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Breast Biopsy

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Breast Biopsy

Needle Biopsy

Image by National Cancer Institute / Linda Bartlett (Photographer)

Finding Breast Cancer

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Breast Cancer Screening & Diagnosis

Video by TheVisualMD

Finding Breast Cancer

Breast cancer can be found through screening tests, a breast self- exam, or when symptoms start.

Screening

Screening tests can find breast cancer before it causes symptoms and when it is most treatable. Two common tests used to check for breast cancer are:

Mammogram (MAM-mo-gram): This test is a breast x-ray. It looks for changes in breast tissue that may be cancer. These changes may look like a shadow on the x-ray. A mammogram can find breast cancer even when it is too small to be felt. This is considered the best screening test for breast cancer.
Breast exam by your doctor or nurse: This is usually part of a woman's yearly exam. But if you find a breast lump or other change that worries you, do not wait. See your doctor to have it checked.

Self-exam

A woman can do a breast self-exam at home to check for changes in breast tissue. If you find a breast lump or any other changes, see your doctor right away to have it checked.

Symptoms

Many women with early breast cancer have no symptoms. The most common symptom of breast cancer is a breast lump. Other possible symptoms include:

Changes in the skin of the breast (such as skin irritation, dimples in the skin, redness, scaly skin, or thickening of the skin)
Swelling of all or part of the breast
Pain in the breast or nipple
The nipple draws back into the breast
Discharge from the nipple (other than breast milk)

If you have any of these symptoms, see your doctor right away.

Follow-up tests and breast biopsy

If a shadow is seen on your mammogram, a lump is felt, or you have other symptoms, your doctor will likely do more tests. Your doctor may recommend another mammogram or a breast ultrasound. These tests tell your doctor if you need a biopsy.

Most women who have followup tests find out they do not need a biopsy. But, if the results of the followup tests are of concern, your doctor will recommend a biopsy.

Source: Agency for Healthcare Research and Quality (AHRQ)

Additional Materials (7)

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What Is Breast Cancer?

Breast imaging and early detection of breast cancer have evolved immensely over the last 25 years, leading to increased survival rates and improved quality of life for millions of women with breast cancer. This video takes you through the process of screening and diagnosis using various imaging modalities, including mammogram, ultrasound and MRI.

Video by TheVisualMD

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Mammography

Breast radiologist Dr.Gillian Newstead of the University of Chicago Medical Center explains the process of a typical mammogram screening.

Video by TheVisualMD

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Breast Density

Women with dense breast tissue often require a further look with ultrasound for screening. University of Chicago Medical Center breast radiologist Dr. Gillian Newstead and a breast cancer survivor with dense breast tissue explain.

Video by TheVisualMD

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Breast Self Exam

Many breast cancers are detected by the patient herself. Dr. Gillian Newstead of The University of Chicago medical Center's breast clinic discusses breast lumps and the importance of seeing your doctor if you feel one.

Video by TheVisualMD

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Cancer and Wellness

Voyage deep inside your body to see, on a cellular level, why 1 in 2 men and 1 in 3 women will be diagnosed with cancer during their lifetime. Watch a cell reproducing normally and a breast cancer cell dividing out of control. Dr. Jeremy Geffen, oncologist, and Dr. Kevin Gardner of the National Cancer Institute explain that damaged DNA causes cancer-and every cell in your body undergoes 10,000 DNA damage events each day. Dr. Candace Pert, neuroscientist, and Dr. Mark Liponis of Canyon Ranch talk about why cancer represents an immune system failure. Most of your risk for cancer is due to lifestyle factors. Watch as fat cells balloon in size and learn how they secrete cancer-inducing chemicals. View breast and colon cancer inside the body. Find out how you can dramatically decrease your risk of cancer.

Video by TheVisualMD

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Breast Cancer Cell

Frontal camera shot zooms into mammary (breast) tissue as it becomes transparent to focus on cancer cells. The camera zooms in at a fast pace so that the lobules, ducts and fatty tissue of the mammary glands are not clearly defined.

Video by TheVisualMD

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Nipple Discharge

It's important to take notice of changes in your breast. Here, breast radiologist Dr. Gillian Newstead of the University of Chicago Medical Center discusses nipple discharge.

Video by TheVisualMD

4:47

What Is Breast Cancer?

TheVisualMD

0:37

Mammography

TheVisualMD

0:43

Breast Density

TheVisualMD

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0:39

Breast Self Exam

TheVisualMD

4:42

Cancer and Wellness

TheVisualMD

0:07

Breast Cancer Cell

TheVisualMD

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0:34

Nipple Discharge

TheVisualMD

Mammogram

Mammogram

Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography

A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.

Mammogram

Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography

A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.

