A guide to additional tests you might need after breast cancer diagnosis

Even after receiving a breast cancer diagnosis, you may need to have some more tests. There are lots of tests and some of them sound quite scary so we’ve put a list of possible tests together from our own experience and research. Not everyone will need these tests. Your breast surgeon or oncologist will tell you if you need these tests.

We’ve written this from our own experience and research that we’ve carried out as patients. Please always ask your medical team about any questions or concerns you have regarding tests – the information here is just a starting point for you to then go and find out more from your medical team.

Some of the common tests are:

1. Core biopsy/Fine needle aspiration (FNA)

This is a test carried out on any suspicious areas in your breast/surrounding area as part of the diagnosis process. For more information see the Breast Cancer Now page on this test.

2. Sentinel node biopsy

This is a surgical procedure done under a general anesthetic, most often done at the same time as breast surgery. It is carried out by a needle to test the lymph nodes for cancer cells and thus whether the cancer has spread from your breast to your lymph nodes. For more information see the Breast Cancer Now page on this test.

3. Stereotactic biopsy

This is a biopsy done under mammogram control.

4. MRI guided biopsy

This is a biopsy done under MRI guidance but these are not common place.

5. Oncotype DX test 

Some breast cancers do not require chemotherapy. Your oncologist may carry out this test to see whether you would benefit from chemotherapy. See the Breast Cancer Now page on this test.

6. Pathology report

When you have your surgery to remove your tumour and lymph nodes (if appropriate for your treatment) a pathologist will analyse the tissue to ascertain more information about your cancer. The type of information that can be gathered from the pathology report is:

• Tumour type
• Tumour grade
• Tumour size
• Whether all cancer has been removed during surgery (the margin status)
• If there are any cancer cells in the lymph or blood vessels
• If any of the lymph nodes under the arm contain cancer cells
• If hormones are helping the cancer to grow (see section below)
• If the cancer is HER2 positive or negative (see section below)

For more information see the Breast Cancer Now page on the pathology report.

Further information

A good place to find out more about the sorts of tests that you may undergo after a diagnosis of breast cancer is to get a copy of the book “The Complete Guide to Breast Cancer” by Professor Trisha Greenhalgh and Dr Liz O’Riordan (breast cancer professionals who have also had breast cancer). Their book is full of helpful information about going through breast cancer and understanding the medical side of things.

SNB: Choose the “surgery to the lymph nodes” link from the menu in this link on the Breast Cancer Now website.

BRCA test: The Royal Marsden website has a “Beginner’s Guide to BRCA1 and BRCA2” (visit their site and search for this)

Oncotype DX Test: Information on the Breast Cancer Now website

NHS information on genetic testing.

Future Dreams hold a range of support groups, classes, workshops and events to help you and your carers during your breast cancer diagnosis. These are held both online and in person at the London-based Future Dreams House. To see what’s on offer and to book your place, see here.

To return to the homepage of our Information Hub, click here where you can access more helpful information, practical advice, personal stories and more.

Reviewed February 2023

Unless otherwise stated, the information and content provided on this page has been written from a patient’s perspective then reviewed by a breast care nurse and it is intended for information and educational purposes only. It is not intended to substitute for professional medical advice. Please contact your medical team for advice on anything covered in this article and/or in relation to your personal situation. The links and/or recommendations in this article to third-party resources are for your information and we take no responsibility for the content contained in those third-party resources.