Diagnosis

Women over the age of 20 years should perform a breast self–examination each month to get to know how their breasts normally feel, so they can detect any changes. Although most lumps are benign, report any changes to your doctor. An examination by your doctor annually especially if you are over 30 years is advised. All women over 40 years should also go in for an annual mammogram.

Ultrasound
Ultrasound is also used to evaluate breast abnormalities that are found by physical examination or mammography. Because of the different ways various tissues interact with sound waves, ultrasound can often reveal whether a lump is solid or a fluid–filled, benign cyst.

Biopsy
When breast cancer is suspected, a biopsy is usually done. All of these biopsy techniques involve removing a sample of tissue, which can then be examined under a microscope to look for cancerous cells. The types of biopsy that can be performed are:
Fine–needle biopsy
Fine–needle biopsy involves the removal of fluid or cells from a lump that can be felt or seen with ultrasound or mammograms. A local anesthetic is administered before the needle is inserted. If you have a cyst, the fluid will be extracted, and the lump will disappear. This sample will be sent to a pathologist, and if there are cells present, they will be examined to determine if they are benign or malignant.
Core biopsy is a similar test, but a larger needle is used to remove a small cylinder of breast tissue.
Stereotactic
Stereotatic needle biopsy is used when the lump is so small that an imaging device is necessary to guide the needle to ensure that the abnormal tissue is sampled. In this procedure, you lie face down on a special table with an opening that lets the breast hang down. A mammogram is then performed to show the location of the lump, and a computer guides the needle into the mass.
Surgical
Surgical biopsy involves removal of all or part of a breast lump for microscopic examination to determine whether cancer is present. When an excisional biopsy is performed, the entire mass is removed, along with a surrounding normal–appearing breast tissue. This procedure is usually done under local anesthesia. However, it is done in the hospital, so that intravenous medications can be given to keep the patient more comfortable. After the biopsy specimen is obtained, a pathologist will analyze it, and then report the findings. The size of the lump and a description of any cells found in the sample is given. If cancer cells are present, they are described by type (the most common types are ductal and lobular), and by whether they have invaded the surrounding tissue). Several tests are also performed to evaluate the cancer cells.

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