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Use the slider below to see how your results affect your health.
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Your result is Negative.
This score confirms that your mammogram results are negative, indicating that the breast tissue shows no signs of a mass or calcifications. However, it’s important to continue regular screening mammograms.
Related conditions
- Screening mammograms are done for women who have no symptoms of breast cancer. It usually involves two x-rays of each breast. Screening mammograms can detect lumps or tumors that cannot be felt. They can also find microcalcifications or tiny deposits of calcium in the breast, which sometimes mean that breast cancer is present.
- Diagnostic mammograms are used to check for breast cancer after a lump or other symptom or sign of breast cancer has been found. Signs of breast cancer may include pain, thickened skin on the breast, nipple discharge, or a change in breast size or shape. This type of mammogram also can be used to find out more about breast changes found on a screening mammogram, or to view breast tissue that is hard to see on a screening mammogram. A diagnostic mammogram takes longer than a screening mammogram because it involves more x-rays in order to obtain views of the breast from several angles. The technician can magnify a problem area to make a more detailed picture, which helps the doctor make a correct diagnosis.
A digital mammogram also uses x-rays to produce an image of the breast, but instead of storing the image directly on film, the image is stored directly on a computer. This allows the recorded image to be magnified for the doctor to take a closer look. Current research has not shown that digital images are better at showing cancer than x-ray film images in general. But, women with dense breasts who are pre- or perimenopausal, or who are younger than age 50, may benefit from having a digital rather than a film mammogram. Digital mammography may offer these benefits:
- Long-distance consultations with other doctors may be easier because the images can be shared by computer.
- Slight differences between normal and abnormal tissues may be more easily noted.
- The number of follow-up tests needed may be fewer.
- Fewer repeat images may be needed, reducing exposure to radiation.
A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. Women ages 50 to 74 years should get a mammogram every 2 years. Women younger than age 50 should talk to a doctor about when to start and how often to have a mammogram.
Mammograms can not find all problems. So, every woman should work with her doctor to check her breasts. Call your doctor or clinic if you notice any change in your breasts like:
- a lump
- thickening
- liquid leaking from the nipple or changes in how the nipple looks
First, check with the place you are having the mammogram for any special instructions you may need to follow before you go. Here are some general guidelines to follow:
- If you are still having menstrual periods, try to avoid making your mammogram appointment during the week before your period. Your breasts will be less tender and swollen. The mammogram will hurt less and the picture will be better.
- If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment.
- Wear a shirt with shorts, pants, or a skirt. This way, you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.
- Don't wear any deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your mammogram appointment. These things can make shadows show up on your mammogram.
- If you have had mammograms at another facility, have those x-ray films sent to the new facility so that they can be compared to the new films.
- Tell the clinic if you have physical disabilities that may make it hard for you to sit up, lift your arms, or hold your breath.
- Talk with the staff about how they will handle issues of modesty that you may have due to your religion.

Breast tissue that shows no signs of a mass or calcifications is considered normal. Most abnormal findings on a screening mammogram turn out to be benign (not cancer) or nothing to worry about. New findings or changes must be further evaluated.

What can mammograms show?

The radiologist will look at your x-rays for breast changes that do not look normal and for differences in each breast. He or she will compare your past mammograms with your most recent one to check for changes. The doctor will also look for lumps and calcifications.

Possible mammogram findings include:

Lumps (mass or tumor). Lumps come in different sizes and shapes. Fluid-filled cysts are usually smooth and rounded, with clear, defined edges and are not cancer. Lumps that have a jagged outline and an irregular shape are of more concern.
Calcifications. There are two types of breast calcifications, or calcium deposits:
- Macrocalcifications, which look like small white dots on a mammogram. They are often caused by aging, an old injury, or inflammation and are usually benign.
- Microcalcifications, which look like white specks on a mammogram. If found in an area of rapidly dividing cells or grouped together in a certain way, they may be a sign of DCIS or breast cancer.
Dense breast tissue: A dense breast has relatively less fat and more glandular and connective tissue. This mammogram finding is both common and normal, especially among younger women and women who use menopausal hormone therapy. Dense breast tissue can make a mammogram more difficult to interpret because both dense breast tissue and breast tumors appear as solid white areas in the image.

What happens if my mammogram is normal?

Continue to get mammograms according to recommended time intervals. Mammograms work best when they can be compared with previous ones. This allows the radiologist to compare them to look for changes in your breasts.

What happens if my mammogram is abnormal?

An abnormal mammogram does not always mean that there is cancer. But you will need to have additional mammograms, tests, or exams before the doctor can tell for sure. You may also be referred to a breast specialist or a surgeon. It does not necessarily mean you have cancer or need surgery. These doctors are experts in diagnosing breast problems. Doctors may order some of these tests:

Diagnostic mammogram, to focus on a specific area of the breast
Ultrasound, an imaging test that uses sound waves to create a picture of your breast. The pictures may show whether a lump is solid or filled with fluid. A cyst is a fluid-filled sac. Cysts are not cancer. But a solid mass may be cancer. After the test, your doctor can store the pictures on video or print them out. This exam may be used along with a mammogram.
Magnetic resonance imaging (MRI), which uses a powerful magnet linked to a computer. MRI makes detailed pictures of breast tissue. Your doctor can view these pictures on a monitor or print them on film. MRI may be used along with a mammogram.
Biopsy, a test in which fluid or tissue is removed from your breast to help find out if there is cancer. Your doctor may refer you to a surgeon or to a doctor who is an expert in breast disease for a biopsy.

