Breast Cancer Diagnosis & Prognosis
Hearing you may have breast cancer can be scary and overwhelming. Many women feel shocked, anxious, and unsure of what comes next. We understand how stressful this time can be—and we’re here to help.
When a woman finds a breast lump or receives an abnormal mammogram result, cancer is often the first worry. In most cases, it is not cancer. That’s why getting clear answers quickly is so important.
We work to see patients as soon as possible, often the same day. During your visit, our team will:
- Perform a clinical exam
- Review of past medical records
- Complete additional imaging, if needed
- Explain results and next steps before you leave
When checking a breast lump or an abnormal area on a mammogram, there are two main goals:
1. To find out if the tissue is benign (not cancer) or malignant (cancer)
2. If cancer is found, to make sure the breast biopsy is done in the right way to support future treatment
Sometimes, women are referred to us after having surgery to remove a lump, and cancer is found afterward. If the tissue was not marked correctly during surgery, it can be hard to know where the cancer remains. This can make future treatment more difficult and may reduce breast conserving options.
Types of Biopsies We Use
In some cases—such as a young woman with a clearly benign lump—it may make sense to remove the lump with surgery right away. However, in most cases, we use less invasive biopsy methods first so we can plan treatment more carefully if cancer is found. Fine Needle Aspiration (FNA)
This is a quick office procedure that takes just a few minutes. A very small needle is used to remove cells from the lump. The cells are sent to a lab, and results are often available within two hours.
- The procedure is simple and usually well tolerated
- It can speed up diagnosis
- In about 30% of cases, it does not give a clear answer, so another biopsy is needed
Because of these limits, we use FNA only when it is likely to be helpful.
Core Needle Biopsy
A core biopsy removes a small piece of tissue instead of just cells. This usually gives a more complete and accurate diagnosis.
- It can tell if tissue is cancer or not
- It often identifies the exact type of condition
- It can show whether cancer is invasive or non invasive
- It can provide details that help guide treatment planning
Core biopsies are usually done using imaging guidance, such as ultrasound or mammography.
Ultrasound Guided Core Biopsy
If the area can be seen on ultrasound, this is our preferred method.
- The patient lies comfortably on her back
- The procedure takes about 10–15 minutes
- Local numbing medicine is used
- A small marker is placed at the biopsy site
- Mild bruising or tenderness may occur afterward
Stereotactic Core Biopsy
If the area can only be seen on a mammogram (often small calcium spots), this method is used.
- The patient lies on her stomach during the procedure
- A needle is guided very precisely using x ray imaging
- A small marker is placed to identify the biopsy location
- The procedure takes less than an hour
Bleeding is the most common side effect. To reduce risk, patients must stop certain medications (like aspirin or blood thinners) at least 10 days before the procedure. A pressure bandage is used afterward to limit bruising.
Surgical (Open) Biopsy
If biopsy results are unclear or show high risk changes, surgery may be needed to remove more tissue. This decision is made together by the radiologist, pathologist, surgeon, and patient.
If the area cannot be felt, wires are placed before surgery to help guide the surgeon. If a lump can be felt, surgery may be done without wires, though a needle biopsy is usually done first.
The most important factors in breast cancer survival are:
- The size of the tumor
- Whether cancer has spread to nearby lymph nodes
If there is no invasive cancer, survival is nearly 100%. If the invasive cancer is very small and lymph nodes are clear, long term survival is very high—about 95% at 10 years.
As tumors grow larger or spread to lymph nodes, treatment becomes more complex. However, treatments have greatly improved. New chemotherapy, hormone therapies, and research advances give many women strong reasons for hope—even with advanced cancer.
Understanding Prognosis
It usually takes 7–14 days after surgery to get full pathology results. These results help doctors understand the cancer and guide treatment decisions.
Once results are available, the woman and her family meet with the oncologist to discuss:
- What the diagnosis means
- What treatments are recommended
- What actions offer the best chance for long term health
After this discussion, each woman chooses the treatment plan that feels right for her.