You’ve just been diagnosed with breast cancer and are looking for answers to the multitude of questions that arise. Questions like:
- What kind of breast cancer do I have?
- Will I need surgery?
- Will I need chemotherapy?
- Will I lose my hair?
- Will my breast cancer come back?
- Will I die of breast cancer?
The time immediately following your breast cancer diagnosis can be difficult and stressful for you and your loved ones. You want to gain control of the situation, you need to clearly understand your cancer treatment options and most of all you want to feel confident in the decisions you face about what to do next.
The following tips for dealing with a breast cancer diagnosis are based on an interview with the Medical Director of the Center for Breast Health at Virginia Hospital Center in Arlington, Dr. Stephanie Akbari, MD, FACS . For the full interview transcript, click here.
Coping after a diagnosis of breast cancer
The best way to cope is to understand your breast cancer treatment options and to make a plan to address the problem. It’s all about taking back control. Once you redirect your energy away from worry and toward making and following a plan of action, you’ll notice that your stress and anxiety levels go down. Patients are not dying from breast cancer the way they used to, nor is breast cancer the “every second counts” situation you may think it is. In fact, most experts believe that breast cancer can be present for as much as two to three years before it’s detected in a mammogram. All this means you should schedule a consultation several days after your initial diagnosis. This allows time for the initial emotional shock to wear off, and helps you to better focus on the discussions to come. Often additional testing is required; MRIs may be needed, as well as a consultation with a plastic surgeon. It is important to take the necessary time to set up these appointments. Doctors don’t want you to look back on your experience and feel you were rushed or unable to make informed decisions.
Understanding your breast cancer
Breast cancer treatment today is not one-size-fits-all. The effort is to individualize treatment. Thus, the better you understand what the choices are and what would fit your needs, the happier you’ll be in the long run. Education is the key to ensuring that your treatment is tailored to you. A valuable resource is your breast cancer treatment team. This is usually comprised of the breast surgeon, plastic surgeon, physician assistants, navigators, and nurse educators. These experts can help you find appropriate educational information, and also direct you to reputable websites. This is preferable to just jumping on the internet. Even though there are many reliable sites, it’s hard to tell what does or doesn’t apply to you, and that can lead to a scary experience. Take the time to write down questions, as they occur to you, to address with your doctor at the next appointment. If possible, have someone come with you to take notes on the doctor’s answers. You’ll be presented with a lot of information about breast cancer and treatment options, much of which may sound like an entirely new language… thus making the details hard to absorb and remember.
Your first consultation with your breast surgeon – what to expect
Typically, a consultation is scheduled a few days after diagnosis, which allows for better focus during the discussion. During this initial meeting, the surgeon may present all of the available breast cancer treatment options including risks and benefits, and then offer advice on the best direction based on your individual profile. The purpose of the consultation is to provide you with an overview of the entire process from start to finish.
Here are some questions you’ll want to cover in the first consultation:
- What kinds of treatment are involved?
- Is chemotherapy for breast cancer recommended?
- Will I need to see other specialists, like a medical oncologist or a radiation oncologist?
- Will reconstructive surgery be needed?
- What other types of testing can I expect?
Fear of chemotherapy
Once you, as the patient, understand that many people are living with breast cancer, you will start to think about your treatment. You will ask the question, “Do you think I’m going to need chemotherapy for my breast cancer?” Everyone has heard stories of side effects like nausea and hair loss. Some patients are not as scared about the surgery or radiation, but chemotherapy is very frightening. When you come with questions specifically addressing your fears, it is easier for the doctor to understand your perspective and to provide the most sensitive help.
Genomic testing (e.g. MammaPrint®)
Genomic testing is a way of looking at the individual biology of your breast cancer, and its behavior to determine how “angry” or aggressive it is (unlike genetic testing, which looks at the biology of your genes). Genomic testing is done by using molecular profiling. It allows doctors to determine the actual behavior of each person’s tumor. This comprehensive understanding – far beyond just the size of the tumor, or whether lymph nodes are involved – helps to better determine which treatments are appropriate for your breast cancer. Molecular profiling is one of the standard National Comprehensive Cancer Network recommendations. It’s important for you to understand your options and speak with your surgeon or oncologist about testing to help guide treatment decisions.
Your support team
Family members and friends are so important when your diagnosis is breast cancer. Whether you have a “fight” mentality or feel paralyzed with fear, your support team can offer that critical guidance or just be there to listen. They can and should provide a loving, caring, and – most important – positive environment where all feelings are valid and all questions are fair game. Family should be there to offer support and reinforcement.