Friday, November 20, 2009

Tests for diagnosis and staging

To diagnose inflammatory breast cancer, your doctor will perform a biopsy. Biopsy is a surgical procedure that removes some of the suspicious breast tissue for examination under a microscope.
Because inflammatory breast cancer usually does not begin as a distinct lump, but instead as changes to the skin, a skin punch biopsy is often used to make the diagnosis. During this type of biopsy, the doctor uses a circular tool to remove a small section of the skin and its deeper layers, and then stitches the wound closed. If your doctor can see a distinct lesion, he or she may perform an ultrasound-guided core needle biopsy. Ultrasound is an imaging method that places a sound-emitting device on the breast to obtain images of the tissues inside. Guided by the ultrasound, the doctor inserts a hollow needle into the breast to remove several cylinder-shaped samples of tissue from the area of suspicion.

If the biopsy shows that inflammatory breast cancer is present, your doctor will order additional tests to figure out how much of the breast tissue and lymph nodes are involved, and whether or not the other breast is affected. Breast MRI, or magnetic resonance imaging, is considered the most reliable test for gathering more information about inflammatory breast cancer.

Once IBC is diagnosed, additional tests are used to determine whether the cancer has spread outside the breast to other organs, such as the lungs, bones, or liver. This is called staging. Tests that may be used include:

• chest X-ray

• CT scan (computerized tomography) of the chest, abdomen, and pelvis

• bone scan

• liver function tests

Some researchers are studying the usefulness of PET/CT scans in staging inflammatory breast cancer. A PET (positron emission tomography)/CT scan is a newer technology used to create images of the body’s cells as they work. First, you would be injected with a substance made up of sugar and a small amount of radioactive material. A special scanning machine then “highlights” any cancer cells throughout the body as they absorb the radioactive substance. Whether PET/CT is better than other tests at staging the cancer is yet to be determined.

Although PET/CT is still being studied, you may want to ask your doctor whether this test would be useful in your treatment planning. If the answer is “yes,” you can ask where PET/CT might be available in your area.

For more detailed information about these tests for diagnosing and staging breast cancer, please visit the Screening and Testing section.

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