NCCN Guidelines for Patients™: Breast Cancer
Part 3: Tests for breast cancer
3.2 Tests after diagnosis
If cancer is found, your doctor will likely order more tests.
The tests are based on your tumor size, whether lymph
nodes may be involved, and whether your cancer has
metastasized. Most women with breast cancer do not
need many more tests following diagnosis.
Lymph node tests
Breast cancer can spread beyond the breast to your
lymph nodes. Needle biopsies of lymph node tissue before
surgery may show if cancer cells are present. There are
two needle biopsies that are commonly used:
Core needle biopsy.
Similar to a core biopsy of the breast
tumor, your doctor will insert a needle through your skin
into your lymph node. The needle used in a core biopsy is
able to remove a solid tissue sample. If your doctor can’t
feel the tumor, an ultrasound may be used to help guide
the needle into your body.
A fine-needle aspiration (FNA)
can be used to remove either fluid from a cyst or a small
group of cells from a tumor. This procedure usually doesn’t
cause pain and can be done in a few minutes.
There are two common tests that use blood samples.
They are needed to plan surgery, look for evidence of
metastases, and plan treatment after surgery.
These blood tests include:
Complete blood count.
This test counts the different
types of cells in the blood and tells whether the amount
of each type is normal. This test is repeated often,
particularly if chemotherapy is needed. It tells if you have
enough red blood cells to carry oxygen to your tissues,
white blood cells to fight infections, and platelets to make
clots needed for healing injuries.
Chemical and enzyme tests.
These tests look for
signs of abnormal activity in other organs. Women with
noninvasive cancer do not need these tests. Abnormal
results may sway your doctor to order other tests, such
as a bone scan, to see whether the cancer has spread to
. For this test, you will receive an intravenous
injection of a radioactive dye. Several hours later, a scan
will show whether there are areas of new bone growth.
New growth suggests possible spread of breast cancer to
the bone. However, many changes that appear on a bone
scan are not cancer.
In early-stage breast cancer, your doctor will use this
test only if there is some reason to think that cancer may
have spread to the bone. Examples of reasons for a
bone scan include changes in blood chemistry tests or
bone pain. Your doctor may also order a bone scan if the
cancer is locally advanced. However, if the cancer has
spread to other organs, a bone scan is needed.