Regardless of your risk of breast cancer, it is important to talk with your healthcare provider about the best screening tests, recommendations, and timelines for screening.

Table of Contents

Use these links to jump to the breast cancer screening information you need:

What is Breast Cancer Screening?
Breast Cancer Screening Recommendations
Breast Cancer Screening Tests
Breast Cancer Diagnostic Tests
Benefits and Risks of Breast Cancer Screening
Breast Cancer Screening for Men
Breast Cancer Screening Facts
Breast Cancer Screening FAQs

What is Breast Cancer Screening?

Breast cancer screening can detect breast cancer before it has spread and before there are symptoms to help reduce the number of people who die from cancer. Screening can also identify those who may need more frequent or additional tests to check for breast cancer.

There are different types of breast cancer screening tests, as well as different age recommendations to begin screenings. The different tests and recommendations are listed below, and you can also check with your doctor to determine which screenings are right for you and at what ages.

The more you know about breast cancer screening, the more you can take charge of your breast health.

Breast Cancer Screening Recommendations

The U.S. Preventative Services Task Force states that women should start receiving mammograms at the age of 40. However, women at higher risk of developing breast cancer may benefit from beginning regular mammography earlier than the age of 40. Family health history can inform the decision to undergo earlier breast cancer screening.

Below are general breast health screening recommendations for women at average risk of breast cancer. Please consult with your healthcare provider on when is the best time for you to begin breast health screenings based on your specific situation and any risk factors that may be present.

High Risk Breast Cancer Screening

Women at higher risk for breast cancer can benefit from screening at an earlier age, as well as from annual breast MRIs in addition to mammography. The American Cancer Society recommends most women at high risk begin screening at age 30, or upon your doctor’s recommendation.

Your doctor can help you assess if you are at higher risk of developing breast cancer. Risk factors include a personal or family history of breast cancer, a BRCA1 or BRCA2 inherited gene mutation, previous radiation to the chest area, and other gene mutations or health conditions.

In addition, breast cancer screening for dense breasts can be more challenging. The Food and Drug Administration (FDA) now requires mammogram providers to notify women if they have dense breast tissue and recommend consultation with a healthcare provider on potential additional screening, since dense breast tissue can make it more difficult to spot breast cancer.

Breast cancer screening after mastectomy is not needed on the side of the body where breast tissue was removed; breast cancer screening after double mastectomy should no longer be required since there likely won’t be enough breast tissue remaining for a mammogram.

Talk with your doctor or healthcare provider to assess breast cancer risk and determine the best age for you to begin breast cancer screening.

Breast Cancer Screening Tests

Although there are several types of breast cancer screening tests available, mammography is the most common and most accurate form of screening.

Breast Self-Exam

A breast self-exam involves looking at and feeling your breasts for potential lumps or swelling. If you are familiar with how your breasts typically look and feel, you will be more likely to notice any changes.

A breast self-exam should be performed once a month by all women. Premenopausal women should perform their self-exam the week after their cycle. Postmenopausal women should choose a consistent time each month to perform their self-exam.

While the majority of breast lumps are not breast cancer, all breast lumps should be investigated by a healthcare professional. If you’re not sure how to perform a breast self-exam, download the Know the Symptoms Guide for instructions. 

Clinical Breast Exam

During a clinical breast examination, a healthcare professional carefully looks and feels for any differences in breast shape and size, as well as lumps, dimpling, rashes, or anything else unusual. Clinical breast exams are often performed during your annual medical check-up or well-woman exam, beginning around the age of 20.

Mammogram

A low-dose x-ray of the breasts, mammograms are the best way to find breast cancer in its early stages. Mammograms can often find breast cancer or breast changes long before symptoms develop. If something is detected on an annual mammogram, typically known as a screening mammogram, additional tests, such as a diagnostic mammogram, will likely be ordered.

