Not sure where to begin when it comes to asking your doctor about your breast cancer diagnosis? These 20 questions are a good place to start:
Ask your oncologist whether you will need other imaging tests to determine whether or not the tumor has spread to lymph nodes or other parts of your body.
Ask your oncologist, based on your biopsy, what subtype of breast cancer you have, where it is located in the breast, and what that means for your treatment plan and your outlook after treatment.
Understanding what stage of breast cancer you have is important. Ask your doctor to explain the stage to you and find out where else besides the breast any tumors are located.
According to the National Cancer Institute, the stage of your breast cancer is based on the size of the tumor, whether the cancer has spread to any lymph nodes, and whether the cancer has spread to other areas in the body.
Particular characteristics of breast cancer cells affect how aggressive your tumor is. These include the amount of tumor cells that are reproducing, and how abnormal the tumor cells appear when examined under a microscope.
The higher the grade, the less the cancer cells resemble normal breast cells. The grade of your tumor can influence your outlook and treatment plan.
Ask your doctor whether your cancer has receptors. These are molecules on the cell surface that bind to hormones in the body that can stimulate the tumor to grow.
Specifically ask whether your cancer is estrogen receptor-positive or receptor-negative, or progesterone receptor-positive or receptor-negative. The answer will determine whether or not you can use medicines that block the effect of hormones to treat your breast cancer.
If your biopsy didn’t include testing for hormone receptors, ask your doctor to have these tests performed on the biopsy specimen.
Some breast cancer cells have receptors or molecules on the surface that can bind to other proteins in the body. These can stimulate the tumor to grow.
For example, the American Cancer Society (ACS) recommends that all patients with invasive breast cancer be tested to see if their tumor cells contain high levels of the HER2 protein receptor. This is important because there are additional treatment options for HER2-positive breast cancers.
Ask your oncologist if your cancer is HER2-positive. And if you haven’t been tested for HER2 protein receptors, ask your oncologist to order the test.
Find out what symptoms of breast cancer you are likely to experience in the future, and what symptoms you should contact your doctor about.
Your treatment will depend on the following:
- type of cancer
- grade of cancer
- hormone and HER2 receptor status
- stage of cancer
- your medical history and age
You may be a candidate for surgical removal of the tumor (lumpectomy), surgical removal of the breast (mastectomy), and surgical removal of affected lymph nodes. Have your doctors explain the risks and benefits of each option.
If your doctors recommend a mastectomy, ask them whether surgical reconstruction of the breast is an option for you.
Ask your oncologist if any of the following therapies are available to you:
- hormone therapy
- monoclonal antibody therapy
If your doctor recommends chemotherapy, ask them which combination chemo regimens are being considered. Find out what the risks and benefits of chemotherapy are.
It’s also important to ask what the possible side effects of the combination chemo regimens are. For example, if losing your hair temporarily is a concern for you, ask your oncologist whether the medications recommended would cause hair loss or alopecia.
If your oncologist recommends hormone therapy, ask which of these therapies is being considered. Find out what the risks and benefits of hormone therapy are and the possible side effects.
Monoclonal antibodies block binding of substances to receptors on the surface of the tumors. If your oncologist recommends therapy with monoclonal antibodies, ask your doctor what therapies are being considered.
Find out what the risks and benefits are and what the possible side effects of the monoclonal antibodies are.
Find out what the risks and benefits of radiation are for your cancer, and what the possible side effects are.
Ask your oncologist if the side effects of your treatment will require you to take time off from work during or after treatment. And let your employer know in advance what your healthcare team recommends.
Your outlook after treatment depends on the following:
- your medical history
- your age
- type of tumor
- grade of tumor
- location of tumor
- stage of the cancer
The earlier your stage of breast cancer is at the time of diagnosis and treatment, the greater the likelihood that the therapy will be successful.
If you have an advanced stage of breast cancer, you may want to think about clinical trials. Your oncologists may be able to point you in the right direction, or you can take a look at http://www.clinicaltrials.gov/ for more information.
This question may be impossible to answer, but it never hurts to ask. There may be risk factors like family history or lifestyle practices such as smoking cigarettes. Obesity can also increase the risk of getting breast cancer.
Ask your oncologist if there are lifestyle changes you can make. Recommended changes may include:
- making changes to your diet
- lowering stress
- stopping smoking
- reducing alcohol intake
These things will help speed your recovery from treatment and increase your chances of a better outcome.
Getting help and support is important during this time. Think about attending local support groups for things like financial issues and getting practical support like finding transportation if needed. You’ll also be able to get emotional support from advocacy groups like the American Cancer Society.