The tests discussed below can be used to work out whether there is evidence that your breast cancer has spread, and if so where to.
A bone scan is a test that may show areas of bone that are affected by secondary breast cancer. A small amount of a radioactive substance is injected into a vein. Abnormal bone absorbs more radioactivity and shows up on a scanner. Sometimes old fractures, injuries or areas of arthritis also show up on a scan.
Ultrasound scans can be used to build up a picture of the liver or kidney or to find fluid around the lungs or abdomen.
CT scans are special types of X-rays that take cross-sectional pictures of the body. CT scans are usually done at a hospital or radiology service and can be used to find areas of cancer that may not be found by X-ray alone. CT scans can also show enlarged lymph nodes. A contrast dye is injected into a vein to enhance the detail of the pictures.
A chest X-ray may show whether there is any secondary breast cancer in the lungs and may also reveal any build-up of fluid on the outside lining of the lungs.
An MRI scan uses magnetic fields and radio waves to build a picture of the organs inside the body. The MRI machine is similar to a CT scanner but has a longer central hole, more like a cylinder (tube). Scanning is very noisy. Earphones (with or without music) are offered to reduce the noise. Some people benefit from medication to help them relaxbefore a scan.
A PET (Positron emission tomography) scan is a technique used to build up pictures of the metabolic activity of the body and cancer. You are injected with a glucose solution containing a very small amount of radioactive material. The scanner can ‘see’ the radioactive substance. Damaged or cancerous cells show up as areas where the radioactive material and glucose are being taken up. A PET-CT scan is a PET scan that is combined with a CT scan.
Questions you may wish to ask about your diagnosis
When you first learn you have secondary breast cancer you may have many questions. We suggest that you think about the questions you would like to have answered, and what you do not want to be told, before you visit your cancer treatment team. You may wish to think about the asking your treatment team about:
• how far your cancer has spread
• the stage your cancer is
• if your cancer is curable
• other tests you might need before treatment starts
• the treatment advised for your cancer.