Mammograms are performed with a machine that has two plates that compress the breast and spread the tissue apart, providing a clearer picture of the breast.

2D screening mammography, which typically takes one picture of the breast from the side and one from above, was the standard for many years.

Today, 3D mammograms, also known as digital breast tomosynthesis, are more common and more accurate at detecting breast cancer. They also work well for women with dense breast tissue and reduce the need for follow-up screening. A more advanced type of imaging, a 3D mammogram takes multiple images of the breast from different angles. Not every insurance plan covers 3D mammography, although more are now doing so.

NBCF offers a free Mammogram 101 resource that helps you prepare for your mammogram.

Breast Cancer Diagnostic Tests

MRI

A breast MRI uses radio waves and magnets to take pictures of the breast and may be used in conjunction with mammograms for women at higher risk of breast cancer or those who have dense breast tissue. Likewise, if your initial breast screening exam is not conclusive, your doctor may order an MRI to take a closer look.

Breast MRI imaging creates detailed pictures of specific areas within the breast that can help your medical team distinguish between normal and potentially cancerous tissue.

Ultrasound

Sometimes used in conjunction with other breast cancer screening tests, a breast ultrasound uses sound waves to view the inside of the breasts. The ultrasound generates a picture called a sonogram, which can help measure the size and location of a lump and determine if it is a cyst, which is not typically cancerous, or a cancerous tumor.

Genetic Screening

Genetic screening for breast cancer scans for mutations in the BRCA1 and BRCA2 genes. Some people inherit mutations in these genes, which can increase their risk of breast cancer as well as ovarian and pancreatic cancer.

Women with a family history of breast cancer are also at higher risk of getting breast cancer; however, most women with a family history of breast cancer do not have an inherited gene that increases their risk. It is important to weigh the pros and cons of genetic testing and screening with your family and doctor. To keep track of your family medical history to share with family members and your healthcare team, use NBCF’s free Family Medical History Checklist.

Benefits and Risks of Breast Cancer Screening

As with many medical tests, there are both benefits and risks. However, the benefits of breast cancer screening far outweigh the risks.

Benefits of Screening 

The most significant benefit of breast cancer screening is reduced mortality. Women who receive annual mammograms from the ages of 40 to 84 experience a 40% lower breast cancer mortality rate than women with no screenings, according to research. Mammograms also decrease the number of women diagnosed with cancer in a later stage, when it is more difficult to treat and more likely to have spread.

Regular breast cancer screening also decreases healthcare costs, since cancer diagnosed at an earlier stage is usually less expensive to treat. Finally, breast cancer screening can provide peace of mind and a reminder of the importance of focusing on overall health and wellness.

Risks of Screening

The chief risk of screening is a false positive result, and the anxiety that may cause. A false positive is when something may initially look like cancer, but turns out not to be cancer upon further examination. Initial false-positive results may lead to additional testing, such as a biopsy, and can create unwarranted anxiety.

However, with recent advancements in mammogram technology, radiologists consider the risk of a false positive to be relatively small. The general consensus is that most women and doctors are willing to risk the small chance of a false positive over missing something suspicious found on a routine mammogram.

Radiation can be risky for women who are pregnant. Pregnant women should always let their doctor or x-ray technician know that they are expecting since pregnant women should limit or forgo any screenings or treatments involving radiation.

While no screening test is 100% accurate, regular mammograms have been repeatedly shown to significantly reduce the risk of dying from breast cancer.

Breast Cancer Screening for Men

Currently, there are no guidelines on screening men for breast cancer, and male breast cancer remains extremely rare, representing less than 1% of all breast cancer cases.

It is generally easier for men and their healthcare providers to feel a breast tumor since men have little breast tissue, yet men with breast cancer have a higher mortality rate than women due to lower awareness and likelihood of seeking treatment. Breast exams and occasionally mammograms and ultrasound may be appropriate for men who have a strong family history of male or female breast cancer or who have BRCA gene mutations.

