The diagnosis stage starts with an appointment with an oncology specialist. Usually at this point the patient has been diagnosed with cancer following a mammography or an ultrasound examination, or she has found something suspicious in her breast. The doctor assesses the patient’s situation and, if necessary, recommends further examinations. Typically required further examinations include needle biopsy, performed in conjunction with an ultrasound examination, and/or magnetic resonance imaging (MRI).
From the very first appointment with a doctor, the patient has a designated personal doctor. The counseling nurse at Docrates ensures that the treatment process runs as quickly and smoothly as possible. The nurse helps the patient with practical matters and provides information and psychological support.
The patient may wish to have a consultation with a physiotherapist specialising in cancer patients. During the consultation, her situation will be assessed and she will receive preoperative instructions.
MRI (magnet resonance imaging) is one of the most sensitive methods used in the diagnosis of breast cancer. Its benefits are greatest before a needle biopsy. An MRI provides detailed information about the size of the tumour and its local spreading, which is valuable when planning surgery.
In a Finnish study, breast MRI revealed that breast cancer was more advanced than previously assumed in 27% of patients. Without a preoperative MRI, surgery would have failed to remove all cancerous tissue in the breast in nearly one woman in five. And without the MRI, nearly one in ten women would have required repeat surgery.
Breast MRI is particularly appropriate for young women considered to have a hereditary risk of breast cancer. The examination does not involve exposure to radiation, and lesion identification is not hampered by dense mammary gland tissue as in mammography.
Contrast media highlight both benign and malignant lesions, and a definite differential diagnosis is only possible in lesions exceeding 5 mm in size. If a suspicious lesion is found, a biopsy sample should therefore be taken for pathological evaluation, perhaps using MRI guidance.