Breast Cancer Diagnosis

If you’ve found a lump in your breast or had an abnormal mammogram, diagnostic testing for breast cancer is the next step. At the Abramson Cancer Center, we use the latest imaging, testing and procedures to thoroughly evaluate areas of concern in the breast. We identify the characteristics of every breast cancer to create personalized treatment plans.

Breast Cancer Diagnosis: Why Choose the Abramson Cancer Center

Our multidisciplinary breast cancer team collaborates to provide a diagnosis you can trust and understand. At the Abramson Cancer Center, you can expect:

  • Timely diagnosis: We aim to complete diagnostic testing within two weeks and before your first surgical consultation. Whenever possible, our radiologists perform a core biopsy with results available within 24 hours. Our breast cancer team uses that information to quickly get you the personalized treatment you need.
  • Coordinated care: Our oncology-certified nurse navigator provides an overview of the process and sets up your testing and consultations. Whenever possible, we schedule your appointments together to avoid additional visits. Meet our oncology nurse navigators.
  • Breast cancer experts: Our specialized radiologists and pathologists work together to deliver a precise diagnosis. They study breast tissue every day and notice important details that others may miss.
  • Full evaluation of benign breast issues: In some cases, breast cancer symptoms may be caused by a benign (non-cancerous) tumor. We conduct a physical examination, additional screening and breast cancer risk assessment to fully understand the source of your symptoms.
  • Care close to home: No matter where you live in the Penn network, you’re near our experts. We diagnose breast cancer at all Penn Medicine locations. Our breast cancer specialists and providers collaborate across the network to identify and treat breast cancer.

How We Diagnose Breast Cancer

We look at breast tissue from every angle before delivering a diagnosis. If you’ve had imaging performed somewhere else, our specialized radiologists interpret your previous scans and order additional imaging when necessary. The tools we use to diagnose breast cancer include the following.

Breast Imaging

We use advanced breast imaging to get a better look at suspicious tissue. Our expert radiologists specialize in breast cancer and use leading-edge technology including:

  • Diagnostic 3D mammogram: Specialized X-ray techniques, such as 3D imaging (digital breast tomosynthesis), may provide more detail than standard 2D mammogram. We use 3D mammography to view the breast in individual "slices" and identify abnormal tissue.
  • Ultrasound: We use ultrasound in addition to mammogram when more information is needed. This technology uses sound waves instead of radiation to create images of the breast.
  • Breast MRI: Magnetic resonance imaging (MRI) uses radio waves and strong magnets to provide more information than a mammogram or ultrasound. It helps us identify breast cancer and determine a tumor's location, size and stage.

Breast Biopsy

A breast biopsy can confirm or dismiss a breast cancer diagnosis after imaging. During a biopsy, the radiologist or surgeon removes a small amount of breast tissue for inspection. Our specialized breast pathologist then thoroughly examines the tissue. We use biopsy to determine whether the breast tissue contains cancer cells and, if so, how advanced the cancer is. Learn more about breast biopsy at Penn Medicine.

Other Breast Cancer Tests

To learn more about a breast tumor, we use lab tests that may include:

Testing for HER2 and Hormone Receptor Status

Certain tumor characteristics affect the growth of breast cancer. Identifying these defining factors helps us treat cancer more effectively. The two most common characteristics we look for are:

  • Hormone receptor status: If cancer is hormone-receptor positive, it means estrogen and/or progesterone help the cancer grow. Certain treatments, such as hormone therapy, may effectively treat this type of cancer.
  • HER2 status: Cancer with an excess of human epidermal growth factor receptor 2 (HER2) grows quickly and tends to recur (come back). If cancer is HER2-positive, we use targeted therapy, which may stop or slow the cancer growth.

If cancer tests negative for hormone receptors and HER2, we call it triple negative breast cancer. That means the cancer does not rely on estrogen, progesterone or HER2 protein to grow.

Gene Expression Testing for Breast Cancer

Genomic testing, also called gene expression profiling, looks at the patterns of various genes. Those patterns may help predict whether early stage breast cancer is likely to recur (come back). This information also helps us determine which patients may benefit from chemotherapy following breast surgery. Once treatment is complete, the 2-PREVENT Breast Cancer Translational Center of Excellence offers research and clinical trials to help women identify and manage any breast cancer recurrence.

Genetic Testing for Breast Cancer

If cancer is common in your family, you may have an increased risk of hereditary breast cancer. Specially trained genetic counselors at the MacDonald Risk Evaluation Center help you determine if you are a candidate for genetic testing. We conduct genetic risk evaluation with or without a cancer diagnosis. If you’ve already been diagnosed with cancer, the results of genetic testing:

  • May affect breast cancer treatment
  • Establish whether you have an increased risk of developing a second cancer
  • Provide your family with important information

The two genes most often linked to hereditary breast cancer are BRCA1 and BRCA2. If you have a BRCA-related cancer or a BRCA1 or BRCA2 gene mutation, the Basser Center for BRCA helps you and your family navigate treatment or reduce your cancer risk. We also offer support, testing, and resources for your family and clinical trials related to hereditary cancer.

Breast Cancer Staging

After an initial breast cancer diagnosis, we assess the size of the tumor. We also look to see whether cancer cells have spread to other parts of the body. With this information, we identify the breast cancer stage. Along with your HER2 and hormone receptor status, the cancer stage helps us personalize a breast cancer treatment plan.

Tawana's Breast Cancer Journey

At the age of 44, Tawana's annual mammogram caused some concern. After a second mammogram and a biopsy, she was diagnosed with ductal carcinoma in situ (DCIS). Tawana turned to the physicians at Penn Medicine, who explained her diagnosis and worked with her to develop a treatment plan. Now cancer-free for seven years, she uses her experience to help others diagnosed with breast cancer. Read Tawana’s story.

Female Scientist With Microscope in Lab

Breast Biopsy

We perform core needle biopsies and surgical breast biopsies using advanced imaging technology. Our expert analysis means you get a precise diagnosis.

Breast Cancer Staging

We provide the most accurate breast cancer staging using advanced imaging and diagnostic tests. Learn more about breast cancer stages.