Breast Cancer Screening Facts

In the United States, 1 in 8 women will develop breast cancer in her lifetime. It is the second most common type of cancer for women, following skin cancer.

About 65% of breast cancer cases are diagnosed in the localized stage, before the cancer has spread outside of the breast. The 5-year relative survival rate for breast cancer detected at this stage is 99%, which is why awareness and regular screenings are so critically important.

Unfortunately, there are notable disparities in breast cancer screening. Nearly half of uninsured women delay or go without care due to costs. In addition, the death rate for breast cancer among Black women is 40% higher than it is for white women, and it is the leading cause of cancer death for Hispanic women in the United States.

National Breast Cancer Foundation shares the latest statistics on breast cancer and breast cancer disparities. In addition, NBCF’s National Mammography Program provides resources on free mammograms and diagnostic services.

Breast Cancer Screening FAQs

When should you start screening for breast cancer? 

Well-woman exams, which can include clinical breast exams, and Pap tests are recommended starting at age 20.

Mammograms are recommended starting at age 40 for women of average breast cancer risk. However, if you have a significant family history of breast cancer, such as one or more first-degree relatives diagnosed with breast cancer, or a first-degree relative diagnosed under the age of 50, then you may need to begin screening earlier. For example, if a mother was diagnosed with breast cancer at age 42, her biological daughter would likely benefit from breast cancer screening beginning at age 32. Talk with your healthcare provider about the best schedule for mammograms.

What are the screening tests for breast cancer?

In addition to mammograms, which are the best screening tests for finding breast cancer in its early stages, other screening tests for breast cancer include breast self-exams and clinical exams. Other forms of imaging studies for screening include ultrasounds and breast MRIs.

Can men get breast cancer? 

While it is rare, men do get breast cancer. In 2023, an estimated 2,800 men will be diagnosed with breast cancer, according to the American Cancer Society. Men diagnosed with breast cancer may be encouraged to undergo genetic counseling and genetic testing to see if they carry a BRCA1 or BRCA2 gene mutation. The most common gene mutation for men is BRCA2.

What is the risk of radiation from mammograms?

Mammograms require very small doses of radiation, lower than that of a typical x-ray. The total radiation for a typical mammogram is about 0.4 millisieverts—the same amount women are exposed to in their natural environment in about seven weeks. Studies consistently show that the benefits of receiving mammograms outweigh the risks of radiation exposure for most women. However, always let your healthcare provider know if you are pregnant or could be pregnant as radiation exposure risk for pregnant women is higher.

Sources:

American Cancer Society
Centers for Disease Control and Prevention
National Cancer Institute
U.S. Preventative Services Task Force

The post Breast Cancer Screening appeared first on National Breast Cancer Foundation.

A mammogram is an x-ray of the breast. While screening mammograms are routinely performed to detect breast cancer in women who have no apparent symptoms, diagnostic mammograms are used after suspicious results on a screening mammogram or after some signs of breast cancer alert the physician to check the tissue.

Such signs and symptoms may include:

• A lump
• Breast pain
• Nipple discharge
• Thickening of skin on the breast
• Changes in the skin texture, such as dilation (or enlargement) of the pores of the breast
• Changes in the size or shape of the breast

A diagnostic mammogram can help determine if these symptoms are indicative of the presence of cancer. As compared to screening mammograms, diagnostic mammograms provide a more detailed x-ray of the breast using specialized techniques. They are also used in special circumstances, such as for patients with breast implants. 

Beginning in late 2024, radiologists will be required to report the degree of density found within your breast tissue. Highly dense breast tissue is considered a risk factor for developing breast cancer. Having dense breast tissue can also make mammogram images harder to read and interpret. If you have dense breast tissue, you should discuss additional imaging studies, such as ultrasound or breast MRI, with your healthcare provider.

What’s Involved In A Diagnostic Mammogram?

