
Managing Your Medical Care: Breast Cancer: Prior To Diagnosis
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Concern about a diagnosis of breast cancer usually starts with noticing a lump during a self exam or annual medical exam, or by a spot revealed during an annual mammogram (an x-ray of the breast).
As you go through the process of finding out what a particular lump or irregularity means, keep in mind that the vast majority turn out to be benign cysts instead of cancer. If you talk with other women who have had breast cancer, also keep in mind that their experience may be very different from yours. We are all unique individuals and each medical situation is different.
Depending on the facility in which a mammogram is performed the following steps may occur in one place at one time or may be spread over time:
- A screening mammogram (an initial mammogram)
- A diagnostic mammogram (a mammogram with a focus on a particular area)
- For information about mammograms, including how to assess the facility, and how to pay for the test(s), click here.
- Other imaging tests such as Breast Ultrasound,Magnetic Resonance Imaging (MRI), and/or a Ductogram
- A Biopsy, with a report of the results (known as a "Pathology Report"). Before getting a biopsy, read: Before Having A Biopsy.
Test results may be shared with you directly or only through your doctor.
Waiting for test results or meetings, or getting a call with the request to take another imaging exam such as an ultrasound or MRI, are likely to be emotionally difficult times. To help you through it, read: How To Cope With Waiting
Before telling friends and family about the testing, think about who to tell and what you want to tell them. Before telling co-workers or your employer, read Disclosing Your Health condition to Co-Workers and Disclosing Your Health Condition To Your Employer. While it is important to tell young children about a diagnosis, there is no need to tell young children about the tests until you know the results.
NOTE: If you do not have health insurance, see Uninsured for ideas about obtaining the health care you need without health insurance. Also consider doing what you can to obtain health insurance. It is not too late. For information, click here.
If cancer is present
Before considering treatment options, in order to make an informed decision:
- Ask your doctor how long you have to make a treatment decision.
- Think about what is important to you. For instance: Go for a cure no matter what the side effects are or whether it is covered by your insurance. Or: only consider a treatment that doesn't interfere with your work.
- Learn the basics about your particular type of breast cancer and available treatments.At the least, it is advisable to learn about the following, all of which will be contained in your pathology report:
- Cancer type
- Size of the tumor if a surgical removal (an excision) was done
- Where it started
- Whether your cancer is aggressive or slow growing.
- Molecular receptors, such as estrogen, progesterone or HER-2 receptors.
- Your breast cancer stage. Staging is a short hand description for factors such as those described above as well as whether it has spread.. All cancers are "staged." NOTE: If your cancer is very large, involving the skin or possibly involving adjacent lymph nodes, your doctor may refer you to a medical oncologist for staging to determine if the cancer has spread to other organs or if you should be treated with other forms of cancer treatment before surgery. This is known as neoadjuvant treatment..
In any event, you will be referred to one or more surgical oncologists - surgeons who specialize in breast cancer. If this occurs choose the specialist(s) best suited to your health condition and your personal values and needs.
- Ask why your doctor suggests the particular surgical oncologist.
- In addition to considering the recommended surgical oncologist, consider other surgical oncologists who fit the profile of doctors with the best success rate for your situation. (For information about choosing an oncologist, click here.)
- Start thinking about a family member or friend to take with you at least to your initial meeting with the surgical oncologist to help ask questions, help remember what the doctor said, and to review the meeting with you afterwards. This person is known in the medical community as a patient advocate. (NOTE: Professional patient advocates are available if necessary.)
These subjects and more are discussed in our article: Diagnosis To Treatment Decision. Click on the following button that will take you to the version that applies to your situation: