What tests will I have for metastatic breast cancer?

Tests can confirm a diagnosis of metastatic breast cancer and find out where the cancer has spread. Tests also help your doctor to decide how best to treat your cancer. Not all metastatic breast cancers are the same. Some tests will examine your bones, liver and lungs or sometimes your brain, as these are the most common places that breast cancer spreads to. 

Some of these tests can also be used to check how you are responding to treatment. 

• X-rays
  X-rays use high-energy rays to take pictures of the inside of your body. An X-ray of your bones can give a picture of the general condition of your bones. A chest X-ray may show if there is any breast cancer in your lungs. It might also look for a build-up of fluid in the space between your lungs and chest wall.
• Blood tests
  Blood tests can check your general health, including how well your kidneys and liver are working. Some cancers make chemicals that can be found in your bloodstream. These are called tumour markers. The tumour marker for breast cancer is called CA153. Blood tests can show the level of tumour markers in your blood. Blood tests can also check the amount of calcium in your blood.
• CT scan
  A type of X-ray that gives a detailed picture of the tissues inside your body. Depending on your symptoms, you may have a whole-body CT scan or a scan of a specific area of your body. 
• Bone scan
  A radioactive injection that can show areas of abnormal bone on a scan, which may be caused by cancer.
• MRI scan
  A scan that uses magnetic energy to build up a picture of the tissues in your body. It is particularly useful to look at the brain and bones, to check for signs of any cancer there.
• PET - CT scan
  A radioactive injection that will show up any cancer spread to other parts of your body on a CT scan picture. 

• Biopsy
  If metastatic breast cancer is your first diagnosis, your doctor will take a small sample of tissue from your breast (biopsy) to confirm your diagnosis. Biopsies can also help to find out whether the cancer cells have certain receptors which encourage the cancer cells to grow. For example, the hormone oestrogen (ER) or HER2. 

  If you have had breast cancer before, you might have a biopsy to see if the breast cancer is the same type as before. Tissue may be taken from where the metastatic cancer is, such as your bones or liver.

  You usually have a biopsy under local anaesthetic. The doctor uses an ultrasound or a CT scan to help them guide the needle to the right place.