Biology Meets Machine Learning
The test works using a type of DNA released by tumor cells. This sheds into the blood, where it is known as cell-free DNA . It can be challenging to identify tumor-specific cfDNA, however, because many other cells also release DNA into the blood.
This test detects DNA that is specifically from cancer cells using changes to the DNA namely, the addition of a chemical called a methyl group, which is associated with tumor growth.
After isolating cfDNA from the blood sample and sequencing it to find the methylated parts, healthcare professionals can feed the results into a computer that can recognize DNA from cancer and noncancer cells.
The computer can then predict whether or not a person has cancer, and even what type it might be.
If your physician suspects cancer during physical examination or while taking a medical history, they might order certain cancer blood tests to guide the diagnosis. These blood tests are called tumor markers. Tumor markers could be specifically raised in certain cancers, and may give some idea about the origin of cancer and whether it is responding to the treatment protocol. These tests, however, are neither specific for certain cancers nor highly sensitive.
Other blood tests could be ordered. While these may not detect cancer or benign tumors, they can give a general idea about the functioning of the organ and indicate whether it has been affected by cancer.
What Questions Should I Ask My Healthcare Provider
Learning everything you can about your diagnosis can help you make informed decisions about your health. Here are some questions you may want to ask your healthcare provider:
- Where is the tumor located?
- Has the tumor spread?
- What stage breast cancer do I have?
- What do the estrogen receptor , progesterone receptor and HER2 tests show and what do the results mean for me?
- What are my treatment options?
- Is breast cancer surgery an option for me?
- Will I be able to work while I undergo treatment?
- How long will my treatment last?
- What other resources are available to me?
A note from Cleveland Clinic
Being diagnosed with breast cancer can feel scary, frustrating and even hopeless. If you or a loved one is facing this disease, its important to take advantage of the many resources available to you. Talk to your healthcare provider about your treatment options. You may even want to get a second opinion before making a decision. You should feel satisfied and optimistic about your treatment plan. Finally, joining a local support group can help with feelings of isolation and allow you to talk with other people who are going through the same thing.
What If You Have Early
If you have early-stage breast cancer but no symptoms to suggest the cancer has spread, you should not get an imaging test to look for cancer in other places in your body. The chance that your cancer has spread is very small. Studies show that breast cancer spreads to the liver and bones in fewer than 6 out of 100 people. And this is usually in patients with stage III breast cancer.
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What Can I Expect If I Have Breast Cancer
If youve been diagnosed with breast cancer, your healthcare provider will talk with you in detail about your treatment options. Treatment and recovery will be different for everyone, so they can tell you what to expect in your situation.
Is breast cancer fatal?
People with early-stage breast cancer often manage their condition successfully with treatment. In fact, many people whove received a breast cancer diagnosis go on to live long, fulfilling lives. Late-stage breast cancer is more difficult to treat, however, and can be fatal.
What is the survival rate for breast cancer?
The overall five-year survival rate for breast cancer is 90%. This means that 90% of people diagnosed with the disease are still alive five years later. The five-year survival rate for breast cancer that has spread to nearby areas is 86%, while the five-year survival rate for metastatic breast cancer is 28%. Fortunately, the survival rates for breast cancer are improving as we learn more about the disease and develop new and better approaches to management.
Keep in mind that survival rates are only estimates. They cant predict the success of treatment or tell you how long youll live. If you have specific questions about breast cancer survival rates, talk to your healthcare provider.
Positron Emission Tomography Scan
For a PET scan, a slightly radioactive form of sugar is injected into the blood and collects mainly in cancer cells.
PET/CT scan: Often a PET scan is combined with a CT scan using a special machine that can do both at the same time. This lets the doctor compare areas of higher radioactivity on the PET scan with a more detailed picture on the CT scan.
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Breast Cancer Testing Types Of Breast Cancer Tests
For people who are at high risk for breast cancer, such as a person who has a personal or family history of the disease, a genetic test may be recommended. The test will look for:
- BRCA1 or BRCA2 gene mutation A person with a mutation in either one of these genes has a significantly higher lifetime risk of developing breast cancer. This genetic test is done with a blood or saliva sample. It takes approximately one month to get the results back.
If you are getting , it is important to receive genetic counseling before and after getting the results. Having a genetic tendency does not mean you will develop breast cancer in your lifetime. Its also important to note that not all people with breast cancer have the BRCA gene mutation.
You may also get a lab test for breast cancer if you have had an abnormal mammogram, or if you or your doctor have detected something suspicious in the breast.
