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Breast cancer diagnosis
Breast examination:
Investigations:
Biopsy
Sentinel Node Biopsy Lymphoedema, Axillary web syndrome
Imaging:
Health professional examination: A woman should have a breast exam as part of her periodic (annual) check-up.
Biopsy is the removal of tissue for examination by a pathologist to make a diagnosis.
A needle biopsy involves taking a core of a lesion by inserting a hollow needle into the lesion.
When a woman has a lump diagnosed on mammography or other imaging she will often have a surgical open (excisional) biopsy. If the lesion is easily felt, i.e., palpable, it can be located by the surgeon by touch. If the lesion is small and not easily felt a radiologist will insert a wire with the tip in the lesion to guide the surgeon. This is usually done during an ultrasound examination done before surgery but can be done also with MRI.
Sentinel Node. Lymph nodes are one of the first defenses against infections. They are situated throughout the body. The lymph nodes that drain the breast are in the armpit (axilla), in the region of the collar bone (clavicle) and near the blood vessels inside the chest that feed the breast (internal mammary artery). They are linked by a network of vein-like vessels that carry lymph. Lymph is a milky fluid that has some ability to fight infection, but mostly it carry germs or other irritants to the lymph nodes to be dealt with by the body's immune system. The first node in the chain that drains the breast is called the sentinel node. There may be more than one sentinel node. The sentinel node is usually in the axilla where there are many nodes draining the breast and arm, often 16-21 nodes in all. When a breast cancer starts to spread (metastasize) it may do so through the lymphatic system. The first lymph gland that the cancer cells reach is the sentinel node. The sentinel node is detected by lymphoscintigraphy. The surgeon will remove the sentinel node for biopsy. If the cancer is already confirmed and the preliminary staging is already done, the surgeon will remove all nodes for biopsy for better staging as a guide to treatment. The main side effect of this is Lymphoedema (Lymphoedema). This is a serious and long lasting condition with pain and swelling in the affected arm. Less serious is Axillary web syndrome which causes tender cords to appear in the axilla and arm. These cords usually go away without treatment, but physio may help. Because the drainage system of the arm is damaged by the surgery the arm may swell.
Breast examination:
Investigations:
Biopsy
Sentinel Node Biopsy Lymphoedema, Axillary web syndrome
Imaging:
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Breast self examination: Women should examine their breasts each month at about the same time in their menstrual cycle if they are pre-menopausal. They should be instructed in this professionally by their doctor or by a health professional at a screening clinic. If a professional is not available, there are several excellent web sites with instructions and diagrams.Health professional examination: A woman should have a breast exam as part of her periodic (annual) check-up.
Biopsy is the removal of tissue for examination by a pathologist to make a diagnosis.
A needle biopsy involves taking a core of a lesion by inserting a hollow needle into the lesion.
When a woman has a lump diagnosed on mammography or other imaging she will often have a surgical open (excisional) biopsy. If the lesion is easily felt, i.e., palpable, it can be located by the surgeon by touch. If the lesion is small and not easily felt a radiologist will insert a wire with the tip in the lesion to guide the surgeon. This is usually done during an ultrasound examination done before surgery but can be done also with MRI.
Sentinel Node. Lymph nodes are one of the first defenses against infections. They are situated throughout the body. The lymph nodes that drain the breast are in the armpit (axilla), in the region of the collar bone (clavicle) and near the blood vessels inside the chest that feed the breast (internal mammary artery). They are linked by a network of vein-like vessels that carry lymph. Lymph is a milky fluid that has some ability to fight infection, but mostly it carry germs or other irritants to the lymph nodes to be dealt with by the body's immune system. The first node in the chain that drains the breast is called the sentinel node. There may be more than one sentinel node. The sentinel node is usually in the axilla where there are many nodes draining the breast and arm, often 16-21 nodes in all. When a breast cancer starts to spread (metastasize) it may do so through the lymphatic system. The first lymph gland that the cancer cells reach is the sentinel node. The sentinel node is detected by lymphoscintigraphy. The surgeon will remove the sentinel node for biopsy. If the cancer is already confirmed and the preliminary staging is already done, the surgeon will remove all nodes for biopsy for better staging as a guide to treatment. The main side effect of this is Lymphoedema (Lymphoedema). This is a serious and long lasting condition with pain and swelling in the affected arm. Less serious is Axillary web syndrome which causes tender cords to appear in the axilla and arm. These cords usually go away without treatment, but physio may help. Because the drainage system of the arm is damaged by the surgery the arm may swell.
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