Diagnosing Breast Cancer

Return to Breast Cancer home

Going to your GP

If you notice a change in your breasts that worries you, make an appointment to see your GP without delay. Most lumps and changes are benign (non-cancerous) but it is important to see your GP to be sure.

Your GP will examine your breasts to see the change and may ask you about your family history and other symptoms.

In some situations the GP may ask you to go back again in a couple of weeks’ time. This is because some non-cancerous breast tissue changes naturally disappear after a menstrual period. Waiting a couple of weeks may make you anxious. But your GP wouldn’t suggest this if there were any obvious signs of cancer.

If you have symptoms that could be due to a breast cancer your GP will refer you to a specialist breast clinic at the hospital for advice or treatment.

You will likely receive a letter in the post with your appointment details. The length of time you will have to wait for a clinic appointment will depend on the type of signs and symptoms you have presented with to your GP. Urgent referrals are seen within 2 weeks, early referrals will be seen within 6 weeks and routine referrals will be seen within 12 weeks as per the National Cancer Control Programme Guidelines.

It is important for the specialist in breast care to take a full history of your signs and symptoms, to be aware of the duration of your symptoms, to carry out a breast examination of both the right and left breasts and to ask about your past medical history before deciding what tests are required in your case. Every breast center will have breast nurse specialists and you will be given the name and contact details of their service so that you can have contact with them going forward.

At the hospital or breast clinic

Again, the doctor or breast care nurse will take your medical history before doing a physical examination. They will

  • Examine your breasts
  • Feel for any enlargedlymph nodes under your arms and at the base of your neck. This is because breast tissue extends to these areas also

After your examination, you may need some tests. The tests used to diagnose breast cancer are described below. You may have some of these tests on your first visit to the hospital or breast clinic. Your nurse will keep you informed of the next step in the process, for example, arranging further tests for you.

Mammograms

A mammogram is an X-ray of the breasts.

Mammograms are useful for finding early changes in the breast, when it may be difficult to feel a lump. It isn’t as helpful in younger women though or in women who are on hormone replacement therapy (HRT) because the breast tissue is denser and more difficult to find abnormalities. If you are under 35, your specialist is likely to suggest that you have an ultrasound instead of a mammogram.

If you have breast implants, it is possible to have a mammogram, but it may take longer.

Having a mammogram can be uncomfortable because the breasts are put between two metal plates and a little pressure is applied. But most women describe this as mild to moderate discomfort. It only lasts a few minutes and the pressure does not harm the breasts.

Breast ultrasound scans

Ultrasound scans use sound waves to make a picture of the inside of the body. Breast ultrasound is painless and only takes a few minutes. It is usually used for women under 35 and women on hormone replacement therapy (HRT) whose breasts are too dense or solid to give a clear picture with mammograms. You may also have an ultrasound if you have a lump in the breast that doesn’t show up on the mammogram. It is not unusual to have both mammogram and ultrasound.

Ultrasound can also show if a breast lump is solid, or if it contains fluid. A fluid filled lump is called a cyst.

Having a biopsy

A breast biopsy means taking a small sample of cells or tissue from your breast. Your doctor sends the sample to a laboratory and a specialist doctor called a pathologist examines it under a microscope. The pathologist can see if the sample contains areas of cancer.

There are different ways of taking biopsies:

 Needle aspiration

This is also sometimes called a fine needle aspiration cytology or FNAC. You have this test in the outpatient clinic. The doctor uses a fine needle and syringe to take a sample of cells from the breast lump specifically. They may also use this test to drain fluid from a benign (non-cancerous) cyst. All tissue will be analysed and your doctor or nurse will discuss the results with you.

Needle biopsy

Needle biopsy is also called a core biopsy or Tru Cut biopsy. You usually have this test under a local anaesthetic. This numbs the area and allows the doctor to take a core of tissue from the lump using a needle that is the same thickness as a pencil lead. In this type of biopsy the pathologist can see the cells in place within the piece of breast tissue that has been removed. So it is possible to tell a non-invasive cancer (DCIS) from invasive breast cancer with this test. It can also show how abnormal the cancer cells are (the grade) and whether they have receptors for hormones or particular treatments.

Sometimes you may have this test while lying on your front or during a mammogram.