If your doctor prescribes a diagnostic mammogram, realize that it will take longer than a normal screening mammogram, because more x-rays are taken, providing views of the breast from multiple vantage points. The radiologist performing the test may also zoom in on a specific area of the breast where there is a suspicion of an abnormality. This will give your doctor a better image of the tissue to arrive at an accurate diagnosis.

In addition to finding tumors that are too small to feel, mammograms may also spot ductal carcinoma in situ (DCIS). These are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.

These abnormal cells do not appear as a mass at all. Instead, they look like tiny grains of sand called microcalcifications. If these microcalcifications are grouped together and/or are in a row, this is a sign they might be DCIS. Not all DCIS findings progress into invasive cancer. There are studies currently being done to help determine which DCIS findings turn into invasive cancer to help physicians plan what treatment is best for a woman’s specific findings of DCIS inside the duct of the breast.

How Reliable Are Mammograms For Detecting Cancerous Tumors?

The ability of a mammogram to detect breast cancer may depend on the size of the tumor, the density of the breast tissue, and the skill of the radiologist performing and reading the mammogram. Mammography is less likely to reveal breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Likewise, a tumor appears white on a mammogram, making it hard to detect.

There have been wonderful improvements in the last 20 years regarding mammogram technology. Today, it is best to get a 3D mammogram also known as tomosynthesis. This type of modern mammogram machine detects breast cancer 28% more accurately than older X-ray analog mammograms.

You can call our mammography facility beforehand to find out if they perform 3D mammography. You may also ask if the radiologist is a breast imaging radiologist. This also contributes to getting an accurate reading of your mammogram.

If you had prior mammograms done at a different facility, get those mammograms either sent to the new facility where you are going or pick them up yourself and take them there. It is important for the radiologist to always compare prior mammograms to the most recent one.

Materials on this page are courtesy of:

• National Cancer Institute
• Centers for Disease Control and Prevention

The post Diagnostic Mammogram appeared first on National Breast Cancer Foundation.

When a suspicious area is detected in your breast through a breast self-exam or on a screening mammogram, your doctor may request an ultrasound of the breast tissue. A breast ultrasound is a scan that uses penetrating sound waves that do not affect or damage the tissue and cannot be heard by humans. The breast tissue deflects these waves causing echoes, which a computer uses to paint a picture of what’s going on inside the breast tissue (no radiation is involved). A mass filled with liquid (which is a benign cyst) shows up differently than a solid mass.

Ultrasound Results: Breast Sonogram

The detailed picture generated by the ultrasound is called a “sonogram.” Ultrasounds are helpful when a lump is large enough to be easily felt, and the images can be used to further evaluate the abnormality.

A breast ultrasound can provide evidence about whether the lump is a solid mass, a cyst filled with fluid, or a combination of the two. While cysts are typically not cancerous, a solid lump may be a cancerous tumor. Healthcare professionals also use this diagnostic method to help measure the exact size and location of the lump and get a closer look at the surrounding tissue. If it is determined that the lump is cancer, the measurement on imaging determines its “clinical” stage.

Abnormal mammogram result? Be informed and ask the right questions.

If your mammogram screening was abnormal, don’t panic. The free resource, Abnormal Mammograms and What to Do Next, details the different kinds of tests you may need and includes a list of specific questions to ask your doctor at your next appointment. Be prepared to understand your results and empowered with critical information about your next steps.

Where can we send your free guide?

Materials on this page courtesy of National Cancer Institute

The post Ultrasound appeared first on National Breast Cancer Foundation.

How Does A Breast MRI Help To Diagnose Breast Cancer?

During diagnostic examinations, it is helpful to get a variety of images and perspectives. If your initial exams are not conclusive, your doctor may recommend a breast MRI (magnetic resonance imaging) to assess the size and specific location within the breast. An MRI can also identify any other abnormal findings within the breast.

