Breast cancer. Diagnosis methods 🔍

October is Breast Cancer Awareness month, so we decided to share with you a sequence of articles about this topic. Breast cancer is the most frequent cancer and the most common cause of death among women. It is a global public health problem with consequences also on a socio economic level. If numbers increase in the same manner as in the present, it is estimated that by 2050 there will be 3.2 new million cases per year.

Last week we talked about breast cancer risk factors.

Now we will talk about the many techniques, old and innovative, that can diagnose breast cancer.

Most of these methods can be used both for screening and diagnosing breast cancer. Cancer screening is a preventive method to identify risk factors and cancer in an early-stage, while cancer diagnosing is establishing the presence/absence of the cancer in order to apply the suitable treatment.

Diagnosing breast cancer in early stages is very important as it increases the chance of survival.

There are many ways of diagnosing/screening breast cancer and can be classified in multiple groups:

  • Clinical Breast Examination (CBE) and Breast Self Examination (BSE): although these are not methods that can medically diagnose breast cancer, by performing it monthly women can detect possible abnormalities, which could be linked to breast cancer, at an early stage. Check our article about BSE to find out more.

  • Breast biopsies: a tissue of breast is removed and analyzed in order to detect cancerous cells

  • Imaging techniques: mammography, ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), positron-emission tomography (PET) and single-photon computed tomography (SPECT); these methods can be used for diagnosis and monitoring patients in different stages

  • Biochemical markers: are currently less used as a diagnostic tool as research is still needed to evaluate their efficacy, but it’s a promising future diagnosis method

  • Microwave breast imaging methods (MI): use different techniques to assess differences between healthy tissue and cancerous one based on electromagnetic radiation or electric frequency (Hz); it is still being tested but it is showing promising results

Imaging techniques

  • Imaging techniques, along with breast examination (by oneself or a physician) help monitor patients

  • Studies show that monitoring healthy subjects increases the chances of detecting small tumors that could lead to breast cancer development

  • These methods have some limitations as some of them are expensive, can lack sensitivity (the ability of the test to correctly identify the patients with a disease), are time consuming and not suitable for young women

  • The sensitivity issues can be improved by using radio-contrast substances; these agents are injected into the patient’s blood flow and improve the images recorded by imaging equipments

1. Mammography

  • It is recommended for women starting from the age of 40 to undergo an annual mammography

  • It is known as the “gold standard” technique as it is characterized by high sensitivity* (approx. 68%) and specificity* (approx. 75%), it is not expensive and tolerated by patients

  • The sensitivity can vary, as it is influenced by age, ethnicity, medical history and the experience of the radiologist

  • Studies show that using mammography can reduce the mortality of breast cancer up to 19%

  • It is used to see the breast mass, image bone (used for determining the density of the bone), soft tissue and the blood vessels at the same time

  • Procedure time: few seconds

  • It has high rates of false-negative or false-positive result in patients under 40 (as their breasts are more dense) or in premenopausal women

  • There are some limitation of mammography as well: ionizing radiation (in high doses it can induce tissue damage and cancer), uncomfortable examination and the inaccuracy that can happen sometimes (in case of dense tissue), therefore it can induce false alarms, anxie