Checking for breast cancer usually involves a number of tests. The tests you have depend on your specific situation.
Waiting for the test results can be a stressful time. It may help to talk to a friend or family member, a health professional, or call 13 11 20.
Learn more about:
Mammogram
A mammogram is a low-dose x-ray of the breast tissue. It can check any lump or other breast changes found during a physical examination. It can also show changes that are small or cannot be felt during a physical examination. If you have breast implants, it is important to let staff know before the mammogram.
Your breast is placed between 2 x-ray plates. The plates press together firmly to spread out the breast tissue so that clear pictures can be taken. You will feel some pressure, which can be uncomfortable, but the mammogram only takes 10–15 seconds. Both breasts will be checked.
Learn more about mammograms.
A national screening program provides a free mammogram for all women aged over 40. For more information, call 13 20 50 or visit BreastScreen Australia Program.
Tomosynthesis
Also known as three-dimensional mammography, tomosynthesis takes x-rays of the breast from many angles and combines them into a three-dimensional (3D) image. This may be better for finding small breast cancers, particularly in dense breast tissue.
Contrast enhanced mammogram (CEM)
This combines tomosynthesis with a dye (contrast) that is injected into a vein in your arm. A CEM may be helpful for people with dense breast tissue.
Ultrasound
An ultrasound uses soundwaves to create a picture of breast tissue. It does not use radiation. It is often the first test done in women under 30 years with breast changes, or if a screening mammogram has picked up breast changes, or if you or your GP can feel a lump.
A gel will be spread on your breast, and then a small device (transducer) is moved over the breast and armpit. This sends soundwaves that echo when they meet something dense, like a tumour. A computer creates a picture from these echoes. The scan takes 15–20 minutes and is painless.
Learn more about ultrasounds.
Breast MRI
A magnetic resonance imaging (MRI) scan uses a large magnet and radio waves to take pictures of the breast tissue. It does not use radiation. It is mainly used for people at high risk of breast cancer or who have very dense breast tissue or breast implants. It may also be used if other imaging test results are unclear or to help plan surgery.
Before a breast MRI scan, you will usually have an injection of a dye (called contrast) to help show any abnormal breast tissue. You will lie face down on a table, which will slide into a large, cylinder-shaped machine.
The scan can take up to 40 minutes. It is painless but loud, so you will wear earplugs. Some people feel claustrophobic. If you are concerned, talk to your doctor. You may be offered a mild sedative.
Learn more about MRI scans.
Before a scan, tell the doctor if you have any allergies or had a reaction to dyes during previous scans. Also tell them if you have diabetes or kidney disease or are pregnant or breastfeeding.
Biopsy
If breast cancer is suspected, a small sample of cells or tissue is taken from the lump or area of concern. A specialist doctor called a pathologist then checks the sample under a microscope for any cancer cells.
There are different ways of taking a biopsy and you may need more than one type. The biopsy may be done in a specialist’s rooms, at a radiology practice, in hospital or at a breast clinic. After any type of biopsy, your breast may feel sore and be bruised for a few days.
| Fine needle aspiration (FNA) | A thin needle is inserted into an abnormal lymph node or other tissue, often with an ultrasound to help guide the needle into place. Tiny pieces of tissue can then be sucked out through the needle. A local anaesthetic may be used to numb the area. |
| Core biopsy | Several pieces of tissue are removed with a needle. Local anaesthetic is used to numb the area, and a mammogram, ultrasound or MRI scan is used to guide the needle into the right area. |
| Vacuum-assisted core biopsy | A needle attached to a suction-type instrument is inserted into the breast through a small cut in the skin. A larger amount of tissue is removed with a vacuum biopsy, making it more accurate in some cases. The needle is usually guided into place with a mammogram, ultrasound or MRI. A local anaesthetic is used, but you may feel some discomfort. Stitches are not usually needed. |
| Surgical (excision) biopsy | If a needle biopsy is not possible, or the diagnosis remains unclear, you may have a surgical biopsy to remove all or part of a lump. A wire or small surgical clip may be inserted to act as a guide during the surgery. The tissue is then removed under general anaesthetic. This is usually done as day surgery. |
Learn more about biopsies.
Further tests
If the above tests show that you have breast cancer, you may have further tests to check whether the cancer has spread to other parts of your body. You will have a blood test to check your general health, and in some cases, it will test for specific tumour markers.
You may also have some of the following types of scans.
| Bone scan | A bone scan is used to see if the breast cancer has spread to your bones. A small amount of radioactive solution is injected into a vein, usually in your arm. This solution is attracted to abnormal areas of the bone. After a few hours, the bones are viewed with a scanning machine. The scan is painless and the solution is not harmful. |
| CT scan | A CT (computerised tomography) scan uses x-ray beams to take pictures of the inside of the body. Before the scan, dye (contrast) will be injected into a vein in your arm. This dye helps to make the pictures clearer. For the scan, you lie flat on a table while the scanner takes pictures. The scan takes about 30 minutes and is painless. |
| PET scan | In a PET (positron emission tomography) scan, a small amount of low-level radioactive solution is injected into a vein in the arm or hand. Any cancerous areas take up more of the radioactive solution and may show up brighter in the scan. |
Before a scan, tell the doctor if you have any allergies or had a reaction to dyes during previous scans. Also tell them if you have diabetes or kidney disease or are pregnant or breastfeeding.
→ READ MORE: Tests on breast tissue
Podcast: Tests and Cancer
Listen to more of our podcast for people affected by cancer
More resources
Dr Diana Adams, Medical Oncologist, Macarthur Cancer Therapy Centre, NSW; Prof Bruce Mann, Specialist Breast Surgeon and Director, Breast Cancer Services, The Royal Melbourne and The Royal Women’s Hospitals, VIC; Dr Shagun Aggarwal, Specialist Plastic and Reconstructive Surgeon, Prince of Wales, Sydney Children’s and Royal Hospital for Women, NSW; Andrea Concannon, consumer; Jenny Gilchrist, Nurse Practitioner Breast Oncology, Macquarie University Hospital, NSW; Monica Graham, 13 11 20 Consultant, Cancer Council WA; Natasha Keir, Nurse Practitioner Breast Oncology, GenesisCare, QLD; Dr Bronwyn Kennedy, Breast Physician, Chris O’Brien Lifehouse and Westmead Breast Cancer Institute, NSW; Lisa Montgomery, consumer; A/Prof Sanjay Warrier, Specialist Breast Surgeon, Chris O’Brien Lifehouse, NSW; Dr Janice Yeh, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC.
View the Cancer Council NSW editorial policy.