What is the Breast Imaging Reporting and Database System (BI-RADS®)?

The American College of Radiology (ACR) has established a uniform way for radiologists to describe mammogram findings. The system, called BI-RADS, includes seven standardized categories, or levels. Each BI-RADS category has a follow-up plan associated with it to help radiologists and other physicians appropriately manage a patient’s care.

Breast Imaging Reporting and Database System (BI-RADS)

Category	Assessment	Follow-up
0	Need additional imaging evaluation	Additional imaging needed before a category can be assigned
1	Negative	Continue regular screening mammograms
2	Benign (noncancerous) finding	Continue regular screening mammograms
3	Probably benign	Receive a 6-month follow-up mammogram
4	Suspicious abnormality	May require biopsy
5	Highly suggestive of malignancy (cancer)	Requires biopsy
6	Known biopsy-proven malignancy (cancer)	Biopsy confirms presence of cancer before treatment begins

BI-RADS also includes four categories of breast density that may be reported. The radiologist who reads the mammogram chooses the category that best describes the level of breast density seen on the mammogram film. The categories, from the least amount of breast density to the highest, are as follows:

The breasts are almost entirely fatty
There are scattered areas of dense glandular tissue and fibrous connective tissue (together known as fibroglandular density)
The breasts are heterogeneously dense, which means they have more of these areas of fibroglandular density. This may make it hard to see small masses in the breast tissue on a mammogram.
The breasts are extremely dense, which makes it hard to see tumors in the breast tissue on a mammogram.

Many states in the U.S. have enacted laws requiring mammography providers to tell women if they have dense breasts (i.e., breasts that are heterogeneously or extremely dense on a mammogram) and to inform them of risks associated with having dense breasts. In addition to making mammograms harder to read, dense breasts are a risk factor for breast cancer.

Although they are not perfect, mammograms are the best method to find breast changes that cannot be felt. If your mammogram shows a breast change, sometimes other tests are needed to better understand it. Even if the doctor sees something on the mammogram, it does not mean it is cancer.
As with any medical test, mammograms have limits. These limits include:
- They are only part of a complete breast exam. Your doctor also should do a clinical breast exam. If your mammogram finds something abnormal, your doctor will order other tests.
- Finding cancer does not always mean saving lives. Even though mammography can detect tumors that cannot be felt, finding a small tumor does not always mean that a woman's life will be saved. Mammography may not help a woman with a fast growing cancer that has already spread to other parts of her body before being found.
- False negatives can happen. This means everything may look normal, but cancer is actually present. False negatives don't happen often. Younger women are more likely to have a false negative mammogram than are older women. The dense breasts of younger women make breast cancers harder to find in mammograms.
- False positives can happen. This is when the mammogram results look like cancer is present, even though it is not. False positives are more common in younger women, women who have had breast biopsies, women with a family history of breast cancer, and women who are taking estrogen, such as menopausal hormone therapy.
- Mammograms (as well as dental x-rays and other routine x-rays) use very small doses of radiation. The risk of any harm is very slight, but repeated x-rays could cause cancer. The benefits nearly always outweigh the risk. Talk to your doctor about the need for each x-ray. Ask about shielding to protect parts of the body that are not in the picture. You should always let your doctor and the technician know if there is any chance that you are pregnant.
1. https://www.womenshealth.gov/a-z-topics/mammograms [accessed on Feb 16, 2019]
2. https://www.nibib.nih.gov/science-education/science-topics/mammography [accessed on Feb 16, 2019]
3. https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm [accessed on Feb 16, 2019]
4. https://www.cancer.gov/types/breast/mammograms-fact-sheet [accessed on Feb 16, 2019]
5. https://www.cancer.gov/types/breast/breast-changes#ui-id-4 [accessed on Feb 16, 2019]
6. https://www.fda.gov/ForConsumers/ByAudience/ForWomen/WomensHealthTopics/ucm117967.htm [accessed on Feb 16, 2019]
7. https://medlineplus.gov/ency/article/003380.htm [accessed on Feb 16, 2019]
8. https://www.healthline.com/health/birads-score [accessed on Feb 16, 2019]
9. https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/Mammography-Reporting.pdf [accessed on Feb 16, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (48)

Mammography Fact Sheet

Mammography is an x-ray imaging method used to examine the breast for the early detection of cancer and other breast diseases. It is used as both a diagnostic and screening tool.

Document by www.nibib.nih.gov

Mammograms

Document by Office on Women's Health, U.S. Department of Health and Human Services

Top Four Mammogram Myths

Knowing the truth about mammograms could help save your life, or the life of someone you love. Over 60% of breast cancer cases are diagnosed before they spread. Nearly 90% of women who find and treat their breast cancer are cancer-free at five years. Mammograms can help reduce the number of deaths from breast cancer among women ages 40 to 70.

