If you have found a lump in your breast or had an abnormal mammogram, a breast cancer diagnosis is the next step. At the Abramson Cancer Center, our diagnostic specialists 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 based on your unique breast cancer diagnosis.
How Is Breast Cancer Diagnosed?
A breast cancer diagnosis is performed using breast imaging after suspicious symptoms, like a breast lump, or an abnormal mammogram are reported. Types of imaging used include 3D mammograms, ultrasounds, and MRI. After imaging tests, a breast biopsy is used to confirm the findings.
We look at breast tissue from every angle before delivering a diagnosis. If you have 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
Advanced breast imaging is used 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 a 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.
Learn about the types of breast imaging services at Penn Medicine
Breast Biopsy
A breast biopsy can confirm 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.
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.
- HER2 status: HER2-positive breast cancer has an excess of human epidermal growth factor receptor 2 (HER2) grows quickly and tends to recur (come back).
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 individuals 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 or other types of cancer. Clinically licensed 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 have 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 essential information
The two genetic mutations most often linked to hereditary breast cancer are BRCA1 and BRCA2. If you have a BRCA gene mutation or a BRCA-related cancer the Basser Center for BRCA helps you and your family navigate treatment or manage your cancer risk. We also offer education, genetic counseling, and resources for your family as well as research and clinical trials related to hereditary cancer.
Learn more about breast cancer risk factors
What Is the First Step After a Breast Cancer Diagnosis?
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 plan for your breast cancer treatment.
Learn more about breast cancer staging
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 can provide 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 crucial details.
- Full evaluation of benign breast issues: In some cases, breast cancer symptoms may be caused by a benign (non-cancerous) tumor or cyst. We conduct a physical examination, additional breast cancer 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 greater Philadelphia region, you’re near our experts. We diagnose and treat breast cancer at all Penn Medicine locations. Our breast cancer specialists and providers collaborate seamlessly across the network to identify and treat breast cancer.
Getting a Second Opinion on a Breast Cancer Diagnosis
Penn Medicine Breast Cancer Program specialists welcome seeing second opinions for cancer diagnoses. To schedule a second opinion, call us at 800-789-PENN (7366) or contact a breast oncology nurse navigator. If you were diagnosed with breast cancer at another health care center and are coming to Penn Medicine’s Abramson Cancer Center for either treatment or a second opinion, additional diagnostic tests may be necessary.
Penn uses specific diagnostic imaging tools, tests and procedures that are often more modern than what is available at other healthcare facilities. The results of these tools help us diagnose your specific type of cancer and guides us in developing your personalized treatment plan.
In advance of your second opinion, we may request items including pathology slides, copies of recent imaging results (CT scans, for example), previous health records, and a list of dates and facts about your past treatments or anything else relevant to your current breast cancer diagnosis.
Prepare any questions you may want answered ahead of the appointment as it can be difficult to remember everything during the physical visit. If you have more questions after your appointment, you can communicate with us via MyChart by myPennMedicine, our secure patient portal. The portal allows for seamless communications with your entire team of health care providers.
Finally, plan to have a friend, family member or support person come with you to your breast cancer diagnosis appointment to help record information, recall the conversation and be of general support throughout the process.
Request an Appointment
To make an appointment, please call 800-789-7366 or request a callback.