Most types of<unk>  are easy to diagnose by microscopic analysis of a sample – or biopsy – of the affected area of the breast. Also, there are types of<unk>  that require specialized lab exams. The two most commonly used screening methods, physical examination of the breasts by a healthcare provider and mammography, can offer an approximate likelihood that a lump is cancer, and may also detect some other lesions, such as a simple cyst. When these examinations are inconclusive, a healthcare provider can remove a sample of the fluid in the lump for microscopic analysis (a procedure known as fine needle aspiration, or fine needle aspiration and cytology, FNAC) to help establish the diagnosis. A needle aspiration can be performed in a healthcare provider's office or clinic. A local anesthetic may be used to numb the breast tissue to prevent pain during the procedure, but may not be necessary if the lump isn't beneath the skin. A finding of clear fluid makes the lump highly unlikely to<unk> ncerous, but bloody fluid may be sent off for inspection under a microscope for cancerous cells. Together, physical examination of the breasts, mammography, and FNAC can be used to diagnose<unk>  with a good degree of accuracy. Other options for biopsy include a core biopsy or vacuum-assisted breast biopsy, which are procedures in which a section of the breast lump is removed; or an excisional biopsy, in which the entire lump is removed. Very often the results of physical examination by a healthcare provider, mammography, and additional tests that may be performed in special circumstances (such as imaging by ultrasound or MRI) are sufficient to warrant excisional biopsy as the definitive diagnostic and primary treatment method. File:Breast MRI T1W FSE ARC T2W FSE ARC T2W FSE IDEAL 09-arrow.MRI showing<unk>  File:Breast cancer.Excised human breast tissue, showing an irregular, dense, white stellate area of cancer 2 cm in diameter, within yellow fatty tissue File:Invasive Ductal Carcinoma 40x.High-grade invasive ductal carcinoma, with minimal tubule formation, marked pleomorphism, and prominent mitoses, 40x field File:Breast carcinoma in a lymph node.Micrograph showing a lymph node invaded by ductal breast carcinoma, with an extension of the tumor beyond the lymph node File:Neuropilin-2 (Nrp2) expression in normal breast and breast carcinoma tissue.Neuropilin-2 expression in normal breast and breast carcinoma tissue File:Mamma-CA.F-18 FDG PET/CT: A<unk>  metastasis to the right scapula File:Needle Breast Biopsy.Needle breast biopsy File:Manual compression elastography of invazive ductal carcinoma 00132.Elastography shows stiff cancer tissue on ultrasound imaging. File:Breast cancer ultrasound.Ultrasound image shows irregularly shaped mass of<unk> . File:Infiltrating breast carcinoma.Infiltrating (invasive) breast carcinoma File:Mammo<unk>  wArrows.Mammograms showing a normal breast (left) and a breast with cancer (right) Classification<unk> s are classified by several grading systems. Each of these influences the prognosis and can affect treatment response. Description of a<unk>  optimally includes all of these factors. Histopathologic types of<unk> , with relative incidences and prognoses * Histopathology.<unk>  is usually classified primarily by its histological appearance. Most<unk> s are derived from the epithelium lining the ducts or lobules, and these cancers are classified as ductal or lobular carcinoma. Carcinoma in situ is growth of low-grade cancerous or precancerous cells within a particular tissue compartment such as the mammary duct without invasion of the surrounding tissue. In contrast, invasive carcinoma does not confine itself to the initial tissue compartment. * Grade. Grading compares the appearance of the<unk>  cells to the appearance of normal breast tissue. Normal cells in an organ like the breast become differentiated, meaning that they take on specific shapes and forms that reflect their function as part of that organ. Cancerous cells lose that differentiation. In cancer, the cells that would normally line up in an orderly way to make up the milk ducts become disorganized. Cell division becomes uncontrolled. Cell nuclei become less uniform. Pathologists describe cells as well differentiated (low grade), moderately differentiated (intermediate grade), and poorly differentiated (high grade) as the cells progressively lose the features seen in normal breast cells. Poorly differentiated cancers (the ones whose tissue is least like normal breast tissue) have a worse prognosis. * Stage.