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Hearing the words, “You have breast cancer,” is an unexpected, life-altering change to anyone’s life that could leave you feeling unprepared to face your new challenge. Emotions range from shock and anger to feeling numb and being speechless. All of these emotions are normal. One thing to remember is that breast cancer is usually a very treatable disease. Learning about and understanding the facts of your breast cancer diagnosis can sometimes help calm fears you may have and is important in helping you face this challenge.
Where we look to learn can be even more important. Therefore before turning to a website article or discussion thread, look to your physician or nurse navigator to help you understand your options. The nurse navigator is a trained professional whose main focus is to guide you through the diagnosis and treatment of your particular type of breast cancer.
The first step is reviewing the pathology. Pathology is defined as “The anatomic or functional manifestations of a disease.” In other words, what do the cells look like? Your physician will typically go over your pathology with you during the first consultation. There are different kinds of breast cancer that only your pathology can identify.
The next step is consultations with all the physicians who would be involved in your care. When you are first diagnosed with breast cancer, it is usually not a medical emergency. You have time to consult with all the physicians before making any final decisions. These meetings will help you understand your treatment options, including the advantages and disadvantages of each option. These treatment options will be discussed during your initial consult with your medical oncologist, radiation oncologist, plastic surgeon, and general surgeon. When you meet with your physicians, be sure to ask questions and write down the answers. It would also be recommended to have someone with you during your consultation with your doctors.
The final step is determining the protocol for your type of cancer. If the protocol for your type of cancer is surgery, there are several types of surgical procedures, including mastectomy (removal of the breast) and lumpectomy (removal of the tumor). In most breast cancer cases, surgery is recommended within several weeks of your biopsy; however, there are some exceptions. One exception would be genetic testing. For women who have a strong family history of breast cancer, it could be recommended that you have genetic testing prior to surgery to guide your treatment. In the mid 1990’s, positive mutations in BRCA1 and BRCA2 (BR=breast; CA= cancer) genes were found to increase the risk of breast and ovarian cancer. These genes are inherited from one generation to another in both males and females. According to the National Comprehensive Cancer Network guidelines, women diagnosed younger than 50 that have at least one close blood relative diagnosed with breast cancer would qualify for genetic testing. Other criteria include, but are not limited to personal history of triple negative breast cancer diagnosed younger than 50 or a family history of a known BRCA1 or BRCA 2 gene mutation. Another exception to surgery right after biopsy is the need for neo-adjuvant chemotherapy, chemotherapy given before surgery to shrink the tumor size, which may allow a woman to keep her breast. The type of surgery is dependent on your pathology, genetic testing, and physician recommendation.
Decide on your treatment plan with your care team based on facts and protocols, not on what you saw on the internet. Reach out to your physician or navigator. Take the time to learn about your specific breast cancer and the different treatment options. Remember that breast cancer is a treatable disease. It certainly is not an illness you would choose, but it is an illness with many proven treatments.
The Community Cancer Center offers a variety of supportive and educational groups and programs, free of charge, to help patients and families cope with cancer and its effects. For more information go to our website at www.cancercenter.org.
By Lisa Lowry RN MSN, Breast Health Navigator at the Community Cancer Center