1. Tests you may have
2. Tests for secondary breast cancer in the bone
3. Tests for secondary breast cancer in the lungs
4. Tests for secondary breast cancer in the liver
5. Tests for secondary breast cancer in the brain
6. Tests for secondary breast cancer in the skin
7. Waiting for test results
If you have any symptoms of secondary breast cancer, you may be offered a number of tests. These will help check whether the cancer has spread from the breast to another part of the body.
Your specialist will examine you and discuss your symptoms, and explain any tests you need.
The tests you have may depend on your symptoms. For example, if you have pain that effects your bones, you may have a bone scan. Some frequently used tests include the following.
CT (computerised tomography) scan
A CT scan, also known as a CAT scan, uses x-rays to take detailed pictures across the body.
MRI (magnetic resonance imaging) scan
This scan uses magnetism and radio waves to produce a series of images of the inside of the body. An MRI doesn’t expose the body to x-ray radiation.
When breast cancer spreads to other parts of the body, the amount of certain substances in the blood may increase. Blood tests can measure these substances and show any changes.
X-ray of the bone
An x-ray can show changes in the bone. The x-ray may not be able to pick up small areas of cancer.
A bone scan checks the whole skeleton. It can help identify changes to the bone caused by injury, healing or disease such as cancer.
A small amount of radioactive substance is injected into a vein, usually in the arm, two to three hours before the scan. This helps identify if there’s been a change in the bones (often called a ‘hot spot’).
In most cases your specialist will be able to tell if you have secondary breast cancer in the bone from your symptoms and scans. However, in some cases a biopsy can help confirm the diagnosis and decide what treatment may help.
A biopsy involves taking a small piece of bone to be examined under the microscope. This may be done using local or general anaesthetic.
A chest x-ray is often the first investigation that will be done to see if there is secondary breast cancer in the lungs.
Sometimes a biopsy of the lung is taken. This involves removing a small piece of tissue from the lung, usually while you are sedated, to be looked at under a microscope. If you have a build-up of fluid in the space around the lungs (pleural effusion), a sample of fluid can also be taken for testing.
The most common procedure for taking a lung biopsy is a bronchoscopy. A tube called a bronchoscope is passed through the mouth and down into the lungs. A small piece of lung tissue can then be removed and examined under a microscope.
CT-guided lung biopsy
Sometimes a biopsy can be taken from the lung through the skin with a needle using a CT scan for guidance.
EBUS (endobronchial ultrasound)
This test involves passing an ultrasound probe attached to a bronchoscope into the lungs. It allows the doctor to see the lungs and lymph nodes and take a sample of tissue if required. EBUS is a relatively new test so is not yet widely available.
An ultrasound scan uses high-frequency sound waves to produce an image of the liver to show any abnormalities.
In most cases your specialist will be able to tell if you have secondary breast cancer in the liver from your symptoms and scans.
However, in some cases it can be useful to have a biopsy taken. This involves removing a small piece of tissue from the liver, under local anaesthetic, to be examined under a microscope. An ultrasound is usually used to guide the procedure. You will need to stay in hospital for a few hours after the liver biopsy because of the risk of bleeding.
A neurological examination is a series of simple tests that provide information about the nervous system.
Your specialist may look in your eyes with an instrument called an ophthalmoscope to see if there is swelling at the back of the eyes caused by pressure from the brain. They may check your arms and legs for changes in feeling and strength, and changes in your reflexes. They may look at your balance and how you are walking.
In most cases your specialist will be able to tell if you have secondary breast cancer in the brain from your symptoms and scans, but occasionally it’s necessary to have a biopsy.
This involves removing a small piece of tissue from the brain, under general anaesthetic, to be examined under a microscope.
To confirm a diagnosis of secondary breast cancer in the skin, a punch biopsy may be performed.
You’ll be given a local anaesthetic before a tiny cutter device is used to take a very small piece of tissue from the area. It’s not unusual for the area to bleed a little after the biopsy so you’ll usually be given a small dressing or plaster afterwards.
Waiting for test results can be very stressful. It may take a few weeks to get all the results of your tests.
You should be offered an appointment to discuss your results. It’s a good idea to take someone with you in case you need support.
If you’re anxious about your results or would like to talk to someone about any concerns you can call our free Helpline on 0808 800 6000.