Metastatic breast cancer is diagnosed based on signs and symptoms. The metastatic breast cancer diagnosis relies on the type of tumor, such as benign or malignant. There are different types of tests for the diagnosis of metastatic breast cancer. When combined with the visuals, the use of electronic devices into a structured, 3-D Visual that showcases any flaw or tumor is a diagnostic approach for metastatic breast cancer. CT scan is used for measuring the magnitude of the tumor. A chest x-ray is used to detect breast cancer prognosis and lung maturation. Other diagnostic methods include a bone scan, computed tomography (CT) scan, Positron emission tomography (PET) CT scan, magnetic resonance imaging (MRI), serum chemistry blood tests, blood tumor marker tests, cancer evaluation using primary receptors (ER & PR and HER2) for quality testing of metastatic breast cancer. Additional testing includes genomic testing, molecular testing of the tumor using PD-L1, Microsatellite instability-high or DNA mismatch repair deficiency, NTRK gene fusions, PIK3CA, and genetic testing.
Diagnosis of Metastatic Breast Cancer
Diagnosis of Metastatic Breast Cancer uses an electronic device that combines these visuals into a structured, 3-D Visual that showcases any flaw or tumor 1. The tumor’s magnitude is measured with the help of a CT Scan 1. Sometimes, a particular metastatic breast cancer matures and starts to spread rapidly. It may or may not show any signs of significant symptoms. If any symptoms occur, These symptoms may prompt a General practitioner to arrange for tests, look for metastatic breast cancer, or see if the breast cancer has already spread. If a patient is diagnosed with native and progressive breast cancer, examination for metastatic illness is done. Testing can also help keep track of the disease’s progress. General practitioners may also have to run through tests to identify which treatment methods are most effective.
The main factors that the General practitioner considers before taking any diagnostic decisions are:
- The Physical examination tests
- Signs and symptoms
- Archive of the medical history
- The position of the breast cancer
The components below outline the options for the diagnosis of metastatic breast cancer:
X-RAY: An x-ray is a type of radiography that employs a little quantity of radiation to produce visuals. A chest x-ray can be used to detect breast cancer that has progressed and matured to the lungs.
Bone scan: A bone scan is used to check whether cancer has spread to the bones. A tracker which emits radiation simultaneously is used to see within the bones during the scan. The tracker is injected into the vein of a patient. A unique lens detects it as it gathers in sections of the bone. Areas of the wound, such as those not affected by cancer, appear lighter to the camera, while the areas of injury, such as those produced by cancer are highlighted. Some cancers do not respond to the treatment in the same way and will get highlighted on a bone scan. Dark patches can also be sighted in a few areas where severe arthritis or healing after a fracture.
Computed tomography scan: A CT Scan is basically used to detect tumours in organs foreign to the breasts. For example such as lungs, liver, bone and lymph nodes. A CT scan also uses an X-RAY to capture visuals from different angles.
A contrast medium is given before the scan to provide better structure in the image. This dye can be introduced into a patient’s vein.
Positron emission tomography scan: A PET-CT Scan similar to the CT Scan is used to identify whether cancer has spread to organs foreign to the breast. A PET scan is normally merged with a CT scan which is known as a PET-CT scan. A PET scan is a way to produce visuals of organs and tissues inside the body. A small amount of a radioactive glucose kind of substance is introduced into the patient’s body. Then the importance is taken up by cells that use the most energy. As cancer leans towards using energy actively, it soaks up plenty of the radioactive substance. A scanner then identifies this substance to produce visuals of the inside of the body.
A PET-CT scan will also display any defects in the bone, identical to a bone scan.
Magnetic resonance imaging (MRI): When a magnetic field comes into play instead of an X-ray to give rise to structured visuals of the body, It’s known as Magnetic resonance imaging. This approach is also used to measure the tumor’s depth. The contrast medium is set before the scan to create better visuals. This dye is usually introduced into a patient’s vein.
