Newly Diagnosed With Breast Cancer: Additional Tests You May Need

Tests Before, During and After Breast Cancer Treatment

After my tumor had been imaged, removed, frozen, sliced, graded, and staged, I thought, 'Well! Now surely we've got all the information needed, and we can get on with treatment.' Not so fast -- more tests were yet to come before I could jump into treatment. Other tests were done during and after treatment, and still more during my five-year follow-up exams. You may not need all of these tests, but it's important to understand why additional tests may be ordered in case you do.

Tests Before Treatment

Prior to starting treatment, some tests may be done to get more information about your cancer. Some tests may determine which treatments will most effectively kill your cancer and prevent recurrence. Other tests may be needed to check on the health of your major organs and bones.

• Bloodwork: A Complete blood count (CBC) will be done to measure your red blood cells (RBC), white blood cells (WBC) and platelets. A liver function test might be needed to see how well your liver is working.

• Chemosensitivity testing: This kind of test may determine whether your cancer will resist, or succumb, to particular drugs. Having the results of this test might help you customize your treatment plan.

• Genetic assay tests: A sample of your tumor tissue may be tested for genetic expression, and the resulting score predicts your risk of recurrence before treatment. Your score will be factored into your treatment decisions.

• MUGA Scan: If you will have an anthracycline chemotherapy drug, you'll need to have your heart tested to see how well it pumps blood.

• Echocardiogram: This test is another way to determine how efficiently your heart can pump blood throughout your body.

Blood Tests and Imaging Studies During and After Breast Cancer Treatment

During treatment, some of these tests may be needed to monitor your health and check the status of your cancer.

• Blood Counts: CBCs are done throughout treatment and follow-up to check for anemia, neutropenia and thrombocytopenia, among other conditions.

• Tumor Marker Tests: These tests will track how well your treatment is working, or will monitor the status of your cancer. After you complete treatment, tumor markers may be done to monitor for recurrence.

• Chest X-ray: Your chest may be imaged to check lung capacity, or to see if cancer has spread to your lungs. If you develop any breathing problems, a chest x-ray will be needed to determine the cause.

• CAT or CT Scan: If your doctor needs an image of a slice or a three-dimensional picture of your internal architecture, you'll need a CAT scan. This may be used to check for metastasis (spreading of the cancer) or after treatment, to make sure no cancer remains.

• MRI: Breast MRI can image both breasts simultaneously. It works well with dense breast tissue and can image invasive breast cancer as well as metastasis.

• Bone Density Scan: Because chemotherapy can cause bone thinning and put you at increased risk for fracture, you may need a bone density scan.

• PET Scan: This type of scan uses a radioactive tracer to help image metastatic breast cancer.

Keeping Track of Your Results

After each test, ask for a copy of your results. Add that information to your medical records. This will help you understand your diagnosis, and will become a part of your treatment plan decision. In case you ever decide to get a second opinion, these results will give your doctor good information with which to follow your case.

Next Steps in Your Journey:

• Treatment Impacts Fertility
• Dealing With Doctors
• Choosing Your Surgery
• Discussing Treatment Plans