During a breast MRI, a magnet connected to a computer transmits magnetic energy and radio waves (not radiation) through the breast tissue. It scans the tissue, making detailed pictures of areas within the breast. These images help the medical team distinguish between normal and diseased tissue.

Dense Breast Tissue

For women with very dense breast tissue and a family history of breast cancer, it is standard of care to get a breast MRI done annually, as well as a mammogram annually, rotating these imaging studies every 6 months (mammogram, then 6 months later a breast MRI, then 6 months later a mammogram, etc.).

Beginning in late 2024, radiologists will be required to report the degree of density found within a woman’s breast tissue since highly dense breast tissue is considered a risk factor for developing breast cancer. Having dense breast tissue can also make mammogram images harder to read and interpret, which is why additional testing is often required for women with dense breast tissue.

Abnormal mammogram result? Be informed and ask the right questions.

If your mammogram screening was abnormal, don’t panic. The free resource, Abnormal Mammograms and What to Do Next, details the different kinds of tests you may need and includes a list of specific questions to ask your doctor at your next appointment. Be prepared to understand your results and empowered with critical information about your next steps.

Where can we send your free guide?

Material on this site courtesy of:

• Centers for Disease Control and Prevention
• National Cancer Institute

The post MRI appeared first on National Breast Cancer Foundation.

Core-needle and surgical biopsies are most commonly used on the breast.

There are several factors that help a doctor decide which type of biopsy to recommend. These include the appearance, size, and location of the suspicious area on the breast.

What is fine-needle aspiration?

In most cases, a fine needle aspiration is chosen when the lump is likely to be filled with fluid. If the lump is easily accessible or if the doctor suspects that it may be a fluid-filled cystic lump, the doctor may choose to conduct a fine-needle aspiration (FNA). During this procedure, the lump should collapse once the fluid inside has been drawn and discarded. Sometimes, an ultrasound is used to help your doctor guide the needle to the exact site, whereby sound waves create a picture of the inside of the breast.

If the lump persists, the surgeon or radiologist, a doctor who specializes in medical imaging such as x-rays and mammograms, will perform a fine needle aspiration biopsy (FNABx), a similar procedure using the needle to obtain cells from the lump for examination.

What is a core-needle biopsy?

Core needle biopsy is the procedure to remove a small amount of suspicious tissue from the breast with a larger “core” (meaning “hollow”) needle. It is usually performed while the patient is under local anesthesia, meaning the breast is numbed. During the procedure, the doctor may insert a very small marker inside the breast to mark the location of the biopsy. If surgery is later required, the marker makes it easier for the surgeon to locate the abnormal area. Even if no further treatment such as surgery is needed, the marker allows a breast imaging radiologist to see on future mammograms where the biopsy was done.

The radiologist or surgeon performing the core-needle biopsy may use specialized imaging equipment to guide the needle to the desired site. As with fine-needle aspiration, this may involve ultrasound.

During an ultrasound-guided core needle biopsy, the patient lies down while the doctor holds the ultrasound against the breast to direct the needle. On the other hand, during a stereotactic-guided core-needle biopsy, the doctor uses x-ray equipment and a computer to guide the needle. Typically, the patient is positioned lying on the stomach on a special table that has an opening for the breast, and the breast is compressed, similar to a mammogram.

Occasionally, no imaging equipment is used, but this is typically only in cases where the lump can be felt through the skin. This type of procedure is called a freehand core-needle biopsy.

There are fewer side effects associated with a core-needle biopsy than with surgical biopsy.

What is a surgical biopsy?

(Also known as “wide local excision,” “wide local surgical biopsy,” “open biopsy,” or “lumpectomy”)

As with a core-needle biopsy, a surgical biopsy is done while the patient is under local anesthesia, or general anesthesia in some cases. Typically, this test is performed in a hospital setting where an IV and medications are administered to make the patient drowsy.