Image by The U.S. Food and Drug Administration

Screening for Cancer

Common Screening Tests and American Cancer Society Recommendations

Image by TheVisualMD

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Mammography

A woman getting a mammogram, showing a cone in position on her right breast.

Image by National Cancer Institute / Unknown Illustrator

Mammography

Image by BruceBlaus

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Mammogram

An adult female is assisted in a mammogram machine by an African-American technician.

Image by National Cancer Institute / Alan Hoofring (Illustrator)

Woman Having Mammogram

Photograph of woman having mammogram. Mammograms are considered the gold standard for breast cancer screening. Mammography requires the breasts to be compressed between plates while the image is captured. Typically, two views are taken of the breast: cranial-caudal (top to bottom) and mediolateral oblique (angled side view).

Image by TheVisualMD

Mammography

Mammogram being conducted

Image by CDC

Woman Receives Mammogram

An African-American female technician positions a Caucasian woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

A Caucasian female technician positions an Asian woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

A Caucasian female technician positions a Hispanic woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

An Asian female technician positions an African-American woman at an imaging machine to receive a mammogram.

Image by National Cancer Institute / Rhoda Baer (Photographer)

Mammography Patient

A female technician prepares to give an older Caucasian female patient a mammogram. the patient is preparing for the exam next to machine with technician in background adjusting controls.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography

A woman's breast being compressed to get the optimum mammographic image.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography

A Caucasian female patient, while sitting, is receiving a mammogram with a technician is standing in the background. The conical tip is compressing the right breast and the left breast is visible. Note the older machine.

Image by National Cancer Institute / Unknown Photographer

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Mammography

A Caucasian female patient receives a lateral mammogram treatment. She is lying on her left side with the left breast compressed and she is holding her right breast out of the way so as to not block the x-ray. Note the older methods of the diagnostic procedure.

Image by National Cancer Institute / Unknown Photographer

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Mammography

A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle that compresses the breast. The patient's face is turned towards the technician, away from the camera, and her right shoulder and breast are exposed.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography

A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera, with her right shoulder and breast are exposed.

Image by National Cancer Institute / Bill Branson (Photographer)

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Mammography Patient

A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera. Her right shoulder is raised obscuring the breast.

Image by National Cancer Institute / Bill Branson (Photographer)

Male Breast Cancer

Senior Airman Elisabeth Stone compresses a male patient's breast tissue during a baseline screening of mammogram at Joint Base Elmendorf-Richardson, Alaska

Image by Staff Sgt. Sheila deVera

Doctor Viewing Mammogram

A doctor examines mammograms on a view box.

Image by National Cancer Institute / Bill Branson (photographer)

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Mammogram Showing Dense And Fatty Breasts

Title Mammogram Showing Dense And Fatty Breasts Description A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.

Image by Dr. Kathy Cho. NIH Radiology / National Cancer Institute

Abnormal Mammogram

This abnormal mammogram is not necessarily cancerous. Also seen are calcifications through ductal patterns. Patient would be avised to have follow-up at 3-month intervals.

Image by National Cancer Institute / Unknown Photographer

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Mammogram vs. MRI

A mammography on left and a Magnetic resonance image (MRI) on right. Breast imaging technology has changed over the years. Note MRI's enhancement ability to confirm diagnosis.

Image by Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania / Unknown Photographer

Bilateral digital mammography images of the breasts

Bilateral digital mammography images of the breasts; mediolateral oblique view.

Image by © Nevit Dilmen

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Normal (left) versus cancerous (right) mammography image.

Normal (left) versus cancerous (right) mammography image.

Image by National Cancer Institute

Duct ectasia of breast

Detail of a mammography showing liponecrosis (round/oval calcifications) and plasma cell mastitis with typical rod-like calcifications

Image by Hellerhoff

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left craniocaudal.

Image by National Cancer Institute (NCI)

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left craniocaudal projection.

Image by National Cancer Institute (NCI)

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left craniocaudal reconstruction.

Image by National Cancer Institute (NCI)

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Mammogram - Normal

Breast tomosynthesis (3D Mammography) of the left mediolateral oblique projection.

Image by National Cancer Institute (NCI)

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Mammogram Showing Dense And Fatty Breasts

A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.

Image by Dr. Kathy Cho. NIH Radiology / Unknown Photographer

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Thermography of breast

Image by FDA

Mammograms vs Breast Ultrasounds

Video by Lee Health/Vimeo

Breast Density: Higher Risk & New Screening Options

Video by Breast Cancer School for Patients/YouTube

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Mammography: NCI B-roll [video]

NCI B-roll of female patient (simulated) receiving a digital mammogram. This video is intentionally silent. This footage, which was filmed at Sibley Memorial Hospital (a Johns Hopkins affiliate institution), includes images of a technician setting up the equipment, a Caucasian female being positioned to receive a mammogram, and mammography images of of dense breasts and fatty breasts. Downloadable video files are 960x540 at 30 fps. This image is part of the NCI B-Roll Videos collection. View video using embedded player on this page or at youtube.com.

