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When you learn that you have breast cancer, it’s normal to want to do everything you can to treat it and be sure it doesn’t come back. But it’s not always a good idea to get all the tests that are available. You may not need them. And the risks may be greater than the benefits.

This fact sheet explains when cancer experts recommend imaging tests and tumor marker tests—and when they don’t.

Imaging tests, such as CT, PET, and bone scans, take pictures to help find out if the cancer has spread in your body. Another test, called a tumor marker test, is a kind of blood test. Tumor markers are also called biomarkers or serum markers. They are higher than normal in some cancer patients. The tests you need depends on the stage of your breast cancer.

What is breast cancer staging?

To determine the stage of your cancer, doctors look at how large your tumor is, where it is, and if it has spread. They also look at your medical history, physical exams, diagnostic tests, and tests of your tumor and lymph nodes.

Early-stage breast cancer includes stages 0, I, II and IIIA (zero, one, two, and three-A).
In stage 0, there are abnormal cells in the ducts or lobes of the breast. They have not broken through the wall of the duct or spread.
In stages I, II, and IIIA, there is a tumor. It may have spread to lymph nodes under the arm, but it has not spread anywhere else.
Later-stage breast cancer is stages IIIB and IV (three-B and four). The cancer has spread beyond the breast and lymph nodes under the arm.
What if you have early-stage breast cancer?

If you have early-stage breast cancer but no symp­toms to suggest the cancer has spread, you should not get an imaging test to look for cancer in other places in your body. The chance that your cancer has spread is very small. Studies show that breast cancer spreads to the liver and bones in fewer than 6 out of 100 people. And this is usually in patients with stage III breast cancer.

Imaging tests have risks and costs.

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