Breast cancer diagnosis

In stage 0 breast cancer, also called carcinoma in situ, the breast mass is noninvasive. Often, this stage is considered a precancerous condition as there is no indication that the tumor cells have spread to other parts of the breast or body. Stage 0 breast cancer is classified as ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS).

In stage 1 breast cancer, the tumor measures up to 2 cm and no lymph nodes are involved. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue. Stage I breast cancer is divided into stage IA and stage IB.

In stage II breast cancer, the tumor is between 2-5 cm, or the cancer has spread to the lymph nodes under the arm on the same side as the tumor, but the cancer has not spread to a distant part of the body. Stage II breast cancer may be divided into stage IIA or stage IIB.

In stage III breast cancer, also called locally advanced breast cancer, the tumor is more than 2 inches in diameter across or the cancer is extensive in the underarm lymph nodes or has spread to other lymph nodes or tissues near the breast. Stage III breast cancer is divided into stage IIIA, stage IIIB, stage IIIC.

In stage IV breast cancer, also called metastatic breast cancer, the cancer has spread beyond the breast to distant parts of the body, such as the bones, lungs, brain or liver. More than one part of the body may be involved.

Stage IV may be either recurrent or "de novo" (metastatic from the start). Recurrent breast cancer refers to cancer that has returned. Breast cancer can return to the original location (local recurrence), in or near the original location (regional recurrence), or it can spread to other parts of the body (distant recurrence, also called metastatic breast cancer). In metastatic breast cancer, cancer cells have spread to distant organs and/or tissue in the body, most commonly the bones, liver and lungs.

Our doctors use biopsy, in which all or part of a breast tumor is removed, for diagnosis and treatment planning. Some biopsies (e.g., fine-needle aspiration, core needle, stereotactic) may be performed using an imaging test, called image-guided breast biopsy, which allows precise positioning of a needle to locate and remove a sample of suspicious breast tissue. A sentinel lymph node biopsy helps determine whether cancer has spread to the lymph glands under the arm.

After your biopsy, a breast coordinator will arrange an appointment in our Breast Biopsy Results Clinic to review the results. There, you'll meet with the radiologist and a breast nurse navigator to receive more detailed information and learn next steps.

Our doctors use mammography, an X-ray of the breast, to determine the location and extent of breast cancer. Full-field digital mammography acquires sharp, digital images of the breasts with less radiation exposure.  

Learn more about understanding your mammogram.

A breast ultrasound is used to detect suspicious changes in the breasts. It may also be used to locate the position of a tumor in order to guide the doctor during a biopsy. For women with dense breasts, automated whole-breast ultrasound (AWBUS) is a supplementary ultrasound examination of both breasts that can detect small cancers that mammography may miss.

Through the use of radio waves and powerful magnets, breast MRI provides detailed cross-sectional images of the breasts. Breast MRI can be used to help gather more information during diagnosis and treatment planning, and for monitoring for recurrence after treatment.

MBI is one of the more recent developments in breast cancer imaging technology. It uses nuclear medicine to differentiate cancer cells from normal cells. Unlike other breast imaging modalities, MBI gives your physician the option to focus on cellular activity within the tissue.

These imaging tests uses X-rays to create detailed pictures of the breasts, and can be used to locate a tumor and determine if the cancer spread to other organs.

This X-ray test may reveal if breast cancer has spread to the lungs.

A bone scan may reveal if breast cancer has spread to the bones.