Diagnosing Cancer: Understanding Hormone Status, HER2 Status, and More

mammogram results
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Breast cancer isn't always detected with the naked eye. Its early signs are often hidden within your breast tissues.

Changes to your breasts that you do see may not be the result of breast cancer at all. Lumps and bumps may come and go as your hormones ebb and flow and as you age. Also, breast skin may change texture due to sunburn, radiation treatments, or infections that cause rashes.

So, how would you know for sure whether or not a lump, skin rash, or skin dimpling is benign or cancerous?

You will need help from your medical professionals to get a clear diagnosis.

Hormone Status

Breast cancers are divided into two main types:

  1. Estrogen receptor positive
  2. Estrogen receptor negative

If you test positive for breast cancer, estrogen and progesterone biomarker test results appearing on your pathology report will help your physician determine which type of the disease you have. This information affects your treatment as well as your follow-up care.

HER2 Status

HER2 (human epidermal growth factor receptor 2) protein can fuel the uncontrolled growth of a breast cancer tumor. Herceptin is used to treat this kind of breast cancer, in combination with other chemotherapy drugs.

Lapatanib is also available for those who are HER2 positive. Knowing your HER2 status affects your diagnosis and treatment.

Clinical Breast Exam (CBE)

Women who are between 20 and 30 years old should have a clinical breast exam during their annual physical.

If irregularities are found, a mammogram and ultrasound can help clarify the nature of the problem.

Mammograms

A mammogram is the gold standard for breast cancer screening and early detection. The American Cancer Society recommends that women 40 years old and up have an annual mammogram, though some other medical associations push that recommendation to age 50.

Mammograms can help detect 85 to 90 percent of all breast cancers, even before you can feel a lump. Check out the following information to better familiarize yourself with what to expect:

Breast Magnetic Resonance Imaging (MRI)

A breast MRI reveals different details of your breast health than a mammogram, so it can be used as a complementary test. MRIs don’t use compression, like mammograms, but are much more expensive and not as widely available. Learn more about how mammograms and MRIs are different.

Elastography

Elastography is a new, though still investigational, technology for imaging breast tissue. It may be better than mammography, ultrasound, and MRI at distinguishing between benign and cancerous growths. Elastograms can find a cancerous lump without a biopsy.

Pathology Testing

If a breast lump is suspicious, a sample of tissue or fluid must be taken and tested by a pathologist.

Fluid Test

  • Ductal lavage has been referred to as the "pap smear for the breast." A tiny tube is inserted into the breast to draw fluid from the breast ducts, which is then examined under a microscope or screened for cancer cells. This is also an investigational screening technique.
  • During an aspiration, your doctor will use a fine needle to suction a sample of fluid from a lump, such as a cyst, to be screened.

Tissue Test

Staging

Once all the test results are in, your doctor will summarize the diagnosis for you. Your cancer will be ranked in stages, once by your oncologist, and again by your radiologist. Knowing the stage of your breast cancer is critical to deciding on a course of treatment

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