Professor Zoe Winters PhD (Oxon), FRCS (Edin), FCS (SA) SFHEA
Diagnosing and treating
If you notice any symptoms of breast cancer, such as an unusual lump in your breast or any change in the appearance, feel or shape of your breasts as described ealier, see your GP as soon as possible.
Your GP will examine you and, if they think your symptoms need further assessment, they will refer you to a specialist breast cancer clinic/breast cancer Consultant. You can choose your preffered Consultant Surgeon at this point.
If you have suspected breast cancer, either due to your symptoms or because your mammogram has shown an abnormality, you will be referred to a specialist breast cancer clinic for further tests.
Mammography and breast utrasound
If you have symptoms and have been referred by your GP, you will have a mammogram to produce an X-ray of the breasts. You may also need an ultrasound scan. If your cancer was detected through the NHS Screening Programme, you may need to have another mammogram or ultrasound scan.
If you are under 35, your surgeon may suggest that you have a breast ultrasound scan only. Younger women have denser breasts, which means a mammogram is not as effective at detecting cancer.
Ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts. The image produced will show any lumps or abnormalities that are present in your breasts. Your surgeon may also suggest a breast ultrasound if they need to know whether a lump in your breast is solid or contains liquid.
A biopsy involves taking a sample of tissue cells from your breast and testing them to see if they are cancerous. You may also need to have a scan and a needle test on the lymph nodes in your armpit (axilla) to see if these are also affected. Biopsies can be taken in different ways and the type you have will depend on what your doctor knows about your condition. The different methods of carrying out a biopsy are outlined below.
Needle aspiration may be used to test a sample of your breast cells for cancer or to drain a benign cyst (a small fluid-filled lump). Your doctor will use a small needle to extract a sample of cells, without removing any tissue.
Needle biopsy is the most common type of biopsy. A sample of tissue is taken from a lump in your breast using a large needle. You will have a local anaesthetic, which means that you will be awake but your breast will be numb. Your doctor may suggest that you have a guided needle biopsy (usually this is guided by ultrasound or X-ray but sometimes MRI is used) to obtain a more precise and reliable diagnosis of cancer and to distinguish it from any non-invasive change, in particular ductal carcinoma in situ (DCIS).
Patients with cancer will be cared for by a multidisciplinary team (MDT). This is a team of specialists who work together to provide the best treatment and care.
The team often consists of a specialist cancer surgeon, an oncologist (a radiotherapy and chemotherapy specialist), a radiologist, pathologist, radiographer, reconstructive breast surgeon and a specialist nurse. Other member may include a physiotherapist, dietitian and occupational therapist, and you may have access to clinical psychology support.
When deciding what treatment is best for you, your Consultant will consider:
You can discuss your treatment with your care team or breast cancer Consultant at any time and ask any questions.
The main treatments for breast cancer are:
You may have one of these treatments or a combination. The type of treatment or the combination of treatments will depend on how the cancer was diagnosed and the stage it is at. Breast cancer that has been diagnosed at screening may be at an early stage, but breast cancer diagnosed when you have symptoms may be at a later stage and require a different treatment. Your Consultant surgeon will discuss with you which treatments are most suitable.