Breast Cancer, Metastatic or Recurrent - Exams and Tests

Exams and Tests

Metastatic disease is present in a small number of women at the time breast cancer is first diagnosed. Breast cancer recurs in as many as 1 in 3 women after the initial diagnosis.¹ Your doctor may use the following tests to determine whether breast cancer has metastasized or recurred.

• Blood and tissue tests may include the following:
  • Blood tests, such as a complete blood count (CBC) and a blood profile, are used to investigate the cause of symptoms such as fatigue, weakness, fever, bruising, or weight loss.
  • Biopsy is a tissue sample of the suspected metastasis, such as a liver biopsy or a lung biopsy.
• Medical imaging studies may include the following:
  • Abdominal ultrasound produces a picture to determine the cause of abdominal pain or increased abdominal girth.
  • Chest X-ray produces a picture to help determine whether symptoms such as persistent coughing, coughing up blood, chest pain, or difficulty breathing are caused by metastatic disease involving the lungs.
  • CT scan produces a picture to help determine whether breast cancer has spread into the chest or organs in the abdomen or pelvis.
  • CT scan or MRI of the head produces a picture of the brain to evaluate symptoms such as confusion, paralysis, numbness, vision problems, vertigo, or headaches that might be signs of metastatic disease.
  • Bone scan or MRI of the spine produces a picture of the spine to determine whether pain in the back, hips, or pelvis may be caused by metastatic disease.

Tests your doctor may use to evaluate recurrent breast cancer that is confined to your breast (local recurrence) include:

• Mammogram, to screen for breast cancer and investigate lumps that can be felt during a breast exam.
• Clinical breast exam (CBE), to check for lumps or other unusual changes.
• Ultrasound, to investigate a lump found during a clinical breast exam or on a mammogram. Breast ultrasound is also used to locate lumps that could be cancerous and to distinguish between solid lumps and fluid-filled (cystic) lumps.
• Magnetic resonance imaging (MRI), which is sometimes used to locate lumps that could be cancerous and to distinguish between solid lumps and fluid-filled (cystic) lumps.
• Breast biopsy, to remove a sample of breast tissue and examine it under a microscope for signs of cancer. Tests that may be performed on any breast cancer cells that are found include:
  • Estrogen and progesterone receptor status, to determine whether these hormones influence tumor growth.
  • HER-2 receptor status, to determine whether a protein that regulates the growth of some breast cancer cells is present.

What to think about

You have a risk of developing recurrent breast cancer if you have had breast cancer in one breast. To be sure that the cancer has not returned, you will have regular checkups that include physical exams and mammograms.

If you find any unusual changes in the treated area or in your other breast, or if you have swollen lymph glands or bone pain, call your doctor to discuss these changes.