Tests required to detect breast cancer are as follows:
1). FNAC ( Fine Needle Aspiration Cytology)
It is a needle test carried out often in the clinic or under ultrasound guidance.
It is a quick procedure, not requiring anaesthesia and gives us a quick result.
Though the test is sensitive, a negative FNAC test does not rule out breast cancer in the presence of strong clinical suspicion.
2.) Trucut / Core Needle Biopsy:
This test uses a slightly thicker needle to remove small cores of tissue and is carried out under local anaesthesia.
A core biopsy gives us a more certain diagnosis of breast cancer and also gives information about the type of cancer. The additional tests performed on the core samples also help us in guiding treatment.
A core biopsy is very important in patients in whom neoadjuvant therapy is being considered, as we know the exact diagnosis and sometimes, the tumour completely disappears post therapy.
1). Mammography + Ultrasound of the breasts:
A basic and the most important investigation to rule out breast cancer.
A well-performed mammogram with a correlating ultrasound will be able to rule out breast cancer in the majority of women.
However, a mammogram may not be able to pick up suspicious lesions in younger women, as they have denser breasts and may require additional evaluation with a Breast MRI.
2). Breast MRI:
A highly specialised test, it is carried out for specific indications only. It is carried out in younger patients as part of the high-risk screening, patients with suspected breast cancer but not seen very clearly on a mammogram, patients with silicone implants, in patients with symptomatic nipple discharge and in patients with suspected bilateral or multifocal or multicentric breast cancer.
3). PET- CT:
This test is specifically carried out to rule out disease spread, before starting treatment and to assess the response of neoadjuvant chemotherapy in locally advanced breast cancers.