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About Breast Cancer
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The following is a list of questions to ask your doctor About Breast Cancer  as well as tips for preparing for these conversations.

What kind of breast cancer do I have?

There are many forms of breast cancer. Malignant cells can be found in one central area, or they may have spread, or metastasized, to other parts of the body. Your doctor will take a biopsy of the area in question and send it to the laboratory to be examined under the microscope to determine the characteristics of your cancer. Some tumors are hormone receptor positive and depend on hormones to grow, and some are stimulated by the growth factor HER2, which tends to result in rapid growth. Tests will be performed to learn the hormone receptor status and HER2 status of your tumor cells. The tumor stage, hormone receptor status, and HER2 status will be used to tailor treatment to your specific type of cancer. Some breast cancers can be caused by a defective gene that may contribute to the development of a breast tumor, so learning your family history of cancer is important.

How You Can Prepare for this Discussion

  • Get a tape recorder or bring another person as another set of ears to help you sort out medical information later
  • Note if anyone in your family has been diagnosed and treated for breast cancer, ovarian cancer or prostate cancer
  • Ask family members with breast cancer what type of cancer they have been diagnosed with
  • Put all your past laboratory reports and lists of questions into a three ring binder and bring it with you to all appointments

What stage is my breast cancer?

Breast cancer is staged depending on the characteristics of the tumor, its size and if cancer cells have been found beyond the breast in lymph nodes or other tissues elsewhere in the body. It is used to help guide treatment decisions and to determine the disease prognosis. Breast cancers are classified as stage 0, which is non-invasive, through stage IV, which has spread to other parts of the body.

How You Can Prepare for this Discussion

  • Note if any lymph nodes were removed and if the biopsy indicated whether they were positive for cancer
  • Bring a picture of the breast so the doctor can illustrate your stage
  • Refer to all pathology reports and imaging study results

What are my treatment options?

Breast cancer treatments will depend on the stage of your tumor, your menopausal status, hormone receptor status, HER2 receptor status, and general health. Treatment plans often include a combination of methods. Most women will begin their treatment with surgery followed by another form of therapy (adjuvant therapy). In some cases treatments will be given before surgery to shrink tumors (neoadjuvant therapy). You should weigh the benefits and risks of each therapy.
  • Surgery—breast conserving lumpectomy, modified mastectomy, radical mastectomy to remove the tumor and/or neighboring tissue
  • Radiation therapy—high energy X-ray beams that keep cells from growing and dividing in the breast or lymph nodes
  • Chemotherapy—drugs given through the blood stream to kill or stop the growth of cancer cells
  • Hormonal therapy—used to treat hormone-receptor positive breast cancers by limiting the amount of estrogen circulating in the body
  • Biologic—used to treat breast cancers that overexpress the HER2 gene

How You Can Prepare for this Discussion

  • Talk to friends and family about dealing with treatment needs and appointment schedules
  • Speak to other women with breast cancer about their experiences during therapy
  • Give yourself time to think about your options
  • Determine your support system at home and at work and what aspects might be affected by treatment

What is the goal of therapy, and will I require additional treatment after surgery?

The goals of therapy will be dependent on the stage of your tumor and your personal preferences. Some treatments will control the growth of the tumor, cure or eradicate the disease, or increase your level of comfort. Typically treatment involves surgery in which the tumor is removed, followed by chemotherapy, radiation therapy and/or hormonal therapy. This is called adjuvant therapy and is recommended to help prevent breast cancer from returning. The choice of treatment will also depend on your menopausal status and whether you plan on becoming pregnant in the future. Doctors may also recommend chemotherapy and radiation to shrink tumors prior to surgery.

How You Can Prepare for this Discussion

  • Educate yourself in advance so you are familiar with treatment options and their side effects
  • Be prepared for an open and frank discussion and prepare a list of your concerns
  • Think about your personal treatment goals

What side effects will I experience with treatment, and what can I do to lessen or prevent these?

All treatments for breast cancer will have some side effects. Everyone is different so not all experiences will be the same. Some side effects will be annoyances while others may require a watchful eye or additional medications.

How You Can Prepare for this Discussion

  • Determine what type of support system you have in place to aid in your care during therapy
  • Talk to other women who have had treatment for breast cancer
  • List all lifestyle issues that might be affected by treatment side effects
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