The surgeon makes a one- to two-inch cut on the breast and then removes all or part of the abnormal lump and often a small amount of normal-looking tissue, known as the “margin.” If the lump cannot be easily felt but can be seen on a mammogram or ultrasound, a radiologist may insert a thin wire to mark the suspicious spot prior to the surgeon performing the biopsy. Once again, a marker is usually placed internally at the biopsy site at the conclusion of the procedure.

What is a skin punch biopsy?

This type of biopsy is performed when there is a rash or reddened area of the breast skin that is determined not to be associated with mastitis (a breast infection usually associated with breastfeeding) or dermatitis (an allergic reaction to things like soap, detergent, or perfume). In a skin punch biopsy, a tiny device that resembles a cookie cutter is used to remove a very small sample of breast skin and the tissue immediately under the skin. The pathologist can then determine if the findings are a very rare form of breast cancer called inflammatory breast cancer (IBC). Only 3% of breast cancers are IBC. However, IBC is an aggressive form of breast cancer that warrants immediate treatment.

What Can Be Learned From The Biopsy Results?

Once the biopsy is complete, a specially trained doctor called a pathologist examines the tissue or fluid samples under a microscope, looking for abnormal or cancerous cells. The pathology report, which can take one or two weeks to complete, is sent to the patient’s doctor. It indicates whether the suspicious area is cancerous and provides a full picture of your situation. For the patient, waiting for results can be a real challenge, but being able to make an informed decision regarding your treatment is well worth it. Your doctor will go over the report with you and, if necessary, discuss the treatment options.

If no cancer cells are found, the report will indicate that the cells in the lump are benign, meaning non-cancerous. However, some type of follow-up or treatment may still be needed, as recommended by the healthcare professional.

If cancer cells are found, the report will provide more information to help determine the next steps.

The report for a core-needle biopsy sample will include tumor type and the tumor’s growth rate or grade. If cancer is found, the pathologist will also perform lab tests to look at cells for estrogen or progesterone receptors.

In the case of a surgical biopsy, the results reveal data about the type, grade, and receptor status of the tumor, as well as the distance between the surrounding normal tissue and the excised tumor. The margin, as we mentioned earlier, shows whether the site is clear of cancer cells.

A positive margin means cancer cells are present at the margin of the tumor. In cases of positive margins, the cancer has spread beyond the immediate area.

A negative margin or clear margin indicates there are no tumor cells at the margin. That means the cancer is contained in the area nearest to the tumor.

A close margin means that the space between the cancerous tissue and surrounding normal tissue is less than about 3 millimeters (0.118 inch).

If you have a biopsy resulting in a cancer diagnosis, the pathology report will help you and your doctor talk about the next steps. You will likely be referred to a breast cancer specialist, and you may need more scans, lab tests, or surgery. Your medical team uses the pathology report and the results of the other tests to determine the stage of cancer and to design the best treatment plan for you.

Material on this page courtesy of:

• Centers for Disease Control and Prevention
• Agency for Healthcare Research and Quality

The post Breast Biopsy appeared first on National Breast Cancer Foundation.

If you are diagnosed with breast cancer, your doctor will order additional lab tests to assist with prognosis. The two most common lab tests are the hormone receptor test and the HER2/neu test. Results from these tests can provide insight into which cancer treatment options may be most effective for you.

Testing The Tumor Cells For Hormone Receptors

A hormone receptor is a specialized protein located on the surface of or within a cell. The receptor binds to the female hormones estrogen and progesterone, which flow through the blood. Once bound, the hormone signals the cell to start growing and multiplying. 

Many breast cancer tumors contain hormone receptors, often in large numbers. When hormone receptors are present, estrogen and/or progesterone can fuel the growth of the cancer. Such hormone-dependent cancers often respond well to hormone therapy, which differs from hormone replacement therapy (HRT). If neither estrogen receptors (ER) nor progesterone receptors (PR) are present, the cancer is said to be “hormone-receptor-negative,” and hormone therapy would likely be ineffective. Knowing whether the cancer cells have hormone receptors can be valuable to your medical team and your treatment plan.