- Biopsy procedures a small amount of tissue is removed and sent to the lab for further testing to look for signs of cancer and determine whether the sample is . A biopsy can also show cellular changes and behavior in cancer cells, which can help determine what kind of is best for your type of cancer. Results are usually returned within a day or two but may take slightly longer, depending on what is found during the test.
Breast cancer lab testing can also be useful for monitoring of breast cancer treatment and to follow tumor markers.
Magnetic Resonance Imaging May Be Used To Screen Women Who Have A High Risk Of Breast Cancer
MRI is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging . MRI does not use any x-rays and the woman is not exposed to radiation.
MRI may be used as a screening test for women who have a high risk of breast cancer. Factors that put women at high risk include the following:
- Certain gene changes, such as changes in the BRCA1 or BRCA2 genes.
- A family history with breast cancer.
- Certain geneticsyndromes, such as Li-Fraumeni or Cowden syndrome.
An MRI is more likely than mammography to find a breast mass that is not cancer.
Women with dense breasts who have supplemental screening show higher rates of breast cancer detection, but there is limited evidence about whether this leads to better health outcomes.
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What Are Genomic Tests
Genomic tests analyze a sample of a cancer tumor to see how active certain genes are. The activity level of these genes affects the behavior of the cancer, including how likely it is to grow and spread. Genomic tests are used to help make decisions about whether more treatments after surgery would be beneficial.
While their names sound similar, genomic testing and genetic testing are very different.
Genetic testing is done on a sample of your blood, saliva, or other tissue and can tell if you have an abnormal change in a gene that is linked to a higher risk of breast cancer. See the Genetic Testing pages for more information.
Where Can I Go To Get Screened
You can get screened for breast cancer at a clinic, hospital, or doctors office. If you want to be screened for breast cancer, call your doctors office. They can help you schedule an appointment.
Most health insurance plans are required to cover screening mammograms every one to two years for women beginning at age 40 with no out-of-pocket cost .
Are you worried about the cost? CDC offers free or low-cost mammograms. Find out if you qualify.
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Results From A Routine Blood Test Could Help In Early Detection Of Cancer
Detecting cancer at the earliest opportunity can improve the chances of successful treatment. New research suggests that a routine blood test could help find cancers early.
Researchers have previously shown that high levels of platelets cells in the blood that help stop bleeding can be a sign of cancer. But now they have found that even slightly raised levels of platelets may be an indication of cancer.
This finding could enable family doctors to send their patients for urgent investigation sooner. The results of this University of Exeter study could help improve cancer detection rates in the UK.
When These Receptors Attach To The Hormones Estrogen And Progesterone And Grow It Can Leave You With One Of Four Results:
- Estrogen-receptor positive or negative : This means the breast cancer cells may or may not have receptors for the hormone estrogen. ER+ results suggest that the cancer cells may receive signals from estrogen that could promote their growth.
- Progesterone-receptor positive or negative : This means the breast cancer cells may or may not have receptors for the hormone progesterone. PR+ results indicate that the cancer cells may receive signals from progesterone that could promote their growth.
- HER2 positive or negative: Treatment can also be affected by the presence of HER2 , which is a protein that appears on the surface of some breast cancer cells and plays a role in how a healthy breast cell grows, divides, and repairs itself. Knowing whether they are present will affect the treatment thats chosen.
- Triple-negative breast cancer: If you are told you have triple-negative cancer, your breast cancer cells test negative for estrogen receptors, progesterone receptors, and HER2. Triple-negative breast cancer will be treated differently from the other types of breast cancer since hormones are not playing a role in breast cancer growth.
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Hormone Receptor Status And Hormone Therapy
Hormone receptor-positive breast cancers can be treated with hormone therapies.
Hormone therapy drugs include tamoxifen and the aromatase inhibitors, anastrozole , letrozole and exemestane . Ovarian suppression, with surgery or drug therapy, is also a hormone therapy.
Hormone receptor-negative breast cancers are not treated with hormone therapies because they dont have hormone receptors.
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What Happens If A Mammogram Shows Something
The mammogram will show no sign of breast cancer. If your mammogram does show something abnormal, you will need follow-up tests to check whether or not the finding is breast cancer. Most abnormal findings on a mammogram are not breast cancer. For most women, follow-up tests will show normal breast tissue.
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What Does A Lump In The Breast Feel Like
What does a breast lump feel like? Breast tissue in and of itself can feel somewhat lumpy and sponge-like, so it can be hard to know if what youre feeling is an actual lump or just normal breast tissue. A breast lump will feel like a distinct mass thats noticeably more solid than the rest of your breast tissue.
