Ask Dr. Christina: Breast Cancer Prevention Screening Tool – HALO

Dear Dr. Christina,

My mother had to go to her doctor to get some tests done and was told she had breast cancer. How can that be? She had a screening mammogram 6 months ago and was told by her doctor that her mammogram was okay. Why did the mammogram miss it? I am so scared. My mom’s breast cancer doctor said I was too young to get a mammogram but that I should tested. She then told me about the HALO breast pap test that was available as well as a blood test. I had never heard about these other tests before. I just wanted to write to you to find out if you are aware of this testing and anything else I should know that might calm my fears.


Dear Cheeri,

I can totally understand your fear. I encourage you and want to tell you that you need to express any questions you may have as well as your own concerns to your mom’s breast cancer specialist.  It’s totally normal to be scared, especially when you see what’s happening to your mom.

Breast cancer is one cancer that can be difficult to diagnose. There are so many statistics out there that may seem intimidating to you as a woman, much less as the daughter of a woman diagnosed with breast cancer. Breast cancer is the leading cause of cancer deaths for women between the ages of 20 – 59. In the United States alone, over 250,000 women are living with breast cancer under the age of 40 and women in this age group are usually not getting regular mammograms. Traditional methods for screening mammograms, which look for lesions or cancer, can be limited due to dense breast tissue.

All this does not necessarily mean that the mammogram your mom had was wrong. There is more to it than just someone taking a picture (an X-ray) of her breast and being able to readily identify cancer in the picture they took.

Let me give you some examples of how breast cancer can be present or not present:

  1. You may have a lump in your breast but the screening mammogram may not see it on film. Your doctor may send you to a breast specialist or order a more specific test such as a diagnostic mammogram (more views), an ultrasound (an X-ray that uses sound waves to produce an image), or an MRI (Magnetic Resonance Imaging). Whether one of these is ordered for you will depend on what your doctor wants. Sometimes a biopsy is needed, where a sample of the tissue from inside your breast is removed during a minor surgical procedure and then examined under a microscope in a lab. You see, doctors can only diagnose breast cancer using cells or tissue from a biopsy, not just from films and X-rays taken of the mammogram, MRI, etc.
  2. You may not have a lump but the screening mammogram may pick up a lesion or an area that looks suspicious on film. Then a biopsy or another appropriate test may be needed to better determine whether there is a need for concern or not.
  3. You may think everything is okay because you have no lump or the mammogram is negative, like your mom’s. If you have dense breasts, the doctors may not be able to see any abnormality on the films (X-rays). Therefore the doctors may miss a cancer diagnosis because they didn’t see it because it didn’t show up.

If you go to your doctor, he or she will explain to you the importance of:

1)    Monthly self-breast exams
2)    Yearly doctor breast exams
3)    The best tests for you depending on your age and family history of breast cancer

Some people feel they are not at risk because they do not have any family history of breast cancer, but the statistics show that 8 out of 9 women who do develop breast cancer do not have to have any family history in order to get it.

You asked about the HALO breast pap test. This test is relatively new and FDA approved. It is a 5-minute, non-invasive test that combines warmth, massage, and suction to your nipples. If there is any fluid in the milk ducts of your breast, where 95% of all breast cancers originate, then this fluid can be tested for abnormal cells that may be present. In some cases, these cells can occur up to 8 years before a breast lump or lesion may appear on a mammogram. Now, for clarification, just because your nipple fluid may show that you have abnormal cells does not mean you have cancer. It only means you need more frequent and closer surveillance by your doctor.

The HALO test is only a screening tool that was developed to try to help identify women who are at greater risk of getting breast cancer in order to allow for earlier intervention and help increase the chances of survival if, in fact, you do get breast cancer.

When breast cancer is found early enough, the 5-year survival rate is nearly 100%.

To be clear, the HALO testing does not replace your routine screening mammogram or breast exams.  It is only a complementary screening tool to routine mammograms.

Women who choose to do the HALO breast pap test are women who want to be proactive about their healthcare. I encourage you to inquire about it further with your doctor if you are interested in having it done.

Cheeri, I hope this helps you to understand what the HALO test is and the importance of you going to your doctor with a list of questions to make sure you understand what risks you have and what tests you may need.

The fact that you wrote to me tells me that you are inquisitive and that you want what is best for you.

My thoughts are with your mom for a good recovery and also with you. My wish for you is peace of mind.

Remember to be proactive about all factors regarding your health. It is your health and your life.

Take great care,

Dr. Christina

  • Posted By: DRC Editor
  • Tags: biopsy breast cancer breast cancer statistics breast exams cell testing diagnose breast cancer diagnosis breast cancer doctor's advice Dr Christina Charbonneau Dr. Christina false negative mammogram HALO breast PAP HALO pap mammogram screening Pap test
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