Mammogram
A mammogram is a breast x-ray. The radiographer (an expert in taking breast x-rays) will ask you to undress to the waist and stand in front of the mammography machine. They will then rest each breast in turn between two x-ray plates so that it is compressed and flattened. Two images of each breast will be taken so that the breast tissue can be seen from two different angles. Some women may find this uncomfortable or even painful, but it only lasts a few seconds.

Ultrasound scan
An ultrasound scan uses high-frequency sound waves to produce an image of the breast. It is not an x-ray. An ultrasound scan is painless and only takes a few minutes to do. You will be asked to undress to the waist and lie on a couch with your arm above your head. Some gel will be spread on your breast and a scanning probe will be moved around the breast. This is the same technique used to look at babies in the mothers womb during pregnancy.

If you are under 35 youre more likely to have an ultrasound scan rather than a mammogram. This is because on a mammogram a younger womans breast tissue is too dense to give a good image. Regardless of age, an ultrasound scan may be done as well as further mammograms when there is an area on the x-ray that needs to be looked at more closely.

Fine needle aspiration cytology (FNAC) & Core biopsy
If a lump or an abnormal area is found during the breast examination, mammogram or ultrasound scan, a sample will be taken. This can be a fine needle aspiration (FNAC) or a core biopsy. Both of these tests can be done with or without using ultrasound for guidance.

FNAC
FNAC involves taking a sample of breast cells using a fine needle and syringe, which is then sent to the laboratory where it is looked at under a microscope.

This can be uncomfortable but rarely requires local anaesthetic. You may need to wear a plaster for a few hours afterwards and the area may feel sore. Your result may be described to you as one of the following:

• C1 inadequate sample (not enough cells for diagnosis)
• C2 benign (non-cancerous)
• C3 suspicious but probably benign
• C4 suspicious and possibly malignant (cancer)
• C5 malignant (cancer)

The specialist will use the result to help decide if further tests or treatments are needed. Further tests or treatments are usually needed for a result showing C3, C4 or C5, or where the findings of the tests do not agree.

Core biopsy
A core biopsy uses a larger needle to obtain a sample of tissue, but you will be given local anaesthetic to numb the area before the sample is taken. The specialist may take several samples at the same time. The tissue samples are sent to the laboratory where they are examined under the microscope to establish a diagnosis.

You will usually be asked to wear a small dressing or plaster for a few hours afterwards. Once the anaesthetic wears off you may find that your breast aches and it may also become bruised. You may need to take painkillers if the area is tender or painful. Your result may be described to you as one of the following:

• B1 normal breast tissue
• B2 benign (non-cancerous)
• B3 suspicious but probably benign
• B4 suspicious and possibly malignant (cancer)
• B5 malignant (cancer).

Further tests or treatment are usually needed for a result showing B3, B4 or B5.

Further tests
Triple assessment is usually all that is needed to make a diagnosis. However, sometimes you may need further tests. These may include a guide wire being inserted into the breast under x-ray guidance to accurately locate the area to be examined more closely. This is more common if the area is deeper in the breast and cant be felt or reached with a biopsy needle.

Getting your results
For the majority of women triple assessment will show nothing more serious than a specific benign breast condition. In this case the Specialist Breast Surgeon will explain what it is and whether you need any treatment or follow up.

Ushalakshmi Breast Cancer Foundation in partnership with Dr Reddys Foundation for Health Education & Breast Cancer Care, UK has published booklets about the most common benign breast conditions

If your results show that you have breast cancer you may feel all sorts of emotions such as shock, fear, anger and helplessness, and you may find it hard to take in what you are being told. Having someone with you who can listen carefully or ask questions can be very helpful.

You will also meet, or be put in contact with, a Breast Care Counsellor, who will talk to you about your diagnosis and treatment and will provide you with support and written information. When you are ready, you may want to contact your Breast Care Counsellor again to discuss what happens next. You may also want to read booklets published by Ushalakshmi Breast Cancer Foundation in partnership with Dr Reddys Foundation for Health Education (DRFHE) & Breast Cancer Care, UK on Treating breast cancer and Breast cancer and you: diagnosis, treatment and the future