Cancer Center - Screening & Diagnosis

At the Cancer Center at Montefiore Nyack Hospital, we provide state-of-the-art screening services. Screening tests recommended by national medical organizations include:

• Breast cancer screening. Mammography has been shown to reduce deaths from breast cancer among women ages 40 to 74. Expert groups recommend that screening start at age 40 for women at average risk. In addition, routine examination of the breasts by healthcare providers (clinical breast exam) or by women themselves (breast self-exam) can detect lumps.
• Cervical cancer screening. Human papillomavirus (HPV) tests and Pap tests are recommended cervical cancer screenings that can be used alone or in combination. Experts recommend screenings begin at age 25.
• Colorectal cancer screening. Colonoscopy, sigmoidoscopy and stool tests can detect colorectal cancer early. Screenings are recommended beginning at age 45 for people at average risk.
• Lung cancer screening. Low-dose helical computed tomography, a type of CT scan, has been shown to reduce lung cancer deaths among heavy smokers. 

People known to be at increased risk of certain cancers may benefit from these additional screening tests:

• Alpha-fetoprotein blood test. Sometimes used, along with ultrasound of the liver, to try to detect liver cancer early in people at high risk of the disease.
• Breast MRI. Often used for women who carry a harmful mutation in the BRCA1 or BRCA2 gene, which can increase the risk of breast and other cancers.
• CA-125 test. Often done together with a transvaginal ultrasound. May be used to try to detect ovarian cancer early in women with an increased risk of the disease.
• Multicancer early detection tests. Measure biological signals in body fluids that may be shed by cancer cells. These signals are also known as biomarkers or tumor markers.
• PSA test. Prostate-specific antigen (PSA) blood tests have been used, often along with digital rectal exams, for prostate cancer screening.
• Skin exams. For people at increased risk of skin cancer, doctors often recommend regular skin exams by a healthcare provider.
• Transvaginal ultrasound. Sometimes used in women at increased risk of ovarian cancer (they carry a harmful BRCA1 or BRCA2 gene mutation) or of endometrial cancer (they have Lynch syndrome).
• Virtual colonoscopy. Allows the colon and rectum to be examined from outside the body. May be recommended if it’s the only colorectal cancer screening test a person finds acceptable.

Diagnostic testing may include lab and imaging tests (scans), and you may a need a biopsy—often the only way to tell for certain if you have cancer. Diagnostic tests for cancer available at Montefiore Nyack Hospital include: 

• Lab tests of your blood, urine or other body fluids. These measure substances in your body that can be a sign of cancer, helping doctors make a diagnosis.
• Imaging tests create pictures of areas inside your body, helping doctors see whether a tumor is present. These pictures can be made in several ways:
  • CT scans use an X-ray machine linked to a computer to take a series of pictures of your organs from different angles, creating detailed 3-D images of the inside of your body.
  • MRIs use a powerful magnet and radio waves to take pictures of your body in “slices.” These slices are used to create detailed images of the inside of your body, which can show the difference between healthy and unhealthy tissue.
  • Nuclear medicine scans use radioactive material to produce internal images of the body, enabling doctors to view the activity of organs and monitor the growth of any cancers.
  • Bone scans are a type of nuclear scan that check for abnormal areas or damage in the bones. They may be used to diagnose bone cancer or cancer that has spread to the bones (also called metastatic bone tumors).
  • PET scans are a type of imaging test used for diagnosis and staging. Positron emission tomography scans use a radioactive substance called a tracer to look for disease in the body.
  • Ultrasounds utilize high-energy sound waves, which echo off tissues inside your body. A computer assembles these echoes to create a picture (called a sonogram) of areas inside your body. 
  • X-rays use low doses of radiation to create pictures inside your body.
• Biopsy. In most cases, doctors need to do a biopsy (remove a tissue sample) to diagnose cancer. A pathologist looks at the tissue under a microscope and runs tests to see if the tissue is cancerous. The tissue sample may be obtained in several ways:
  • With a needle. The doctor uses a needle to withdraw tissue or fluid. This method is used for bone marrow aspirations, spinal taps and some breast, prostate and liver biopsies.
  • With endoscopy. The doctor uses a thin, lighted tube called an endoscope to examine areas inside the body. Examples of endoscopy exams include:
    • Colonoscopy, which uses an endoscope through the anus, allowing the doctor to examine the rectum and colon. If polyps are seen, they will be removed and sent to a lab for testing. 
    • Bronchoscopy, an exam of the trachea, bronchi and lungs. In bronchoscopy, an endoscope goes through the mouth or nose and down the throat.
  • With surgery. A surgeon removes an area of abnormal cells during an operation. Surgery may be excisional (removing the entire area of abnormal cells) or incisional (removing part of the abnormal area).

Source: National Cancer Institute