After a breast cancer diagnosis, you could face an onslaught of varying emotions that make it difficult to focus. No one is prepared to have the conversation about the next steps. At AiRS, we want to help guide you through a few of the right questions to ask your doctor so that you can make choices that are best for you.
We recommend you have a friend or family member at your initial doctor visits, with your questions in hand, so that you can clearly receive all the information you need about your prognosis. Having a support team will help you navigate the options, including if and when reconstructive breast surgery is right for you.
1. What type of breast cancer do I have?
Not all breast cancer is the same. There are different ways breast cancer is classified. According to the Cancer Treatment Centers of America, the most basic way to classify breast cancer is by where the cancer cells originate. The cancer cells origin helps doctors understand if the cells may spread and what the best course of treatment will be.
2. How big is my tumor?
Tumor size is another factor that will determine your course of treatment. Your doctor uses the size of your tumor to “stage,” or further categorize your cancer.
4. What is the stage of my cancer?
According to the American Cancer Society, a tumor’s stage refers to its size and spread in the body. Cancer confined to the breast is often referred to as localized cancer. Cancer that has spread to other organs is called metastatic cancer. A cancer’s stage is often denoted by the Roman numerals I – IV. The higher the numeral, the more the cancer has spread within the body.
5. What is the grade of my tumor?
A tumor’s grade refers to how the tumor cells look under a microscope. The more different they look from healthy cells, the higher the grade and the more quickly the cancer is likely to grow.
6. What is my hormone receptor status?
According to the US National Library of Medicine, some breast tumors are stimulated to grow by the hormone estrogen. Tumors take in estrogen via structures on tumor cell surfaces called estrogen or progesterone receptors. Tumor cells with many of these receptors on their surfaces are called estrogen or progesterone receptor positive. These tumors are often successfully treated with hormonal therapy.
7. What is my HER2 status?
HER2/neu is a substance that is overproduced by about 25% of breast tumors. Tumors that overproduce HER2/neu are called HER2 positive and may respond to treatment with drugs.
8. Will I need surgery, and what kind should I have?
According to the American Cancer Society, most women with breast cancer have some type of surgery. Some breast cancers cannot initially be surgically removed. In other cases, whether to operate and the type of surgery may depend on the cancer’s stage, the tumor’s size and location, the size of your breast, and your preference.
9. Should I have breast reconstruction, and when?
Some women opt not to have reconstruction. Others believe it benefits their appearance and psychological recovery. If you are having one or both breasts removed and are considering reconstruction, the stage of your cancer may dictate the timing of the reconstructive surgery. Some patients may be able to have breast reconstruction surgery when the breast(s) are removed during a mastectomy.
10. Will I need radiation?
Many oncologists recommend radiation treatment for all breast cancer patients who undergo a lumpectomy. For women who undergo whole-breast removal, radiation may be recommended for those who are considered high-risk.
11. Will I need chemotherapy?
Typically, chemotherapy is a consideration for patients with high-risk breast cancers. Some factors that may indicate the need for chemotherapy are lymph node involvement; tumor grade, tumors that are HER2-positive and breast cancers in younger patients, especially those below the age of 40.
If you need help navigating through the options made available or have questions about reconstructive breast surgery, feel free to reach out to one of patient advocates.
Sources: American Cancer Society, Cancer Treatment Centers of America, US National Library of Medicine