If there is any suspicion of breast cancer, a mammogram will be performed to clarify the situation, along with an ultrasound examination if necessary. If this does not provide satisfactory information, an additional fine needle aspiration (removal of individual cells), a punch biopsy (removal of tissue) or magnetic resonance imaging (MRI) will be performed.
A mammogram is a special x-ray of the breast and is a standard screening technique. It enables display of the glandular tissue on two to three levels. This allows the radiologist to detect fine differences in the density and composition of the tissue. Even the presence of the tiniest calcium deposits, which is frequently the first sign of breast cancer, can be identified. To produce the images, the breast is placed between the x-ray tube and the film plate and then carefully compressed.
A supplementary ultrasound examination may be performed to confirm the results of the mammogram. This provides the doctor with two-dimensional images that offer a spatial view of the size, shape, structure and composition of the breast, soft tissue and vessels.
MRI, or Magnetic Resonance Imaging, is a technique for displaying internal organs and tissue. It uses magnetic fields and radio waves. During the procedure, the patient lies on a so-called “bore” inside the machine. The advantage of this technique is that it provides very accurate and detailed images of body tissue. Even minimal changes in the body can be detected using this method. This is why magnetic resonance imaging is used when the diagnosis of breast cancer is unclear.
Fine needle aspiration
Fine needle aspiration is a technique to extract cellular material from certain tissue sections. The doctor inserts a hollow needle into the tissue from which a sample is to be taken. The sample is then examined under a microscope in the laboratory. Experienced cytologists can make a relatively accurate assessment of the cells, confirming suspected diagnoses from previous investigations.
In the case of a punch biopsy, a thin cylinder, usually controlled by ultrasound, is used to remove and examine tissue samples. This method is somewhat more painful, but it produces more detailed results than a fine needle aspiration and is therefore used when the findings of previous tests are inconclusive.