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Women's Health

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Finding Out You Have Breast Cancer

separator One of the first things you should know when you find out you have breast cancer is that you have time to stop, think, and weigh your options for treatment. According to Dr. Susan Love, a nationally renowned breast cancer expert, director of the National Breast Cancer Coalition and medical director of the Susan Love, M.D., Breast Cancer Foundation, by the time your breast cancer is diagnosed, it’s probably been there for eight to 10 years. That’s how long it takes before breast cancers are visible on a mammogram or able to be felt in a clinical exam.

One of the most important things you can do for yourself when you find out you have breast cancer is to make sure you feel comfortable with the breast cancer specialist who will be treating you. This person could be a surgeon, an oncologist (a doctor who specializes in cancer treatment), maybe a radiation therapist or sometimes even your primary care doctor. You need to feel assured that your doctor is explaining your diagnosis and treatment options clearly. You also need to feel completely comfortable asking your doctor questions—even if you have to ask them over and over again—until you understand what type of treatment you’re getting and why.

For all of these reasons, it’s important to take the time make sure you have good rapport with your doctor, and that you feel comfortable with the decisions you and your doctor agree to regarding your treatment.

Understanding your diagnosis
One of the first responsibilities of the breast cancer specialist who will be treating you is to explain what your diagnosis means. To make the diagnosis, your doctor will gather information from the different members of your healthcare team. This information typically comes from

  • The biopsy you probably had when your cancer was first detected
  • Bone scans
  • Blood tests
  • X-rays
  • A test for levels of a protein called HER2 or HER2/neu

Newly diagnosed cancer is classified by stage, from stage 0 to stage 1V. Your doctor determines what kind of treatment plan you’ll need by learning what stage your cancer has reached. The stages are described below:

Stage 0: This is a very early stage of the disease. The cancer has not spread beyond the breast duct or lobe where it started. This stage is called “in situ breast cancer.”

Stage I: The cancer is no larger than about one inch, and it hasn’t spread outside the breast. This stage is called “invasive breast cancer.”

Stage II: This stage is also called “invasive breast cancer.” It’s grouped into subcategories, depending on the size of the cancer and whether or not it has spread to lymph nodes.

Stage III: This stage is also divided into subcategories. They are determined by the size of the cancer, whether it has spread to lymph nodes that are attached to each other or to other structures, and whether the cancer has spread to tissues near the breast or to lymph nodes inside the chest wall along the breast bone. Stage III is also called “invasive breast cancer.”

Stage IV: In this stage, called “metastatic cancer,” the cancer has either spread to other organs in the body or to lymph nodes in the neck, near the collarbone.

The stage determines the treatment plan
As you can see, there’s not just one kind of breast cancer. There are various categories and subcategories. So it makes sense that there are many different treatment approaches.

Generally, tumors that are smaller need less aggressive treatment than tumors that are larger. Cancer that has spread to lymph nodes requires more aggressive treatment than cancer that has not, as does cancer that has spread to other areas of the body (metastatic cancer).

Your doctor should help you understand exactly how aggressive your cancer is and what your options are for treatment. The less aggressive your cancer is, the more simple your treatment is. You may need surgery to remove a tumor and then a series of radiation treatments, for example, and nothing more, if your cancer is not very aggressive. If it is, you may need a mastectomy (removal of your breast), then radiation treatment, and chemotherapy as well. There’s no cookie cutter treatment when it comes to breast cancer.

Even chemotherapy has many variations. Sometimes chemotherapy treatments last only three months, while others may need to go on for much longer. Some cause you to lose your hair, while others don’t. Some cause nausea, some don’t.

After treatment begins…
Be sure to tell your doctor about any side effects your treatment causes. There are often ways to help control the nausea or extreme fatigue many cancer patients experience. And ask any questions that come to mind along the way. It’s a good idea to keep a notebook just for questions and thoughts about your cancer.

As your treatment for cancer gets underway, don’t ignore the part of yourself that needs nurturing. Try to eat as well as you can. Try to fit exercise into your daily routine, even though you may feel tired, because exercise can be a tremendous help to you in your recovery. (See the article in this magazine titled Dance and Movement as a Tool for Recovery.) Join a breast cancer support group if that interests you. And reach out to family and friends, because their help is crucial to you right now.

American Cancer Society; National Cancer Institute; The New York Times, 13 May 2003.
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