Some of the diagnostic techniques involve imaging scans, biopsies, and a range of blood tests in order to diagnose metastatic breast cancer. MBC is an advanced type of breast cancer that occurs when the cancer cells invade many body parts, such as the brain, liver, lungs, and bones, other than the breast and nearby lymph nodes.
Learn more about metastatic breast cancer diagnostics.
Diagnosis of metastatic breast cancer
MBC is a late-stage diagnosis of breast cancer. Some patients receive a first-time diagnosis of breast cancer after it has metastasized to other parts of their body. “De novo” metastatic breast cancer is the term used for this. A diagnosis of MBC usually comes after treatment for early-stage breast cancer.
After treatment, cancerous cells of the breast will spread in various parts of the body to form a new set of tumors, if these find their way into the circulation of lymphatic fluid. In short, this is called metastatic recurrence.
An oncologist is a medical professional who specializes in the diagnosis and treatment of cancers. To determine whether you have cancer cells in your body, an oncologist may prescribe a number of tests.If you are in the early stages of breast cancer, have symptoms of MBC such as headache, bone pain, or shortness of breath, have abnormal results from a recent mammogram, or have a biopsy that shows you have breast cancer in a later stage, they will most likely order tests for MBC.
Blood Examinations
Blood tests reveal information about your general health as well as clues about the metastases or spread of cancer. Your healthcare team may prescribe one or more of the following tests:
- Complete Blood Count or CBC: measures the blood levels of different cell types such as hemoglobin, platelets, and red and white blood cells.With the help of CBC data, anemia (low count of red blood cells), thrombocytopenia (low count of platelets), and impaired immunological function (low count of white blood cells) can be identified.
- Serum chemistry panel: measures the blood’s levels of several minerals, including calcium and potassium, as well as enzymes to assess kidney and liver function. In some cases, abnormal amounts of certain minerals and enzymes can be a sign that breast cancer cells have spread. For example, abnormal calcium levels may indicate that breast cancer has metastasized to the bones.
- Tests for tumor markers: Measuring the amounts of specific proteins, or antigens, that exist in the blood of women with metastatic breast cancer.
- CTCs or circulating tumor cells will determine the presence of cancerous cells within the bloodstream. A blood cell count of circulating tumor cells tells that cancerous cells are separated from their location site, which was their originating tumor in this case. End.
Imaging Tests
Imaging scans provide you with vivid images of the inner anatomy of your body. Such scans help doctors to identify suspicious tumor masses or abnormalities that denote the spread of breast cancer to other parts of your body. Common imaging tests of MBC include:
- An X-ray of your chest will be checked for breast cancer that may have metastasized to the lung, one of the common sites for breast cancer spread.
- More typically in the later stages, a bone scan can assess the presence of cancer in a bone. In this scanning test, a tracer-that is, a small quantity of radioactive material-is injected in your vein. Your bones will be scanned using a specialized camera. The lesions appear to be darker on the scanner, and healthy bone reflects to be light because the former accumulates in the defective sections of the bone, say, the tumors.
- A CT scan is a computed tomography scan that uses X-rays to take photographs of different angles of your body and creates detailed cross-sectional scans of your body. This can be useful in measuring tumors if they are found and checking for abnormalities in the lungs, liver, bones, and lymph nodes.
- Magnetic resonance imaging (MRI) scans use strong magnetic fields and radio waves to give detailed images of organs and tissues. Before the test, a special dye called contrast medium is injected into your veins to help produce a crisper image. An MRI can be used to estimate the size of tumors and assess particular areas of concern.
- It determines the location of metastatic cancers in the body’s tissues and organs through a Positron Emission Tomography scan. In this test, radioactive sugar is injected into your bloodstream, which is used by cells as fuel. The cancer cells are brighter in the scan because they consume more energy and absorb more radioactive carbohydrates than healthy cells.
Biopsy
Biopsy Imaging and blood tests are essential tools in the metastatic breast cancer diagnostic process, but a biopsy is the only way to provide a definitive diagnosis. A biopsy involves removing a small tissue sample from a part of your body for microscopic examination by a pathologist (a doctor specializing in diagnosing diseases). The pathologist examines the suspicious tissue to identify and confirm the presence of cancer cells. The specific biopsy procedure for diagnosing metastatic breast cancer depends on the location of the suspected metastasis. Common types of biopsies include:
- Needle biopsy: A very small needle is inserted into the suspected tumor site to extract a tissue sample. To locate the precise area, doctors use imaging tests such as CT and ultrasounds to guide the needle.
- Laparoscopic or thoracoscopic biopsy involves small incisions into the belly, and with a laparoscope—this is a small flexible tube that has a miniature camera and light—a worrisome area is evaluated to remove small tissue samples. A thoracoscopic biopsy collects tissue samples from the chest, while a laparoscopic biopsy gets tissue samples from the belly and pelvic.
- Surgical biopsy: An incision in the skin is done in order to take a more significant tissue sample or tumor for examination. The nature of the surgical procedure is determined by the location of the suspected tumor.
- A biopsy can confirm metastatic breast cancer and even provide information about the breast cancer subtype by looking at specific tumor characteristics, which include the following:
- Estrogen and progesterone receptors: A determination of the hormone receptor status of the tumor helps test for the presence of receptors (proteins) that bind to estrogen and progesterone in breast cancer cells. These hormones can stimulate the growth of cancer when breast cancer cells have these receptors. Knowledge of the hormone receptor status of the cancer cells makes the decision easier to determine whether treatment that regulates or prevents hormones from functioning on breast cancer cells is needed.
- HER2 status: The protein HER2 promotes the growth of breast cancer cells. Compared to other breast cancer cells, those with high HER2 tend to grow and spread more rapidly. Medications that target the HER2 protein are more likely to be effective on metastatic breast cancer if it is HER2 positive.
- To search for biomarkers in cancer cells, your doctor might even perform additional tests on the tissue sample. Biomarker tumor testing analyzes the genes within cancer cells to identify mutations that may impact how a cancer might respond to treatment.
Genetic Examination
If you suspect that breast cancer runs in your family, your healthcare provider can refer you to genetic testing. You may determine whether you inherited gene mutations (alterations) that increase your risk of MBC by taking a genetic test. The test takes a small amount of blood, saliva, or cheek swabs, which is then sent to a lab for processing.If the results are positive, medical professionals can then trace the cause of growth for the cancer and provide information that can be used in advising treatment choices. This information will also come in handy for family members at risk and might want to have more frequent breast cancer screenings.
