Diagnosis and assessment at our Breast Care Units
Most patients referred to the Breast Care Units will not have cancer, but it is important to establish the correct diagnosis for each patient quickly, so that appropriate advice and treatment can be given where needed.
If you have a new breast cancer symptom your GP will assess you. GPs diagnose and treat many illnesses themselves. However, they may need to refer you to our dedicated Breast Care Unit for more specialist care.
If you are referred, you will be seen within two weeks. We perform as many of the tests as possible that are needed for cancer diagnosis in one clinic visit.
What will happen at the Breast Care Unit?
After you have reported to the reception, one of our staff will meet you in the waiting room, you will then be taken to a changing room and be asked to remove your clothes from above your waist. It is best to wear separates such as a skirt or trousers and top, rather than a dress.
A gown will be provided for you to wear, you can then put your cardigan/coat/shawl around your shoulders while you wait in a separate waiting area. Several tests may then be performed.
You may have some or all of the following tests:
X-ray of the breasts (mammogram)
This helps us see into the breast. We can spot lumps or other strange patterns in the tissue.
The doctor or practitioner will talk to you about your mammograms, ask you some general questions about your health, and will then examine your breasts.
This uses sound waves to make a picture of inside the breasts. It is harmless and pain free and does not involve any x-ray.
Fine needle biopsy (FNA)
This is the least invasive method of biopsy and it is usually leaves no scar. A very thin needle is used to get cells for testing. This is a minor and safe procedure. You will be lying down for this procedure. A specialist will use a thin needle with a hollow centre to remove a sample of cells from the suspicious area. In most cases, he or she can feel the lump and guide the needle to the right place. In cases where the lump cannot be felt, they may need to use an ultrasound probe to guide the needle to the right location.
Core Needle Biopsy (Core Biopsy)
This type of biopsy uses a larger hollow needle than fine needle aspiration does.
If the lesion cannot be felt through the skin, the clinician can use an image guided technique, such as ultrasound guided biopsy, or stereotactic needle biopsy. If you have this type of biopsy, you will normally be lying down. After numbing the breast with local anaesthetic, the clinician will use the needle to remove several samples of tissue from the suspicious area. This type of biopsy will normally not leave a scar. A small metal clip (made of titanium) may be inserted into the breast at the end of the biopsy procedure to mark the site of the biopsy. If the biopsy is inconclusive and leads to a larger, Vacuum Assisted Biopsy or to surgery, the clip will be removed at that time. If further tests and/or surgery are not required, the clip will be left inside the breast. It is not harmful to the body. It will not set off metal detectors (e.g. at airports) and will not prevent you from having an MRI scan.
Vacuum Assisted Biopsy (VAB)
This type of biopsy uses the largest biopsy needle. However, unlike a core biopsy (which involves inserting the needle through the skin several times to get the tissue samples, a VAB uses a special probe/needle that is only inserted through the skin once.
This type of biopsy also removes more tissue than a core biopsy does. Vacuum Assisted Biopsies are normally performed using x-ray/mammography guidance, but can also be done under ultrasound guidance. For a VAB, you be given an injection containing a larger amount of local anaesthetic to numb your breast. The clinician places the probe into the suspicious area of the breast. A vaccum pump then draws the tissue up, into the probe, removing a larger tissue sample. The probe then rotates, taking further samples, until the suspicious area has been thoroughly sampled. Once again, a small metal clip is normally inserted into the area that has been biopsied, at the end of the procedure.
If a needle sample is taken, we will make an appointment for you to receive your results, usually within 2 weeks.
Tissue samples are sent to a tissue expert (pathologist) for examination under a microscope. This is the only way to confirm (without doubt) the presence of cancer.
When will I get the results?
The doctor or practitioner will tell you the results of any mammograms and ultrasound scans that you may have had done at the assessment clinic. If a needle sample is taken, we will make an appointment for you to receive your results, usually this is within 2 weeks.
How long will I be at the clinic?
Your appointment may take between 1 to 3 hours. Friends and relatives are asked to wait in the main waiting area while patients wait for their tests in the clinic. This is to respect the privacy of other patients undressed and wearing hospital gowns. However, you may request your friend or relative to accompany you when it’s your turn to see the doctor.