Serum chemistry blood tests: The quantity of minerals such as potassium and calcium in the blood is found by a serum chemistry blood test 2. This test is also used to sight proteins which are called enzymes that can very unusual if cancer matures. It’s also beneficial in finding out how the kidneys and liver are functioning. However these tests can be very uncommon if cancer has already spread in the body; non-malignant states can also affect the results in these tests.
Blood tumor marker tests: Tumor proteins discovered in a person’s blood are serum tumor markers or biomarkers 3. They’re produced by the tumor or the body’s response to cancer growth. Higher levels of a tumor marker in the blood can lead to either cancer or a noncancerous disease. Cancer antigen and carcinoembryonic antigen tests may be done for metastatic breast cancer. People with breast cancer may have these indicators in their blood. Unusual amounts of these biomarkers, on the other hand, could indicate an illness other than cancer. Some tests for circulating DNA or circulating tumor cells may also be performed.
Along with symptoms and imaging tests, tumor marker testing may be beneficial in monitoring the progression of recurrent or metastatic disease. The actual level of a tumor marker at any given time is less significant than how the levels change over time. Tumor markers that are decreasing usually indicate that the treatment is effective to shrink the tumor. Tumor markers should not be utilized to check for recurrence because they don’t appear to improve a patient’s chances of recovery. Treatment options and modifications are generally determined by factors other than biomarkers, such as the magnitude and position of the tumor, general health, and the treatment inclination.
Tumor biopsy is one of the most important tests that a patient must undergo when diagnosed with metastatic breast cancer. What exactly is a biopsy? It’s the removal of a small amount of tissue for examination under a microscope. It can be done for various body parts, including lymph nodes, bone, skin, and the lungs. A CT scan or ultrasound is required as a guide during the procedure. If there’s any discomfort, Pain medication is ordered. The pathologist next examines the tissue.
If you’ve been detected with metastatic breast cancer, your GP may approve a biopsy to assess cancer characteristics and see if they’ve altered since your initial diagnosis. The significance of these findings is undeniable. Breast cancer subtypes are determined by testing, and treatment choices are then determined.
The Major receptors prefered for quality testing of Metastatic breast cancer are,
- ER & PR
Additional testing may very much be a necessity. Testing the tumour DNA, for example, may reveal alterations in cancer’s genes. This can help forecast how cancer will behave and identify therapy alternatives. To hunt for cancer genes, you can undertake the following tests:
1. Genomic testing – The study of the genes in a cancer cell. Breast cancer genomic testing look at the genes to see what is causing the disease to grow 4.
2. Molecular testing of the tumor – Other laboratory tests on a tumor sample may be recommended by your doctor to discover specific genes, proteins, and other components specific to the tumor 5.
- Microsatellite instability-high or DNA mismatch repair deficiency
- NTRK gene fusions
3. Genetic testing – If you have a family history of breast cancer, genetic testing may be recommended 6.
As the diagnosis of metastatic breast cancer is scary and life-threatening, the patients and their families are encouraged to showcase their emotions on how they feel with their GP’s and their loved ones.
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- 3.Berghuis A, Koffijberg H, Prakash J, Terstappen L, IJzerman M. Detecting Blood-Based Biomarkers in Metastatic Breast Cancer: A Systematic Review of Their Current Status and Clinical Utility. IJMS. Published online February 9, 2017:363. doi:10.3390/ijms18020363
- 4.Akcakanat A, Zheng X, Cruz Pico CX, et al. Genomic, Transcriptomic, and Proteomic Profiling of Metastatic Breast Cancer. Clinical Cancer Research. Published online March 29, 2021:3243-3252. doi:10.1158/1078-0432.ccr-20-4048
- 5.Litton JK, Burstein HJ, Turner NC. Molecular Testing in Breast Cancer. American Society of Clinical Oncology Educational Book. Published online May 2019:e1-e7. doi:10.1200/edbk_237715
- 6.Tischler J, Crew KD, Chung WK. Cases in Precision Medicine: The Role of Tumor and Germline Genetic Testing in Breast Cancer Management. Ann Intern Med. Published online October 22, 2019:925. doi:10.7326/m18-2417