Who Needs Hormone Receptor Testing?

Hormone receptor testing is generally recommended for all breast cancers, including DCIS. If your doctor orders this test, you may be asked to discontinue taking any prescribed hormones for a period of time before the breast tissue sample is obtained. Usually, the sample comes from a biopsy, but the test may also be performed on tissue removed during a lumpectomy or mastectomy. It is standard of care however to obtain these types of pathology results on biopsy tissue.

How Does The Test Work?

The testing lab typically uses a specialized staining process on the breast tissue sample to see if hormone receptors are present. The technical name for this procedure is an “immunohistochemical staining assay” or an “ImmunoHistoChemistry (IHC).” Findings will be included in a pathology report given to your doctor.  If the cancer is deemed “estrogen-receptor-positive” (ER+), its cells have receptors for the estrogen hormone. That means that the cancer cells likely receive signals from estrogen to promote growth. About two out of every three breast cancers contain hormone receptors.

If the cancer is progesterone-receptor-positive (PR+), its cells have receptors for progesterone. This hormone could then promote the growth of the cancer. 

The cancer cells being estrogen and/or progesterone receptor-positive (hormone positive) is a good prognostic factor to have, usually leading to a better prognosis.

What do the results of hormone testing mean?

Breast cancer patients who test positive for both estrogen receptors and progesterone receptors usually have a better-than-average prognosis for survival and a complete recovery than those who have no receptors present. Also, the more receptors and the more intense their reaction, the better they respond to hormone therapy. Patients with one type of receptor but not the other may still reap benefits from this form of treatment, but likely not to the same degree. As mentioned earlier, if the cancer is both ER- and PR-negative, it probably won’t respond to hormone therapy. Typical response rates to hormone therapy are as follows:

• ER and PR positive: 75-80%
• ER positive and PR negative: 40-50%
• ER negative and PR positive: 25-30%
• ER negative and PR negative: 10% or less

HER2/neu Test

Similar to the hormone receptor test, the HER2/neu test looks for a specific kind of protein that is found with certain types of cancer cells and the gene that produces it. The formal name of that gene is the human epidermal growth factor receptor 2, and it makes HER2 proteins. These proteins are receptors on breast cells.

In a sense, genes contain the formula for the number and combination of proteins a cell needs to remain healthy and function properly. Certain genes and the proteins they create can determine how breast cancer progresses, as well as how it responds to various types of treatment. 

What is a HER2 receptor and how does it relate to breast cancer?

Healthy HER2 receptors are the proteins that help manage how a breast cell grows, divides, and repairs itself.  However, in about a quarter of all breast cancer patients, the HER2 gene isn’t functioning properly. It makes an excess number of copies of itself in a process known as “HER2 gene amplification.” Then these extra genes instruct the cells to make too many HER2 receptors, which is called “HER2 protein overexpression.” The ultimate result is that breast cells grow and divide in an uncontrolled fashion. 

The HER2/neu test can discover whether the sample is normal or whether it has too much of the HER2/neu protein or an excessive number of copies of its gene. If you have been diagnosed with invasive breast cancer or have had recurrent breast cancer, your doctor may recommend this test. It will help your oncology team determine your prognosis, characteristics of the tumor including how aggressive the tumor is likely to be, and the best treatment options. 

This test is often ordered in conjunction with the hormone receptor test. Typically, the breast cancer tissue sample from a biopsy or the tumor removed during a mastectomy is used. This test can take about a week to get the pathology results back, whereas determining if the cells are cancer usually is known in just a day or two.

What will the HER2/neu results tell me?

There are four tests for HER2, and results of these may appear on your pathology report, which may take several weeks to come back.