Video by National Cancer Institute (NCI)

What to Expect -- Digital Mammography

Video by Hologic, Inc./YouTube

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Mammography

Breast radiologist Dr.Gillian Newstead of the University of Chicago Medical Center explains the process of a typical mammogram screening.

Video by TheVisualMD

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Breast Density

Women with dense breast tissue often require a further look with ultrasound for screening. University of Chicago Medical Center breast radiologist Dr. Gillian Newstead and a breast cancer survivor with dense breast tissue explain.

Video by TheVisualMD

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Breast Cancer Screening & Diagnosis

Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.

Video by TheVisualMD

A closer look at modern mammography

Video by Siemens Healthineers/YouTube

Mammogram

A mammographic image is displayed on state of the art mammography monitors at the David Grant USAF Medical Center. (U.S. Air Force photo/Staff Sgt. Liliana Moreno)

Image by U.S. Air Force photo/Staff Sgt. Liliana Moreno

Nipple Aspirate Test No Substitute for Mammogram

Some companies are marketing a new test—the nipple aspirate test—as the latest and greatest tool in early breast cancer screening. But FDA warns that the nipple aspirate test is no substitute for a mammogram.

Image by The U.S. Food and Drug Administration

Do More Screening Tests Lead to Better Health? Choosing Wisely

Video by DocMikeEvans/YouTube

New Guidelines for Mammograms

Video by Lee Health/Vimeo

Mammogram questions | Mercy Health

Video by Bon Secours Mercy Health/Vimeo

Getting Screened for Breast Cancer

Video by Lee Health/Vimeo

Mammography Fact Sheet

www.nibib.nih.gov

Mammograms

Office on Women's Health, U.S. Department of Health and Human Services

Top Four Mammogram Myths

The U.S. Food and Drug Administration

Screening for Cancer

TheVisualMD

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Mammography

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Mammography

BruceBlaus

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Mammogram

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Woman Having Mammogram

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Mammography

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Woman Receives Mammogram

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Woman Receives Mammogram

National Cancer Institute / Rhoda Baer (Photographer)

Woman Receives Mammogram

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Woman Receives Mammogram

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Mammography Patient

National Cancer Institute / Bill Branson (Photographer)

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Mammography

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Mammography

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Mammography

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Mammography

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Mammography

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Mammography Patient

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Male Breast Cancer

Staff Sgt. Sheila deVera

Doctor Viewing Mammogram

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Mammogram Showing Dense And Fatty Breasts

Dr. Kathy Cho. NIH Radiology / National Cancer Institute

Abnormal Mammogram

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Mammogram vs. MRI

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Bilateral digital mammography images of the breasts

© Nevit Dilmen

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Normal (left) versus cancerous (right) mammography image.

National Cancer Institute

Duct ectasia of breast

Hellerhoff

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Mammogram - Normal

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Mammogram - Normal

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Mammogram - Normal

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Mammogram - Normal

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Mammogram Showing Dense And Fatty Breasts

Dr. Kathy Cho. NIH Radiology / Unknown Photographer

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Thermography of breast

FDA

1:51

Mammograms vs Breast Ultrasounds

Lee Health/Vimeo

8:30

Breast Density: Higher Risk & New Screening Options

Breast Cancer School for Patients/YouTube

2:39

Mammography: NCI B-roll [video]

National Cancer Institute (NCI)

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What to Expect -- Digital Mammography

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Mammography

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Breast Density

TheVisualMD

4:57

Breast Cancer Screening & Diagnosis

TheVisualMD

3:37

A closer look at modern mammography

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Mammogram

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Nipple Aspirate Test No Substitute for Mammogram

The U.S. Food and Drug Administration

10:18

Do More Screening Tests Lead to Better Health? Choosing Wisely

DocMikeEvans/YouTube

1:41

New Guidelines for Mammograms

Lee Health/Vimeo

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Mammogram questions | Mercy Health

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Getting Screened for Breast Cancer

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Breast Exam

Breast Exam

Also called: Clinical Breast Exam, CBE

A clinical breast exam (CBE) is a physical exam of the breast performed by a health care provider to check for lumps or other changes. It’s often done during your regular medical check-up. If a CBE is not offered at your check-up and you would like one, ask your health care provider to perform one (or refer you to someone who can).

Breast Exam

Also called: Clinical Breast Exam, CBE

A clinical breast exam (CBE) is a physical exam of the breast performed by a health care provider to check for lumps or other changes. It’s often done during your regular medical check-up. If a CBE is not offered at your check-up and you would like one, ask your health care provider to perform one (or refer you to someone who can).

