Screening & Diagnosis
Breast Cancer
Breast cancer is the second most common cancer among women in the United States, next to skin cancer. Regular screening with mammography helps find cancer early, when it is still treatable.
Our immediate response to your breast cancer screening findings gives you your results and information about your options, so you can move forward with the right treatment for you.
What is Breast Cancer Screening?
ScreeningBreast cancer screening refers to physical examination and diagnostic imaging of the breast to detect signs of cancer. Maintaining a schedule for breast cancer screening is essential to ensure that proper care is provided before breast cancer advances.
Self-exam
Monthly self-examinations help you understand the normal texture of your breasts and notice anything abnormal. If you notice a lump or dimpling of the skin during a self-exam, you should contact your doctor.
- Visually examine your breasts. Check for puckering, dimpling, or changes in your breasts' size, shape, or structure.
- Check if your nipples have become inverted (turned in)
- Use your hands to examine your breasts. Lying down makes it easier to detect malformations in the breast. Examining your breasts in the shower with soap-lathered hands also makes it easier to move your hands across your breast skin.
Clinical breast examination
When your physician performs a breast examination, you will be asked to put your arms behind your head. The doctor will examine your breasts with the pads of the fingers to find lumps or physical changes. The doctor will examine your nipple for any discharge by gently pressing it down around the nipple. Your underarms will also be examined for lumps.
Only a trained healthcare professional is qualified to conduct a breast examination properly. All adult women should have a breast exam performed during their annual visit.
Screening mammograms
Doctors recommend annual screening mammograms to begin at age 40 for people with an average risk of developing breast cancer. Mammograms are critical in reducing the number of women who die from breast cancer.
At NewYork-Presbyterian cancer screening centers, digital and 3D mammography, also called tomosynthesis, are used to capture and display X-ray images on a computer. These images can be viewed from different angles. 3D mammography can take a deeper look into the breast tissue.
During a mammogram, you will stand in front of the X-ray machine while your breast is placed between two plastic plates. These plates flatten your breast so a clear picture of the breast tissue can be seen. Sometimes more than one screening mammogram might be done if better clarification is needed to show tumors or other abnormalities which could indicate cancer. Mammograms have proven useful in diagnosing breast cancer before any signs of the disease have become apparent.
Breast ultrasound
Ultrasound imaging can view the breast's internal structures using sound waves to produce pictures. Doctors use these images to help diagnose lumps or abnormalities in the breast. These types of breast cancer screening tests are safe and noninvasive. There is no radiation used during ultrasound imaging.
Breast MRI
MRIs are sensitive and often reveal abnormalities that end up being benign. For this reason, we recommend routine MRIs only for patients who have a higher risk of breast cancer due to dense breasts, a strong family history of breast cancer, certain genetic mutations, or a history of radiation treatment to the chest before age 30. For these patients, doctors may recommend a breast MRI in addition to mammography to screen for breast cancer. MRI is also used to evaluate patients with symptoms of breast cancer.
It is also a useful diagnostic tool for detecting breast cancer in women who have had breast implants.
How Breast Cancer is Diagnosed
DiagnosisThe technology used to diagnose breast cancer is constantly updated, and today patients have access to various diagnostic tools.
Contrast-enhanced digital mammography (CEDM) combines digital mammograms and dye-enhanced contrast imaging. Medical professionals inject a special dye called a contrast agent into the area. Cancer absorbs more of the contrast agent than healthy breast tissue, making it easier for doctors to see cancer on the mammogram. CEDM has proven helpful in screening women with a higher risk of breast cancer and those with dense breasts.
Diagnostic mammograms
Compared to screening mammograms, diagnostic mammograms can show greater detail and allow a doctor to confirm whether breast cancer is present. Diagnostic mammograms take longer because additional X-ray images are taken. Based on the results, a doctor may determine whether the abnormality is dangerous and requires a biopsy.
Breast biopsy
A breast biopsy is a minimally invasive procedure that uses a needle to extract tissue from the affected area. This tissue sample is then sent to a laboratory to be analyzed. Most biopsies result in noncancerous diagnoses.
A breast biopsy is the only way to diagnose breast cancer. Biopsies are usually sent to our in-house pathologists.
Breast cancer screening recommendations
Patients should see their doctor to review their risk information and develop an individualized plan. For some patients, screening could start at age 25 or younger. This includes:
- Those with a family history of breast cancer who have other risk factors
- Those who have verified BRCA1 or BRCA2 gene mutation or have a parent or sibling with this gene mutation have not yet been genetically tested
- Those who had radiation therapy to the chest were between the ages of 10 to 30
- Those with dense breasts
If you are less than 40 and have risk factors, you may need to begin screening mammograms earlier. The best way to determine an individualized care plan is with a breast care specialist aware of your medical and family history.
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Schedule Breast Cancer Screening at NewYork-Presbyterian
You are your own best advocate when dealing with breast cancer. If you are concerned about abnormal changes to your breasts or discover a lump, do not wait until "it goes away." Schedule an appointment at one of NewYork-Presbyterian's modern cancer treatment centers. Knowing and understanding the symptoms is essential to your survival. The earlier breast cancer is caught, the better the prognosis after treatment.