How Is Breast Cancer Diagnosed
Magnetic resonance imaging may be used to diagnose breast cancer.
Doctors often use additional tests to find or diagnose breast cancer. They may refer women to a breast specialist or a surgeon. This does not mean that she has cancer or that she needs surgery. These doctors are experts in diagnosing breast problems.
- Breast ultrasound. A machine that uses sound waves to make pictures, called sonograms, of areas inside the breast.
- Diagnostic mammogram. If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
- Breast magnetic resonance imaging . A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
- Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies .
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What Does Receptor Status Mean In Breast Cancer
Your breast cancer may be classified as hormone receptor positive or negative, depending on whether it has particular protein receptors on its surface or not. This is known as the hormone receptor status. Breast cancer cells with hormone receptors may be stimulated by your own natural hormones, or by the pill or hormone replacement therapy.
The hormone receptor status you receive may include:
- ER+ breast cancer has receptors for oestrogen
- PR+ breast cancer has receptors for progesterone
- ER- and PR- breast cancer has neither oestrogen or progesterone receptors
If your breast cancer is classified as hormone receptor positive, it may respond to treatments that adjust or block the hormones in the body. This is known as hormone or endocrine therapy.
If your breast cancer is classified as hormone receptor negative, hormone treatment will not be effective.
Mammaprint + Blueprint Test
The Mammaprint® 70-Gene Breast Cancer Recurrence Assay may be used to determine the risk that a patients cancer will return. A high-risk score means the cancer has a three-in-10 chance of returning. A low-risk result puts the chances at one in 10. Neither result is a guarantee that the malignancy will or will not come back, but the assessment may be used to guide treatment decisions.
The Blueprint® 80-Gene Molecular Subtyping Assay examines which of the tumors mutations are dictating the cancers behavior. When used with the Mammaprint assay, Blueprint may narrowly define each tumor into a subtype classification, which also may help guide treatment decisions.
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Treatment For Breast Cancer
While there are many different types of breast cancer, its important to know that there are a wide range of treatments available. Your doctor will help you to understand what type of breast cancer you have and discuss your treatment options with you. These will depend on the subtype and stage of your breast cancer as well as your own health and personal situation.
Breast cancer treatment includes local treatment to the breast and lymph node regions. If your breast cancer can be removed with a clear margin, a lumpectomy and radiation therapy is as effective as a mastectomy. Breast cancer treatment also commonly includes drug therapy, such as hormone therapy and chemotherapy.
What Is The Oncotype Dx Breast Recurrence Score Test
The Oncotype DX Breast Recurrence Score Test analyzes the activity of a group of genes that can affect how an early-stage breast cancer is likely to behave and respond to treatment. The Oncotype DX Breast Recurrence Score Test is used in two ways:
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to help doctors figure out a personâs risk of early-stage, estrogen-receptor-positive breast cancer coming back in a part of the body away from the breast
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to help figure out if a person will benefit from chemotherapy
The results of the Oncotype DX Breast Recurrence Score Test, combined with other features of the cancer, can help you make a more informed decision about whether or not to have chemotherapy to treat early-stage, hormone-receptor-positive, HER2-negative breast cancer.
You may be a candidate for the Oncotype DX Breast Recurrence Score Test if:
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you and your doctor are making decisions about chemotherapy
Most early-stage, estrogen-receptor-positive, HER2-negative breast cancers are treated with hormonal therapies, such as an aromatase inhibitor or tamoxifen, after surgery to reduce the risk that the cancer will come back in the future. Whether or not chemotherapy is also necessary has been an area of uncertainty for patients and their doctors.
The Oncotype DX Breast Recurrence Score Test analyzes the activity of 21 genes that can influence how likely a cancer is to grow and respond to treatment.
Looking at these 21 genes can provide specific information on:
For women age 50 and younger:
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Reasons Not To Have A Mammogram
One of the goals for the creation of Breast Cancer Awareness Month when it was started back in 1985 was to promote mammography. Of course, many of the sponsors of Breast Cancer Awareness Month stood to profit from the diagnosis and treatment of breast cancer. I have been warning women of this for over 20 years.
Here are 5 more reasons you may want to avoid mammography:
There are tried and true ways to maintain breast health, and also monitor it. One of those ways is to pay attention to your dreams. My colleague Dr. Larry Burke has published studies showing that a dream about having breast cancer is often very accurate at diagnosing the problem. But, there are other, more conventional approaches, including thermography.