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Chart 2.1

Health care before cancer treatment

Main tests and services

Other care based on signs and symptoms

• Medical history

• Complete blood count

• Physical exam

• Liver function tests

• Diagnostic bilateral mammogram

• Bone scan

• Ultrasound if needed

• Chest diagnostic CT

• Breast MRI is an option

• Abdominal ± pelvic diagnostic CT or MRI

• Pathology review

• Lymph node biopsy

• Hormone receptor test

• HER2 test

• Genetic counseling if hereditary breast

cancer is likely

• Fertility counseling if you can have babies

• Distress screening


NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016

Physical exam

Doctors often perform a physical exam along with

taking a medical history. A physical exam is a study of

your body for signs of disease. During this exam, your

doctor will listen to your lungs, heart, and gut.

Your doctor will also look at and feel parts of your

body. This is done to see if organs are of normal

size, are soft or hard, or cause pain when touched.

A clinical breast exam involves your doctor touching

your breasts and nearby lymph nodes. Your breasts

may be felt while you sit or stand up as well as when

you lie back. Some women feel uneasy having their

breasts touched by their doctor. Keep in mind that this

test provides important information and is quick.

Blood tests

Blood tests may be done to check for any health

problems before starting treatment. For a blood test,

a needle will be inserted into your vein to remove a

sample of blood. The needle may bruise your skin

and you may feel dizzy from the blood draw. Your

blood sample will then be sent to a lab where a

pathologist will test it.

Complete blood count







ount) measures the number

of blood cells in a blood sample. It includes numbers

of white blood cells, red blood cells, and platelets.

Cancer and other health problems can cause low or

high counts.


Treatment planning

Physical exam | Blood tests