<unk>  staging using the TNM system is based on the size of the tumor (T), whether or not the tumor has spread to the lymph nodes (N) in the armpits, and whether the tumor has metastasized (M) (i.e. spread to a more distant part of the body). Larger size, nodal spread, and metastasis have a larger stage number and a worse prognosis. The main stages are: * Stage 0 is a pre-cancerous or marker condition, either ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS). * Stages 1–3 are within the breast or regional lymph nodes. * Stage 4 is 'metastatic' cancer that has a less favorable prognosis since it has spread beyond the breast and regional lymph nodes. File:Diagram showing stage T1<unk>  CRUK 244.Stage T1<unk>  File:Diagram showing stage T2<unk>  CRUK 252.Stage T2<unk>  File:Diagram showing stage T3<unk>  CRUK 259.Stage T3<unk>  File:Stage 4 of<unk> .Metastatic or stage 4<unk>  :Where available, imaging studies may be employed as part of the staging process in select cases to look for signs of metastatic cancer. However, in cases of<unk>  with low risk for metastasis, the risks associated with PET scans, CT scans, or bone scans outweigh the possible benefits, as these procedures expose the person to a substantial amount of potentially dangerous ionizing radiation. * Receptor status.<unk>  cells have receptors on their surface and in their cytoplasm and nucleus. Chemical messengers such as hormones bind to receptors, and this causes changes in the cell.<unk>  cells may or may not have three important receptors: estrogen receptor (ER), progesterone receptor (PR), and HER2. ER+ cancer cells (that is, cancer cells that have estrogen receptors) depend on estrogen for their growth, so they can be treated with drugs to block estrogen effects (e.g. tamoxifen), and generally have a better prognosis. Untreated, HER2+<unk> s are generally more aggressive than HER2-<unk> s, but HER2+ cancer cells respond to drugs such as the monoclonal antibody trastuzumab (in combination with conventional chemotherapy), and this has improved the prognosis significantly. Cells that do not have any of these three receptor types (estrogen receptors, progesterone receptors, or HER2) are called triple-negative, although they frequently do express receptors for other hormones, such as androgen receptor and prolactin receptor. * DNA assays. DNA testing of various types including DNA microarrays have compared normal cells to<unk>  cells. The specific changes in a particular<unk>  can be used to classify the cancer in several ways, and may assist in choosing the most effective treatment for that DNA type. File:Diagram showing stage 1A<unk>  CRUK 199.Stage 1A<unk>  File:Diagram showing stage 1B<unk>  CRUK 202.Stage 1B<unk>  File:Diagram 1 of 2 showing stage 2A<unk>  CRUK 003.Stage 2A<unk>  File:Diagram 2 of 2 showing stage 2A<unk>  CRUK 009.Stage 2A<unk>  File:Diagram 1 of 3 showing stage 2B<unk>  CRUK 006.Stage 2B<unk>  File:Diagram 2 of 3 showing stage 2B<unk>  CRUK 012.Stage 2B<unk>  File:Diagram 3 of 3 showing stage 2B<unk>  CRUK 015.Stage 2B<unk>  File:Diagram 1 of 3 showing stage 3A<unk>  CRUK 007.Stage 3A<unk>  File:Diagram 2 of 3 showing stage 3A<unk>  CRUK 013.Stage 3A<unk>  File:Diagram 3 of 3 showing stage 3A<unk>  CRUK 016.Stage 3A<unk>  File:Diagram 1 of 2 showing stage 3B<unk>  CRUK 004.Stage 3B<unk>  File:Diagram 2 of 2 showing stage 3B<unk>  CRUK 010.Stage 3B<unk>  File:Diagram showing stage 4<unk>  CRUK 228.Stage 4<unk>
Breast cancer
Mastitis
Ovarian cancer
Fibrocystic breast changes
Prostate cancer
Breast disease
Skin cancer
Cervical cancer