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The diagnosis of breast cancer must be made with certainty before surgery can be undertaken. The diagnosis cannot be made on history and examination alone.

Investigative measures to confirm the diagnosis include:

  • imaging:
    • mammography
    • ultrasound
    • ductography

  • biopsy:
    • fine needle aspiration biopsy
    • core needle biopsy
    • localisation biopsy
    • open biopsy

  • detection of metastatic disease:
    • liver function tests
    • serum calcium
    • chest radiograph
    • isotope bone scan
    • liver ultrasound scan
    • CT brain

The yield from an extensive search for metastatic disease is poor except in cases where suspicion is great clinically. Hence, symptoms of metastasis or patients with stage III disease should have a bone scan, chest X ray and liver ultrasound. A CT scan of the brain should only be carried out when the history or examination is suggestive of metastasis e.g. fits.

Last reviewed 01/2018