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that the nipples, breast tissue, and areas around the breast look normal and are normal in size and shape. A normal result does not mean that breast cancer is not present. Depending on your age and your personal and family history of breast cancer, your health care provider may do other tests, such as a mammogram.
Related conditions
1. PDQ® Screening and Prevention Editorial Board. PDQ Breast Cancer Screening. Bethesda, MD: National Cancer Institute. [accessed on Jan 15, 2022]
2. Breast Exam | Michigan Medicine [accessed on Jan 15, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (8)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining her. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining her. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hand examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up with a doctors hands examining. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

This is a series of 16 photos demonstrating the 16 steps of a clinical breast examination. The image shows a female nude from the waist up. The steps are as follows: 1) arms in normal position 2) arms on hips 3) pressed forward elbows 4) pressed forward 5) arms overhead 6) arms overhead 7) arms raised and pressing down 8) exam of cervical nodes 9) exam of supraclavicular 10) infraclavicular 11) axilla 12) exam of breast 13) axilla 14) breast exam 15) exam of nipple 16) exam of nipple for discharge.

Image by National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

National Cancer Institute / Photogroup (Photographer)

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Breast Exam (Series of 16)

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Breast Exam (Series of 16)

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Breast Exam (Series of 16)

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Breast Exam (Series of 16)

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Breast Exam (Series of 16)

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Breast Exam (Series of 16)

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Breast Biopsy

Breast Biopsy

Also called: Biopsy of the Breast

A breast biopsy is a test that can confirm or rule out breast cancer. It is used if other breast tests or a physical exam show you might have breast cancer. There are three main types of breast biopsy procedures: fine-needle aspiration, core needle biopsy, and surgical biopsy.

Breast Biopsy

Also called: Biopsy of the Breast

A breast biopsy is a test that can confirm or rule out breast cancer. It is used if other breast tests or a physical exam show you might have breast cancer. There are three main types of breast biopsy procedures: fine-needle aspiration, core needle biopsy, and surgical biopsy.

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal biopsy means that no cancer or abnormal cells were found.
Related conditions
You may need a breast biopsy if:
- You or your health care provider felt a lump, thickening, or other change in your breast.
- A mammogram, ultrasound, or MRI test shows a lump, calcium deposits, or other signs that might mean cancer.
- The skin on your breast or nipple is red, scaly, or swollen, or your nipple is pulled inward.
- You have a discharge of abnormal fluid coming from your nipple.
If your provider suggests that you have a breast biopsy, it doesn't mean you have breast cancer. Most breast lumps and other changes that are checked with biopsies turn out to be benign, which means they are not cancer.
There are three main types of breast biopsy procedures. They are usually done on an outpatient basis, which means you go home the same day:
- Fine needle aspiration biopsy uses a very thin needle to remove a sample of breast cells or fluid. The biopsy takes about 15 minutes.
- Core needle biopsy uses a wide needle to remove one or more small tissue samples about the size of a grain of rice. Sometimes a small vacuum probe is used instead of a needle. The device gently suctions some tissue and removes it with a small rotating blade. A core needle biopsy takes between 15 minutes and an hour, depending on how it's done.
- Surgical biopsy (or open biopsy) is surgery to remove all or part of a lump. The biopsy usually takes about an hour.
Biopsies are often done using mammography, ultrasound, MRI, or x-rays to help see exactly where to take the tissue sample. Your procedure will vary depending on which method is used to guide the biopsy, but the general steps are usually the same.
For a fine needle aspiration biopsy or a core needle biopsy:
- Your provider will clean the skin on your breast and give you a shot of medicine to numb the area, so you won't feel any pain. The shot may sting briefly.
- You may be sitting or lying down. If images are used to guide the biopsy, you may lie on your side, back, or belly with your breast over an opening on the table.
- For a fine needle aspiration biopsy, your provider will insert the needle into the biopsy site and remove a sample of cells or fluid. For a core biopsy, a tiny cut may be made to insert a wide needle or a vacuum device. You may feel a little pressure when the sample or samples are removed.
- Pressure will be applied to area until the bleeding stops.
- Your provider will cover the biopsy site with a sterile bandage. If you had a small incision, small strips of medical tape may be used to close the wound.
For a surgical biopsy:
- You'll lie on an operating table. You may have an IV (intravenous line) in your arm or hand that may be used to give you medicine to relax. The skin over the biopsy area will be cleaned.
- To prevent pain, you'll have either:
  A shot of medicine to numb your breast. The shot may sting briefly.
  General anesthesia, which is medicine given through an IV to make you sleep.
- When you are numb or asleep, the surgeon will make a small cut in your breast tissue to remove part or all of the lump. In certain cases, tissue around the lump may also be removed. This may help avoid the need for more surgery if cancer cells are found in the lump.
- The cut in your skin will be closed with small strips of medical tape or stitches and covered with a sterile bandage.
The type of biopsy you have will depend on:
- The size and location of the suspicious tissue in your breast
- How many areas of your breast are involved
- How abnormal the tissue looks on a mammogram or other image
- Your general health and preferences
Ask your provider about why you need a biopsy and which type is right for you.
It's common to have some bruising and temporary discomfort after a breast biopsy. Possible risks include:
- Infection, which can be treated with antibiotics
- Bleeding
Your provider will give you instructions for how to care for biopsy area and manage any discomfort. If you're having general anesthesia, talk with your provider about how it may affect you. General anesthesia is very safe even for most people with other health conditions.
It may take several days to a week to get your biopsy results. The results are called a pathology report. The report is written for your provider and will include a lot of medical terms. Your provider can explain what your report means.
The most important part of your report will be the diagnosis. In general, your results will be one of these categories:
- Normal. No cancer or abnormal cells were found.
- Abnormal breast changes that aren't cancer and don't increase your risk for breast cancer. Some of these conditions often get better on their own and others may need treatment.
- Abnormal breast changes that increase your risk for breast cancer. These cells are not cancer, but if you have them, you are more likely to develop cancer.
  If you had a needle biopsy that diagnosed a condition that increases your breast cancer risk, you may need a surgical biopsy to remove all the abnormal tissue. To find out what you can do to reduce your breast cancer risk, you will likely see a doctor who specializes in breast cancer.
- Breast cancer. If your biopsy finds cancer cells, your report will include details about how fast the cancer cells are growing, how much they look like normal cells, and other information to help plan the most effective treatment for your type of cancer. Usually, a doctor who specializes in breast cancer will provide your care.
1. Breast Biopsy: MedlinePlus Medical Test [accessed on Mar 22, 2022]
2. Having a Breast Biopsy | Effective Health Care (EHC) Program [accessed on Mar 22, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (13)

PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement

Video by PreOp.com Patient Engagement - Patient Education/YouTube

How a core breast biopsy is taken

Video by Bupa Health UK/YouTube

Stereotactic Biopsies for Breast Evaluation | UPMC Magee-Womens Hospital

Video by UPMC/YouTube

What It’s Like to Get a Breast Biopsy

Video by RAYUS Radiology™/YouTube

Ultrasound-guided core-needle breast biopsy

Video by Institute for Cancer Genetics and Informatics/YouTube

Having a breast biopsy. A review of the research for women and thier families (2016 report)

This information is right for you if: -- You are a woman. The information in this summary is from research on women. -- Your doctor has found a breast lump or shadow on your mammogram and has recommended a breast biopsy.

Document by effectivehealthcare.ahrq.gov

Ultrasound Guided Breast Biopsy 1

Ultrasound image of possible breast tumor before biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.

Image by TheVisualMD

Ultrasound Guided Breast Biopsy 2

Ultrasound image of possible breast tumor showing core needle penetrating suspicious breast lesion during biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.

Image by TheVisualMD

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Needle Biopsy

Adult Black female breast visible. Physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.

Image by National Cancer Institute / Linda Bartlett (Photographer)

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Biopsy

A Caucasian woman patient is being operated on. Her nipple is being incised by the surgeon. The male surgeon and an operating room attendant are visible. A surgical biopsy is being performed to determine exact nature of solid tumor.

Image by National Cancer Institute / Linda Bartlett (Photographer)

Breast Biopsy

Image Caption : Needle Breast Biopsy

Image by BruceBlaus

Mammotome

Mammotome probe - biopsy

Image by Waglione/Wikimedia

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Breast Cancer Biopsy

If a woman has symptoms of breast cancer (such as a lump), or if a suspicious area is found in an imaging exam, the next step is to physically examine the breasts by noting any changes in their appearance and palpating the breast and the underarm region. A complete physical exam may be done as well. If symptoms or results of these exams suggest cancer might be present, then further tests will be done. (Note: The following diagnostic procedures are common to the US; procedures may vary in other countries.)

Video by TheVisualMD

2:22

PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement

PreOp.com Patient Engagement - Patient Education/YouTube

1:39

How a core breast biopsy is taken

Bupa Health UK/YouTube

2:47

Stereotactic Biopsies for Breast Evaluation | UPMC Magee-Womens Hospital

UPMC/YouTube

3:57

What It’s Like to Get a Breast Biopsy

RAYUS Radiology™/YouTube

1:29

Ultrasound-guided core-needle breast biopsy

Institute for Cancer Genetics and Informatics/YouTube

Having a breast biopsy. A review of the research for women and thier families (2016 report)

effectivehealthcare.ahrq.gov

Ultrasound Guided Breast Biopsy 1

TheVisualMD

Ultrasound Guided Breast Biopsy 2

TheVisualMD

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Needle Biopsy

National Cancer Institute / Linda Bartlett (Photographer)

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Biopsy

National Cancer Institute / Linda Bartlett (Photographer)

Breast Biopsy

BruceBlaus

Mammotome

Waglione/Wikimedia

0:56

Breast Cancer Biopsy

TheVisualMD

Kinds of Biopsy

Ultrasound Guided Breast Biopsy 1

Image by TheVisualMD

Kinds of Breast Biopsies

Core-Needle Biopsy

Your doctor will probably suggest a core-needle biopsy. It is done using local anesthesia (an-ess-THEE-zhuh), which means that the breast will be numbed.

The doctor puts a hollow needle into the breast and takes out a small amount of tissue. The doctor may place a tiny marker inside the breast to mark the spot where the biopsy was done.

There are several ways to do core-needle biopsies. Some of these use different types of imaging equipment.