Vacuum biopsy

After giving you a local anaesthetic to numb the area, the surgeon makes a small cut in your breast tissue. Guided by an ultrasound or X-ray, the surgeon uses a small vacuum assisted probe to take a biopsy from the suspicious area. This type of biopsy removes a slightly larger sample of breast tissue than a needle biopsy. It can sometimes cause quite a lot of bruising. It is sometimes called Mammotome biopsy or MIBB, which stands for Minimally Invasive Breast Biopsy.

Punch biopsy

A punch biopsy is when the doctor removes a small circle of skin tissue to biopsy. You might have this type of biopsy if your doctor thinks you could have inflammatory breast cancer or Paget’s disease of the nipple.

Excision biopsy (surgical)

Excision biopsy is also called a surgical biopsy. In this biopsy, you have a minor operation to remove the whole lump under local or general anaesthetic.

Wire guided biopsy

A wire guided biopsy is also called a wire localisation. Doctors usually use this technique if you have calcium deposits showing up on your mammogram, but no clear lump. In these cases, the surgeon can’t really see or feel which area needs to be removed. So during a mammogram or ultrasound, the doctor puts a fine wire into the suspicious area. The doctor makes sure the tip of the wire is right in the centre of this area and then secures the wire firmly.

The wire stays in until you have your biopsy, which is usually the same day but may be the next day. Your surgeon knows that where the wire ends is where they need to take a biopsy of the tissue.

Getting your test results

Waiting for test results is always an anxious time. It may take several working days to get the results because the hospital or clinic will need to carry out various tests on your biopsy samples.

Specialized tests to find out the type of cancer can take quite a few days to carry out. So you may have to wait longer for these results. These test results are then discussed at a Multidisciplinary Team Meeting together with your clinical presentation and examination findings and an optimal treatment plan recommended for you. This will be discussed with you at your clinic appointment.

Each clinic has a standard for waiting time. You can ask the breast specialist or breast care nurse when you should expect your results.

While you are waiting for results it may help to talk to a close friend or relative about how you feel. Or you may want to contact a cancer support group in your local area to talk to someone who has been through a similar experience.

If you have questions about the tests that you are getting or would like to speak to a nurse, you can email info@mariekeating.ie and one of our nurses will come back to you.

Breast Cancer Information

Some useful Breast Cancer resources…

01

What You Should Know

A summary of the signs and symptoms, advice on how to check your breasts and an overview on how breast cancer is diagnosed and treated.

Learn more
02

Risk Factor

Read about the factors that can increase or reduce your risk of breast cancer.

Learn more
03

Symptoms

Information on the signs and symptoms of breast cancer, how to check your breasts and what to do if you find something.

Learn more
04

Prevention

We can take steps to reduce our breast cancer risk.

Learn more
05

How To Check Your Breasts

Find out what to look and feel for.

Learn more
06

Diagnosing Breast Cancer

Find out about seeing your GP, referral to a specialist and tests you might have.

Learn more
07

Your Breasts

Find out about the structure of the breasts and about the lymphatic glands.

Learn more
08

Inflammatory Breast Cancer

This page has information about diagnosis, treatment and side effects.

Learn more

Check Monthly

One week after the end of your period is the best time. If you have reached the menopause, check your breasts on the same day every month.

Look For Changes

Stand in front of a mirror with your hands in the air. Look for changes in size or shape, puckering, dimpling or redness of the skin.

Feel For Changes

Using your fingers, check for any lumps, thickening or bumps.

Areas Not To Forget

Gently squeeze the nipple to check for discharge. Check your armpit as breast tissue also extends here.

Talking

Breast Cancer

This season we are talking about breast cancer. Helen Forristal, Director of Nursing services at the Marie Keating Foundation hosts this informative and impactful 5-episode patient-led series.
This season focuses on open and honest discussions with two groups of women. Three women living with Metastatic breast cancer and two women Surviving and thriving after localized breast cancer. These women share valuable insights from their unique experiences at every step of their journey. They share what they wish they knew and what they want others to know that may be hugely supportive to anyone newly diagnosed.
This season we are letting the patient voice take the lead. Season 4 is for patients by patients.
With thanks to our co-sponsors…
Season 4

Talking Breast Cancer

Here’s a sneak peek at what to expect from this series of The Marie Keating Foundation Talks Breast Cancer!

