Our Screening Guidelines We have developed breast cancer screening guidelines based on risk 
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Breast cancer may present as a physical change in the breast itself, a lump, thickening, or inflammatory changes such as redness or hardening of the breast. Breast cancer may also be detected in a breast that feels normal, but appears on a screening mammogram as a mass or calcifications. These changes are not always a sign of breast cancer, but if present, they should be evaluated by a physician in a timely manner.
Screening Methods
Early detection is the best way to find breast cancer in its earliest, most curable stages. Memorial Sloan-Kettering offers early breast cancer detection programs, including mammography and breast physical examinations at the Guttman Diagnostic Center and the Breast Examination Center of Harlem.
Our Special Surveillance Breast Program (SSBP), located at the Evelyn H. Lauder Breast Center, follows women with a higher than average risk of breast cancer. As part of the program, we educate patients regarding their risk of developing breast cancer and present strategies for early detection and prevention. The patients in the SSBP also undergo biannual clinical breast examinations and appropriate imaging examinations.
Breast cancer screening approaches include breast self-examination, clinical examination by a physician, and mammography. Ultrasound and MRI are also performed in some women. See specific breast cancer screening guidelines.
Breast Biopsy Techniques
If either a physical examination or imaging tests show a concerning change in the breast, the next step is a biopsy. During a breast biopsy, a sample of tissue is taken from the breast and the cells or tissue are then examined under a microscope by a pathologist, who can determine whether or not they are cancerous.
There are different types of biopsy methods. These include:
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Fine Needle Aspiration (FNA)
During this procedure, the doctor inserts a very thin needle into the suspicious area of the breast. Cells or fluid are withdrawn (aspirated) from the lump and placed on a slide for examination under a microscope by a pathologist. This type of biopsy is relatively quick, and any discomfort lasts only a few seconds.
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Core Needle Biopsy
A core needle biopsy may be used if a tissue sample larger than can be obtained with a fine needle aspiration biopsy is needed, or if the tissue removed during a needle aspiration biopsy does not yield a definitive diagnosis. This type of biopsy requires a local anesthetic. The doctor inserts a larger, hollow needle into the breast. A thin cylinder of tissue about one inch long is removed and is sent to a pathologist for analysis.
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Image-Guided Biopsy
If the suspicious area cannot be felt, then a radiologist can use imaging techniques to biopsy the area. The choice of ultrasound, stereotactic mammographic imaging, or MRI depends on what the abnormality looks like and which technique is most appropriate for visualizing it.
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Surgical Biopsy
- A surgical biopsy may be done if other biopsy procedures do not provide a definitive diagnosis. A surgical biopsy is also performed if the suspicious area is too deep or too superficial for a core biopsy.
- If the surgeon cannot feel the area in question, then the radiologist will insert a thin wire into the breast using mammography, ultrasound, or MRI to localize the area for the surgeon. This process is called a needle localization.
- A surgical biopsy takes place in an operating room, but it does not usually require an overnight stay in the hospital. During a surgical biopsy, the patient undergoes "twilight" sedation, but does not require general anesthesia. Under sterile conditions, a small incision is made on the breast; the suspicious breast tissue is removed entirely, or a representative sample is removed for analysis.
