymph nodes in your armpit and
above your collarbone. They will also check the rest of your body for signs of cancer.
A mammogram is a breast x-ray. It will tell your doctor more about lumps and other changes. It can find lumps that are too small to be felt.
Both breasts are checked. Your breast is pressed between 2 x-ray plates. These spread the breast tissue out so clear pictures can be taken. Many women find this uncomfortable, but it lasts for only about 20 seconds.
Sometimes, a lump that can be felt is not seen on a mammogram. Other tests will need to be done. Even women with small breasts can have a mammogram, and many men can have mammograms. The radiation dose used in mammograms is a very low, safe level.
You may also have an ultrasound scan. This uses sound waves to make a picture of your breast. You uncover your chest and lie down. Once you are comfortable, a gel is spread on the skin on the area being scanned. A small device called a ‘transducer' is moved across your skin. It sends sound waves into the body. Echoes are made when the sound waves meet something dense, like an organ or a tumour. A computer makes pictures from these echoes.
Ultrasound can show if there is a tumour, and how large it is. It can often tell the difference between benign lumps and malignant tumours, and between solid masses (like tumours) and cysts.
This test is painless and takes 15 to 20 minutes. Ultrasounds and mammograms often combine to give the best assessment.
Some breast cancers cause a discharge from the nipple. A ductogram is a type of x-ray that can help find the cause. The discharge fluid can also be tested to see if there are any cancer cells.
Your doctors will suggest a biopsy if they are concerned about a lump in your breast. Biopsy means removing the lump, or part of it, so it can be looked at under a microscope. There are different types of biopsies.
A needle and wire is sometimes put in the breast just before an open biopsy, when a lump cannot be felt. This is done in the radiology department. The wire shows the surgeon exactly where the lump is. The surgeon removes the wire, along with the lump.
‘After the shock, my initial feeling was an overwhelming sense of helplessness; I thought, "I'm going to die". I couldn't believe it, I was too young ... Then I started to read the literature, and ask more questions of my medical team. I felt better, more in control, as I became more informed.'
Fine needle and core biopsies provide only a small amount of tissue. An open biopsy, lumpectomy or mastectomy provides the whole cancer, so the doctors can learn more from it. Information gained from looking at the removed tissue can help
you and your doctor decide the best treatment for you. This information includes:
The tests described already show whether you have cancer. They also show where the breast cancer is. Your doctor may ask for
other tests to check there are no obvious cancer spots in other parts of your body. This helps your doctors ‘stage' the disease.
‘Stage' describes the extent of the cancer in the body. It helps define what sort of treatment is needed. It also gives a guide to
prognosis.
The staging system used for breast cancer is known as the ‘TNM system' (T = tumour, N = nodes, M = metastases).
Doctors combine this information to determine the stage of the cancer, from Stage 1 to Stage 4. For example, a cancer assessed as T1, N0, M0 (a small tumour contained within the breast, lymph nodes not affected and no metastasis) would be called a Stage 1 cancer.
Accurate stage may not be known until after your surgery. Ask your doctor to explain the stage of your cancer in a way you
can understand. This will help you to choose the best treatment for your own situation.
