Breast Cancer Awareness Month: 7 Things to Ask Your Doctor After Receiving a Breast Cancer Diagnosis

As you may already know, October is Breast Cancer Awareness Month. As the husband of a breast cancer survivor, I know how scary it can be for someone to receive a breast cancer diagnosis. Although it’s natural for many fears to run through your mind, many women diagnosed with breast cancer survive. Obviously, the road from diagnosis to cure is a long one that requires endurance and strength, but belief that you’ll get better is as key as the actual treatments. In addition, doctors suggest that you ask the following eight questions after receiving your breast cancer diagnosis:

1. What exactly is breast cancer? Breast tissue is comprised of two different varieties: milk-producing glands called lobules, and the ducts, which carry milk down and out the nipple. About 80 percent of cancer occurs in the ducts, 15 percent in the lobules, and about 5 percent in other areas of the breast (these types are considered rare, but not necessarily more aggressive). Normal ducts and lobules are lined by a single layer of cells that all look alike, but when these cells proliferate and create disorganized and abnormal-looking layers, this is called atypical hyperplasia. When these cells create a bridge across a duct or lobule and nearly fill up the central spaces, then it becomes carcinoma in situ. If left untreated, these abnormal cells can break through the lobules or ducts it can invade surrounding breast tissue and travel into other areas of the body.

2. What stage is my cancer? Stages range from 0 to 4, depending on tumor size, whether the cancer is invasive or non-invasive, how many lymph nodes are involved, and whether or not the cancer has spread to other parts of the body.

STAGE 0: This stage is called DCIS (ductal carcinoma in situ) or LCIS (lobular carcinoma in situ). The cancer cells are still within the intact ducts or lobules of the breast, and therefore Stage 0 cancers have no ability to spread. Stage 0 is the most curable type of cancer, although DCIS generally requires more treatment than LCIS.

STAGE 1: In this stage, cancer cells have invaded the walls of the duct or lobule, but the total size is less than 2.0 cm, and cells have not yet spread to lymph nodes or anywhere else in the body.

STAGE 2: Cancers less than 5 cm in size that have spread to one to three axillary (armpit) lymph nodes, and cancers over 2 cm that have not spread to nodes and have not invaded the chest muscles or skin are all Stage II.

STAGE 3: Cancers of any size that have spread to four or more axillary (armpit) lymph nodes, the nodes around the clavicle (collarbone), and/or the nodes near the sternum (internal mammary nodes); cancers over 5 cm that spread to any number of nodes; and tumors that have grown into the chest wall or skin are all Stage III.

STAGE 4: This stage cancer has spread beyond the breast and nearby nodes, and has metastasized to other organs or distant nodes. The most commonly involved areas are liver, lung, brain, and bone.

3. What kind of operation is best for me? A lumpectomy only removes the affected portion of the breast while a mastectomy removes the entire breast. Ironically, your chances of relapse and survival are the same, whether you choose to have a lumpectomy followed by radiation or a mastectomy. Make sure to ask your doctor to help you make a decision that is best for you.

4. Do I have a choice about radiation? If you opt for a lumpectomy, your chances of relapse are about 40% if you don’t undergo radiation. If you do choose to have radiation, the chance of relapse drops to about 3-4%.

5. If I get radiation do I need chemotherapy? People often confuse these two treatments. Radiation only treats a specific area of the body, such as the breast, while chemotherapy is targeted at killing “rogue cells” floating through the blood stream and trying to land in an organ or other body part. Chemotherapy causes hair loss and nausea while radiation causes skin redness and fatigue. Overall, chemo and radiation are two totally different treatments and having one therapy doesn’t mean you can avoid having the other.

6. How do I best weigh my options? Arm yourself with information specific to your situation; it will help you feel more empowered and calm about your battle. Discuss the pros and cons of different treatments with your doctor, consider your age, family history, and the stage of your breast cancer that would make some choices more appropriate than others, consider the opinions of your family, spouse, close friends, and especially other breast cancer survivors.

7. What should I expect? The road to recovery will be hard, but you can do it with supportive family, friends, and support groups. Expect to give back to breast cancer causes such as the Susan G. Komen Race for the Cure, and most of all, expect to live! A positive attitude is just as crucial to recovery as all the treatments that you will endure.