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Ask an expert: Breast cancer video: How is it diagnosed?

Want to know more about breast cancer? Dr Nick Plowman, Clinical Oncologist at St Bartholomew's Hospital in London answers some common questions about the symptoms, diagnosis, and treatment of breast cancer. Use the video clip menu below to select a question.

 

 

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The expert: Dr Nick Plowman

Clinical Oncologist, St Barts, London

 

Video Transcript: How is breast cancer diagnosed?

  

Once the clinician has ascertained that there is a suspicious lump in the breast he will want to get a piece of it under the microscope.  There are two common ways in which we do this.  The first is via a fine needle which produces cells (cytology specimens) which are looked at under the microscope by the histologist. 

 

The second is a formal biopsy, often an excision biopsy of the lump which can then be fully analysed under the microscope. 

 

The histologist who is the specialist who looks at these specimens is a very important member of the team.  No only does he tell us whether it is or it is not a cancer, but he will tell us which type of cancer it is and the grading which often tells us how aggressive we anticipate the tumour to be. 

 

He will also do supplementary tests, for example, he will tell us whether the hormone receptors are positive or negative on the tumour. 

 

If they are positive then the tumour may respond well to anti hormonal treatments, drugs like Tamoxifen, Anastrazol, Letrozole and others.  He can also do tests for an onco gene product called Her II, which if positive will mean that that patient will respond to the interesting new drug Traztuzumab also called Herceptin and several subsequent developments in the pattern in Pertuzumab and others in the field.