A: Your doctor will give you a series of screening tests to help determine the size of the cancer, as well as whether the cancer is only in your breast or whether it is present in the lymph nodes or in other organs in your body. These may include:
- Bloodwork helps plan for surgery, screen for evidence of cancer and plan for treatment after surgery. A complete blood count (CBC) determines whether your blood has a healthy number of blood cells. Abnormal test results could identify other health problems, such as anemia, that could impact the course of your treatment. Blood chemistries and liver enzyme tests are done if your cancer has started to grow beyond the ducts or lobules in your breast (invasive breast cancer). These tests can sometimes tell if the cancer is present in the bones or liver. If these test results are abnormal, your doctor will order imaging tests such as bone scans or CAT scans.
- Chest x-rays. If you have invasive breast cancer, a chest x-ray before surgery may show any evidence of breast cancer in your lungs.
- Bone scans involve injecting a small dose of a radioactive substance into your vein, which collects in areas of new bone formation and can be seen on the bone scan picture. A bone scan provides information about the presence of breast cancer in your bones.
- CAT scans take 3 dimensional x-ray pictures of your body to provide detailed pictures of your internal organs. CAT scans of your abdomen or chest may be done to see if the cancer is present elsewhere in your body.
- MRI, or magnetic resonance imaging, is a procedure in which radio waves and a powerful magnet linked to a computer create detailed pictures of areas inside your body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of some organs and soft tissue than other scanning techniques, such as CT or x-ray. MRI is especially useful for imaging the brain, spine, the soft tissue of joints and the inside of bones. Your doctor may order an MRI if you have had a biopsy result showing cancer in the armpit but you do not show signs of breast cancer when your breasts are examined by your doctor or by a mammogram. It may also be ordered if you have a biopsy result showing cancer in your breast and you have dense breasts (breasts with a lower amounts of fat compared with other tissues) that cannot be fully evaluated with mammography.
- PET scans begin with an injection of sugar and a small amount of radioactive material. Because of the high amount of energy that breast cancer cells use, areas of cancer in the body absorb large amounts of the radioactive sugar. After the sugar has traveled throughout your body, a special camera on the PET machine detects the radioactivity to help identify the location of the cancer. PET scans are not routinely ordered but may be used if other test results do not clearly show whether the cancer is present in other areas of the body.
Reviewed by Rick Michaelson, MD
A: Waiting for test results can cause a lot of fear and anxiety. Try to avoid being tested before the weekend or a holiday, which can delay reporting of your test results. Talk to your doctor about your concerns, and ask how you can get your test results as quickly as possible. If you feel you have waited long enough, you should call your doctor or nurse and ask for information. If you want someone to talk to about your concerns, your doctor may also be able to put you in touch with a counselor or someone who has been through a similar experience.
Reviewed by Angela DeMichele, MD, MSCE