Ultrasound-guided core-needle biopsy uses ultrasound to guide the needle to the lump. Ultrasound uses sound waves to create a picture of the inside of the breast. It is like the ultrasound used to look at the baby in the womb while a woman is pregnant. You will lie on your back or side for this procedure. The doctor will hold the ultrasound device against your breast to guide the needle.
Stereotactic-guided core-needle biopsy uses x-ray equipment and a computer to guide the needle. Usually for this kind of biopsy, you lie on your stomach on a special table. The table will have an opening for your breast. Your breast may be squeezed and flattened as it is for a mammogram.
MRI-guided core-needle biopsy is similar to stereotactic- guided core-needle biopsy, but magnetic resonance imaging (MRI) equipment is used to guide the needle.
Freehand core-needle biopsy does not use ultrasound, x-ray, or MRI equipment. It is used less often and only for lumps that can be felt through the skin.

Open Surgical Biopsy

An open surgical biopsy is usually done only if you have a high risk of cancer or if the lump is in an area of the breast that cannot be reached with a core-needle biopsy. It is done using general anesthesia. You will be given medicine to make you sleepy through an IV needle placed in a vein in your arm.

The surgeon makes a 1-inch to 2-inch cut in the breast and removes part or all of the lump. Some of the tissue around the lump also may be taken out.

If the lump can be seen on a mammogram or an ultrasound but cannot be felt, a radiologist (a doctor who specializes in medical imaging) usually inserts a thin wire to mark the spot for the surgeon before the biopsy.

Note: It is not unusual to feel nervous about having a biopsy. Ask your doctor or nurse what to expect. It may help to talk with your family and friends. You also might want someone to come to your appointment with you.

Source: Agency for Healthcare Research and Quality (AHRQ)

Additional Materials (1)

Ultrasound Guided Breast Biopsy 2

TheVisualMD

Accuracy & Side Effects

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Biopsy

Image by National Cancer Institute / Linda Bartlett (Photographer)

Research About Breast Biopsy

Accuracy

Open surgical biopsies and core-needle biopsies both work well for finding breast cancer. But, biopsies are not 100-percent accurate. In a few cases, a biopsy can miss breast cancer. Or, a biopsy that appears to show cancer can be wrong.

Open surgical biopsies and ultrasound-guided or stereotactic-guided core-needle biopsies have about the same accuracy. Freehand coreneedle biopsies appear to be a little less accurate. There is not enough research to know the accuracy of MRI-guided core-needle biopsy.

Accuracy of breast biopsies
Kind of breast biopsy	Out of 100 women who do have breast cancer, this kind of biopsy correctly identifies:	Out of 100 women who do not have breast cancer, this kind of biopsy correctly identifies:
* More research is needed to know this for sure.
Ultrasound-guided core-needle biopsy	97 to 99 of these women, depending on the exact method used	97 to 99 of these women, depending on the exact method used
Stereotactic-guided core-needle biopsy	97 to 99 of these women, depending on the exact method used	92 to 99 of these women, depending on the exact method used
Freehand core-needle biopsy	91 of these women*	98 of these women*
Open surgical biopsy	At least 98 of these women	Not reported in the research

Side effects

Bleeding, bruising, and infection can happen after a breast biopsy. Core-needle biopsies have a lower risk of these side effects than open surgical biopsies.

Side effects are rare with any kind of core-needle biopsy.

Less than 2 out of 100 women who have a core-needle biopsy have a side effect like severe bruising, bleeding, or infection.

Side effects happen more often with open surgical biopsy.

Up to 10 out of 100 women who have open surgical biopsy get severe bruising.
Up to 6 out of 100 women who have open surgical biopsy get an infection.

Some medicines, including aspirin, increase the risk of bleeding and bruising. Your doctor will ask you about the medicines you take. You may need to stop taking some medicines a few days before the biopsy.

Pain

Women who have an open surgical biopsy sometimes need prescription pain medicine after the procedure. Women who have a core-needle biopsy rarely need prescription pain medicine.

Source: Agency for Healthcare Research and Quality (AHRQ)

Biopsy Results

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Doctor Reviews Images

Image by National Cancer Institute / Rhoda Baer (Photographer)

Biopsy Results

After the biopsy, the pathologist who looked at the tissue will send a report to your doctor. The report will tell if the lump is cancer or not. Your doctor will go over the report with you. Waiting for these results can be difficult. It can take about a week to get the results.

If no cancer is found, the biopsy result is called benign (be- NINE). Benign means it is not cancer. Some benign results need followup. Talk with your doctor or nurse about what is recommended for you.
If cancer is found, the report will tell you the kind of cancer you have. It will help you and your doctor talk about the next steps. Often, this may include seeing a breast cancer specialist. You also may need more imaging tests or surgery. All this information will help you and your doctor think through your treatment options.

Take time to think. Most women with breast cancer have time to think about their options.

Note: Ask your doctor if you do not understand your test results. After going over the results with your doctor, ask for a copy of the report for your records.

Source: Agency for Healthcare Research and Quality (AHRQ)

Additional Materials (1)

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Breast Cancer in Women: Know the Subtype

National Cancer Institute (NCI)

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