Breast cancer diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
Diagnostic Study of Choice
Study of choice
Biopsy is the gold standard test for the diagnosis of breast cancer. Either fine needle aspiration (FNA), core needle aspiration, or surgical biopsy (excisional biopsy) might be the first step or confirmatory test in selected patients. Meanwhile, the diagnostic study of choice for breast cancer screening is mammography. Magnetic resonance imaging (MRI) is also recommended in selected patients. Compared to the Mammography, MRI has higher sensitivity and lower specificity. For more information please refer to breast cancer screening.
Investigations:
- Among the patients who present with clinical signs of breast cancer, the Mammography is the most specific test for the diagnosis.
- Estimates of mammography sensitivity range between 75% and 90% with specificity between 90% and 95%. The PPV ranges from 20% in women under age 50 to 60% to 80% in women age 50-69. Although there are reports of the sensitivity (67.8%) and specificity (75%), particularly in older studies.[1]
- Among the patients who present with clinical signs of breast cancer, the MRI is the most sensitive test for diagnosis.
The comparison of various diagnostic studies for breast cancer
Test | Sensitivity | Specificity |
---|---|---|
Mammography | 75-90% | 90-95% |
Breast MRI | 37-97% | 99% |
[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity
Diagnostic results
The following finding(s) on performing [investigation name] is(are) confirmatory for breast cancer:
- [Finding 1]
- [Finding 2]
Sequence of Diagnostic Studies
The [name of investigation] must be performed when:
- The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
- A positive [test] is detected in the patient, to confirm the diagnosis.
OR
The various investigations must be performed in the following order:
- [Initial investigation]
- [2nd investigation]
Name of Diagnostic Criteria
It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
breast cancer is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of breast cancer.
OR
There is no single diagnostic study of choice for breast cancer, though breast cancer may be diagnosed based on [name of criteria] established by [...].
OR
The diagnosis of breast cancer is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of breast cancer is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
breast cancer may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
OR
IF there are clear, established diagnostic criteria
The diagnosis of breast cancer is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of breast cancer is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of breast cancer is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
IF there are no established diagnostic criteria
There are no established criteria for the diagnosis of breast cancer.
References
- ↑ Qaseem A, Snow V, Sherif K, Aronson M, Weiss KB, Owens DK; et al. (2007). "Screening mammography for women 40 to 49 years of age: a clinical practice guideline from the American College of Physicians". Ann Intern Med. 146 (7): 511–5. doi:10.7326/0003-4819-146-7-200704030-00007. PMID 17404353.