Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Chapter 1 - Diagnosis and Staging of Breast Cancer and Multidisciplinary Team Working

Family history of BC, age at menarche, number of births and pregnancies, age at first birth, history of breast biopsies and breast operations, date of the last menstrual period, use of hormone replacement therapy and detection of breast tumour in mammography screening are the key events to note.

The breasts should be palpated when the patient is sitting or standing, the arms hanging freely as well as elevated (A, B). The examination is repeated when the patient is lying supine (C, D).

Lesions located in the upper parts of the breast are best detected with the patient sitting or standing (A, B). Lesions in the lower parts of the breast may become obvious only when the patient is lying supine with the arms elevated (D).

The triple diagnostic approach consists of breast inspection and palpation, breast imaging usually with mammography and ultrasound, and a core needle biopsy (CNB) of the breast lesion.

When one of the components of the triple diagnostic approach is suspicious, a repeated core biopsy or surgical biopsy should follow, even when the other components do not suggest cancer.

Breast imaging should precede a biopsy, since a haematoma or other tissue alterations may interfere with image interpretation. Breast imaging usually consists of mammography and ultrasound examination of the breast and the axilla.

Typical findings suggestive of cancer in mammography include an irregular mass, star-like (stellate) or spicular lesions, microcalcifications and structural distortions. The sensitivity of mammography is lower in patients with dense breast tissue, typically associated with younger age.

BC usually causes an echo-poor irregular lesion in ultrasonography.

Benign and malignant lesions cannot always be reliably distinguished by breast imaging. Some BCs resemble a benign lesion, viewed as a regular and well-defined mass.

Revision Questions

  1. What are the key events to note in the patient history?
  2. What components are included in the triple diagnosis?
  3. What are the findings typical of BC at mammography?
Chapter 1 - Diagnosis and Staging of Breast Cancer Percutaneous Needle Biopsy and Axillary Staging

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.