Season 4

Episode 1: Breast Cancer in Ireland

Talking Breast Cancer Season 4 Episode 1 : Breast Cancer in Ireland

This series we are talking Breast Cancer and letting the patient voice take the lead. Season 4 is for patients, by patients. We are kicking it off in episode one by setting the foundations of Breast Cancer in Ireland.

In this episode Director of Nursing, Helen Forristal talks to CNS, Niamh Byrne and ANP, Carol Spillane from The St James Hospital Breast care clinic.

The topics covered include, Facts, stats and background to Breast Cancer in Ireland. Signs and Symptoms, when to go to your GP, Family History, Influence of Covid and so much more valuable information.

Season 4

Episode 2: A discussion with two women about living with and beyond a Localised Breast Cancer Diagnosis

From here onwards we let the patient voices take the lead.

In this episode we talk to Erica Tierney and Paula Gleeson from The Marie Keating Foundation Survive and Thrive community about living with and beyond a localised breast cancer diagnosis.

This episode covers a wide range of valuable information that stems from the lived experiences of these women.

We discuss, at diagnosis what would they like women or men to know that they did not know back then?
Treatments, the benefits versus risks, family history, choices, trauma, follow up, support services and so much more.

Season 4

Episode 3: Living with Metastatic Breast Cancer

In this episode we have the privilege of talking to three women from The Marie Keating Foundation Positive Living Community, Aine Murphy, Deirdre Digan and Lisa Dowling. These women will take us through their unique experiences living with metastatic breast cancer and want the listeners to understand what it means to have an incurable cancer. They will also enlighten us on what they would like women and men to know that they did not know.

They will talk us through diagnosis, treatment, risks, family history, communication, clinical trials, counselling, palliative care, nutrition, and exercise, going back to work and so much more in this incredibly impactful conversation.

Season 4

Episode 4, Part 1: Survivorship and Living with and Beyond Cancer

We have reached the final episode of this series There is so much valuable information in this episode that we have made it a 2 Part.

What a journey we have been on discussing every step of a breast cancer journey. In these episodes we are continuing with the patient voice as we discuss survivorship, living with and beyond cancer and how the women we spoke to in this series have learned to live their best lives despite cancer.

Each offers valuable insight and advice from their own unique experience culminating in conversations packed with information for anyone facing a similar journey or those with family, friends or work colleagues facing a breast cancer journey. These episodes cover topics like returning to work, need for public education, chemotherapy, symptom tracking, such as fatigue, pain, peripheral Neuropathy. We discuss weight loss and gain, sexual function, menopause, depression, hair loss, trauma and so much more.

They will talk us through diagnosis, treatment, risks, family history, communication, clinical trials, counselling, palliative care, nutrition, and exercise, going back to work and so much more in this incredibly impactful conversation.

Season 4

Episode 4, Part 2: Survivorship and Living with and Beyond Cancer

A continuation of the important conversations started in Part 1.

How to reduce your risk of breast cancer

Learn more about how you can reduce your risk of breast cancer.

Be a healthy weight

Being overweight or obese after menopause increases the risk of breast cancer. If you are overweight, try to reduce your intake of sugary and processed foods and eat more fruit and vegetables.

Limit alcohol

Research consistently shows that drinking alcohol increases your risk of breast cancer. The more alcohol you drink, the greater your risk. Women are recommended to have 11 units or less of alcohol a week, and no more than 2 units a day. Try to have days where you consume no alcohol at all. If you have been diagnosed with breast cancer you should consider giving up alcohol.

Get active

Most studies indicate that physically active women have a lower risk of developing breast cancer than inactive women. The more often and longer you exercise, the less your risk of developing breast cancer. Aim for 30 to 60 minutes per day of moderate- to high-intensity physical activity.

Breast feed

Breastfeeding lowers the risk of breast cancer, especially in premenopausal women. Mothers who breastfeed for a total of one year over the total of their lifetime are slightly less likely to get breast cancer than those who have never breastfed.

Check Your Breasts

Unfortunately there is little we can do about some risks associated with breast cancer apart from being aware of them. But you can be aware of breast changes to look out for.  It is important to attend for breast screening tests with BreastCheck when you are invited. You should also check your breasts once a month, looking and feeling for any changes.

Don’t smoke

Smoking is linked to a higher risk of breast cancer in younger, pre-menopausal women. Research has also shown that there may be a link between very heavy second-hand smoke exposure and breast cancer risk in post-menopausal women.

DONATE