Diagnosis

More tests after diagnosis

Posted by Sara Liyanage on 10 April 2022

The whirlwind of a breast cancer diagnosis may lead to more tests. Some tests that you may have to undergo, or that you may hear about, are listed below. This is not a complete list. Not everyone will need these tests. Your breast surgeon or oncologist will tell you if you need these tests. Please always ask your medical team about any questions or concerns you have regarding test – 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 that you might undergo are the following:

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.

Sentinel node biopsy

This is carried out by a needle test or by surgery 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.

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.

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.

Genetic testing

With thanks to Luca Jahreiss, PhD of Ancora.ai for providing the following explanations of genetic testing for breast cancer:

There is no one-size-fits-all approach to treating breast cancer, so it is key for your doctor(s) to have a detailed diagnosis of your specific cancer to choose the most appropriate treatment. As your cancer may continue to evolve, it will also have to be reevaluated every so often as well.

Genetic testing is a key aspect of a comprehensive breast cancer diagnosis, as there are now a number of breast cancer treatments available that target cancer cells with specific genetic mutations/alterations. Should you be eligible for a targeted treatment, this could mean not having to undergo chemotherapy or at least less of it, thereby experiencing less side-effects.

Genetic tests might only look for a very specific mutation or across a whole panel of genes that have previously been implicated in cancer (there are number of different ones available, e.g. Oncotype Dx, Guardant 360, FoundationOne CDx).  What all those tests have in common is that you will have to provide some DNA (via a saliva or blood sample) and then wait for a few weeks to get the results.  See the article from Ancora about genetics testing here.

Helpful resources and information

The absolute best 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.

The information and content provided on this page is intended for informational and educational purposes only and is not intended to substitute for professional medical advice.

Reviewed April 2022

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