Checking for breast cancer usually involves a number of tests. The tests you have depend on your specific situation.
Waiting for the test results can be a stressful time. It may help to talk to a friend or family member, or call Cancer Connect on 13 11 20 to speak to a qualified professional.
Learn more about:
Mammogram
A mammogram is a low-dose x-ray of the breast tissue. It can show changes that are small or cannot be felt during a physical examination. Let staff know before the mammogram if you have breast implants.
Your breast is placed between 2 x-ray plates. The plates press together firmly to spread out the breast tissue so that clear pictures can be taken. You will feel some pressure, which can be uncomfortable, but the mammogram only takes 10–15 seconds. Both breasts will be checked.
Learn more about mammograms.
A national screening program provides a free mammogram every 2 years for:
- all women over 50
- trans women over 50 who have been taking gender-affirming hormones for 5 years or more
- trans men over 50 who have not had gender-affirming chest surgery.
For more information, call 13 20 50 or visit BreastScreen Australia Program.
Tomosynthesis
Also known as three-dimensional mammography, tomosynthesis takes x-rays of the breast from many angles and combines them into a three-dimensional (3D) image. This may be better for finding small breast cancers, particularly in dense breast tissue.
Contrast enhanced mammogram (CEM)
This combines tomosynthesis with a dye (contrast) that is injected into a vein in your arm. A CEM may be helpful for people with dense breast tissue.
Ultrasound
An ultrasound uses soundwaves to create a picture of breast tissue. It’s often the first test done in women under 30 with breast changes, or if a routine screening mammogram has found breast changes, or you or your GP feel a lump.
A gel will be spread on your breast, and then a small device (transducer) is moved over the breast and armpit. This sends soundwaves that echo when they meet something dense, like a tumour. A computer creates a picture from these echoes. The scan takes 15–20 minutes and is painless.
Learn more about ultrasounds.
Breast MRI
A magnetic resonance imaging (MRI) scan uses a large magnet and radio waves to take pictures of the breast tissue. It does not use radiation. It is mainly used for people at high risk of breast cancer or who have very dense breast tissue or breast implants. It may also be used if other imaging test results are unclear or to help plan surgery.
Before a breast MRI scan, you will usually have an injection of a dye (called contrast) to help show any abnormal breast tissue. You will lie face down on a table, which will slide into a large, cylinder-shaped machine.
The scan can take up to 40 minutes. It is painless but loud, so you will wear headphones. Some people feel claustrophobic. If you are concerned, talk to your doctor beforehand. You may be offered a mild sedative to take before the scan.
Learn more about MRI scans.
Before a scan, tell the doctor if you have any allergies or if you have had a reaction to dyes during previous scans. You should also tell them if you have diabetes or kidney disease or you are pregnant or breastfeeding.
Biopsy
In a biopsy, a small sample of cells or tissue is taken from the lump or area of concern. A specialist doctor called a pathologist then checks the sample under a microscope to see if there are any cancer cells.
During the biopsy, the doctor might place a small metallic clip to mark the area. You should let the medical team know if you take blood-thinning medicine as you will need to stop it 5–7 days before the procedure. Your breast may be bruised for a few days afterwards.
There are different ways of taking a biopsy and you may need more than one type. The biopsy may be done in a specialist’s rooms, at a radiology practice, in hospital or at a breast clinic.
| Fine needle aspiration (FNA) | A thin needle is inserted into an abnormal lymph node or other tissue, often with an ultrasound to guide it into place. Tiny pieces of tissue can then be sucked out through the needle. A local anaesthetic may be used to numb the area. |
| Core biopsy | Several pieces of tissue are removed with a needle. Local anaesthetic is used to numb the area, and a mammogram, ultrasound or MRI scan is used to guide the needle into the right area. |
| Vacuum-assisted core biopsy | A needle attached to a suction-type instrument is inserted into the breast through a small cut in the skin. A larger amount of tissue is removed with a vacuum biopsy, making it more accurate in some cases. The needle is usually guided into place with an ultrasound or MRI. A local anaesthetic is used, but you may feel some discomfort. Stitches are not usually needed. |
| Surgical (excision) biopsy | If a needle biopsy is not possible, or the diagnosis is unclear, you may have a surgical biopsy to remove all or part of a lump. A wire or small surgical clip may be inserted to act as a guide during the surgery. The tissue is then removed under general anaesthetic. This is usually done as day surgery |
Learn more about biopsies.
Further tests
If these tests show that you have breast cancer, you may have further tests to check whether the cancer has spread to other parts of your body. You will have a blood test to check your general health and, in some cases, it will test for specific tumour markers.
You may also have some of the following types of scans.
| Bone scan | A bone scan is used to see if the breast cancer has spread to your bones. A small amount of radioactive solution is injected into a vein, usually in your arm. This solution is attracted to abnormal areas of the bone. After a few hours, the doctors look at the bones with a scanning machine. The scan is painless and the solution is not harmful. |
| CT scan | A CT (computerised tomography) scan uses x-ray beams to take pictures of the inside of the body. Before the scan, dye (contrast) will be injected into a vein in your arm. This helps to make the pictures clearer. You might have a feeling of passing urine, but this won’t last long. You then lie flat on a table while the scanner takes pictures. The scan takes about 30 minutes and is painless. |
| PET scan | In a PET (positron emission tomography) scan, a small amount of low-level radioactive solution is injected into a vein in the arm or hand. Any cancerous areas take up more of the radioactive solution and may show up brighter in the scan. You will usually have to fast (not eat anything) for 4–6 hours before the scan. |
Before a scan, tell the doctor if you have any allergies or had a reaction to dyes during previous scans. Also tell them if you have diabetes or kidney disease or are pregnant or breastfeeding.
→ READ MORE: Tests on breast tissue
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More resources
Dr Diana Adams, Medical Oncologist, Macarthur Cancer Therapy Centre, NSW; Prof Bruce Mann, Specialist Breast Surgeon and Director, Breast Cancer Services, The Royal Melbourne and The Royal Women’s Hospitals, VIC; Dr Shagun Aggarwal, Specialist Plastic and Reconstructive Surgeon, Prince of Wales, Sydney Children’s and Royal Hospital for Women, NSW; Andrea Concannon, consumer; Jenny Gilchrist, Nurse Practitioner Breast Oncology, Macquarie University Hospital, NSW; Monica Graham, 13 11 20 Consultant, Cancer Council WA; Natasha Keir, Nurse Practitioner Breast Oncology, GenesisCare, QLD; Dr Bronwyn Kennedy, Breast Physician, Chris O’Brien Lifehouse and Westmead Breast Cancer Institute, NSW; Lisa Montgomery, consumer; A/Prof Sanjay Warrier, Specialist Breast Surgeon, Chris O’Brien Lifehouse, NSW; Dr Janice Yeh, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC.
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