The first one is the IHC test, which is short for “ImmunoHistoChemistry.” It looks at whether there is excess HER2 protein in the cancerous cells. A result of 0 or 1+ indicates there is no excess, 2+ is borderline, and 3+ means the cells test positive for HER2 protein overexpression.

The remaining three tests all examine if the cells contain too many copies of the HER2 gene. These tests include:

• The FISH test (“Fluorescence In Situ Hybridization”)
• The SPoT-Light HER2 CISH test (“Subtraction Probe Technology Chromogenic In Situ Hybridization”)
• The Inform HER2 Dual ISH test (“Inform Dual In Situ Hybridization”)

There are three possible results for these tests: positive (meaning HER2 gene amplification), negative (indicating the number of HER2 genes is not excessive), or low (provides some patients with advanced breast cancer the opportunity to receive therapy that is specific for HER2/neu positive breast cancer patients).

In the pathology report, breast cancers with HER2 protein overexpression and HER2 gene amplification are called HER2-positive. This type of cancer often grows faster, spreads to other areas more readily, and has a higher likelihood of recurring versus HER2-negative breast cancer. 

When all three of the tests come back negative for receptors for hormones (progesterone and estrogen) and negative for HER2, triple negative breast cancer may be the diagnosis.

Materials on this page courtesy of:

• Agency for Healthcare Research and Quality
• National Cancer Institute
• BreastCancer.org

The post Lab Tests appeared first on National Breast Cancer Foundation.

Waiting for the results of biopsy testing, scans, or lab tests can understandably weigh heavily on your mind. Some people cope by educating themselves and trying to map out their possible options; others reduce stress by distracting themselves with whatever feels fun; still others find the waiting time provides the opportunity to assess their priorities or deepen meaningful relationships.

Regardless of the balance that works best for you, here are a few thoughts of hope to keep in mind.

• Only about 20% of all breast tumors are cancerous.
• Most cancerous tumors are highly treatable.
• Cancer treatment opportunities are continually improving.

Some Practical Tips For The Wait

• Evaluate how you are spending your emotional energy and reduce “optional” stress.
• Continue with your normal routine, including going to work.
• Treat yourself to healthy food.
• Go for a walk or continue to get exercise if you can.
• Seek support from others who have been in similar situations. 
• Calm your mind with meditation, prayer, or thoughts that bring you a sense of peacefulness.

Signs That May Indicate It’s Time To Learn Some New Coping Skills

Obsession. If you find yourself obsessing about cancer, it may be time to intentionally back off from the intensity.

If you’re losing sleep, neglecting self care, unable to care for your children, “awfulizing,” or spending several hours online researching, it might be time to step away for a while. Take breaks!

Avoidance. Don’t diagnose yourself, delay, or avoid recommended tests and treatment.

If your physician has ordered more tests, it is because he or she feels the need to gather more facts. If treatment or further testing is recommended, it’s in your best interest to respond promptly.

Feeling overwhelmed with advice. Don’t assume anyone else’s situation or story will be identical to yours.

You have the right to be discerning about when and how you get your advice, although well-meaning friends and acquaintances may be drawn to share their positive and negative experiences, you can listen to your own emotions. It’s always okay to say when you’ve had enough.

Hopelessness or Despair. Notice depression.

If you find yourself experiencing symptoms of depression, be sure to let your healthcare provider know. Although sadness, anxiety, and grief are natural emotions at this time, do your best to cultivate hope and keep it alive inside you.

Abnormal mammogram result? Be informed and ask the right questions.

If your mammogram screening was abnormal, don’t panic. The free resource, Abnormal Mammograms and What to Do Next, details the different kinds of tests you may need and includes a list of specific questions to ask your doctor at your next appointment. Be prepared to understand your results and empowered with critical information about your next steps.

Where can we send your free guide?

Material on this page courtesy of:

• Johns Hopkins Medicine
• Agency for Healthcare Research and Quality

The post Waiting For Results appeared first on National Breast Cancer Foundation.