Understanding Breast Cancer – Staging

    Published: 06-16-2009
    Views: 9,365
    Dr. Rebecca Zuurbier, M.D. and Dr. Jacqueline Eghrari – Sabet, MD discuss breast cancer and staging.

    Jacqueline Eghrari-Sabet: Suppose you are diagnosed with breast cancer, the next steps will involve figuring out where else it may be. Where else is it in the breast, where else is it potentially outside of the breast. So you'll have a series of extra tests, not all of these tests may be performed on you, if you have breast cancer. It's really up to you and your doctor to figure out, which ones are appropriate.

    You may have mammographic and ultrasounds, imaging to exclude cancer in other areas of the breast. There's also a new imaging tool called Breast MRI, MRI stand for Magnetic Resonance Imaging. It's a test where you're lying on a table much like in a Cat Scans, if you've ever had one of those, it's been used traditionally for looking at the brain and spinal cord but physicians have realized that with the use of intravenous contrast injection, certain cancers in the breast may lied up if you will. And show up as an abnormality on the Magnetic Resonance Imaging study.

    So breast MRI for staging breast cancer is being used more often. It's a very sensitive test, meaning it finds a lot of cancers. Unfortunately it's not that specific. Things lied up that aren't always breast cancer and so it's used in breast cancer staging is becoming more popular but is does have limitations. But breast MRI may be one of the additional tests ordered. Additionally to what we call stage of the disease, figure out what's going on, your surgeon may test the lymph nodes in the armpit and that's called a sentinel lymph node dissection. With that an injection of dye or an injection of a radioactive substance is made near the tumor in the breast and then the surgeon looks for the dye or uses geiger counter to find where that first node is.

    The theory is, if it has gone to that first or sentinel lymph node, it's unnecessary to biopsy other lymph nodes in the armpit and it's unlikely that disease has spread outside of the breast which would be favorable. Prognosis is sometimes related to the number of lymph nodes involved in the armpit, none or few is good. Other staging tests that could be offered to you include a chest X-ray, simply to look for cancer potentially in the lungs. A bone scan is a test where they look for disease in the bones, it uses a radioactive injection and a scan under a camera. Again a painless study to look for potentially arise of disease in the bones. A cat scan of your abdomen and pelvis may help to look for disease in the organs of your abdomen and pelvis such as the lever especially. So those are a series of tests that may be performed, not all of them may be performed however. So once you've been diagnosed with breast cancer and you've had proper staging to figure out how extensive the disease is, now it's time to undergo treatment and what are the treatment options. We'll be discussing those next.