I was just diagnosed.

Shock….Fear….Anger….Concern….Anxiety. These are just some of the thoughts that spin through a woman’s mind when diagnosed with breast cancer. She might think: “You’ve made a mistake”; “Why me?”; and, “Am I going to live?” Since every woman is unique, the approach to guiding a woman through the process of understanding her diagnosis and her treatment options must be individualized. However, experience has taught us that there are a series of helpful steps that minimize the stress in the journey from just being diagnosed to the successful completion of treatment.

This website has been developed intentionally to help guide a woman through the initial stages of being diagnosed with breast cancer. A special thank you to Dr. John West at The Breast Care & Imaging Center of Orange County for allowing me to borrow information from his website.

Within 48 hours of being diagnosed, most women are ready to focus on their treatment options. Before reviewing these options, it is essential that a woman has a clear understanding of her cancer diagnosis. The first question that must be answered: “Is my cancer invasive or non-invasive?” (See: Understanding Your Pathology Report). With non-invasive cancers, the initial focus of the discussion is whether or not the breast can be saved (in most cases, it can). The amount of time required to eventually make a decision is less of an issue, since these cancers are almost always curable.

With invasive cancers time is an issue; however, the process should not be rushed. It is essential that a woman take the time to fully understand the nature of her cancer, as well as all her treatment options. It is also essential that the treatment team have time to study the various clinical issues so that the most accurate treatment recommendations can be made.

Summary of the three basic initial treatment options:

  • Breast conserving surgery (lumpectomy + irradiation)
  • Mastectomy (with or without immediate reconstruction)
  • Chemotherapy first (to reduce the size of a larger tumor), followed by surgery.

What is my prognosis?

One of the first questions a woman asks after learning she has breast cancer is:
“Am I going to live?” Or, in other words, ” What is my prognosis?” When a woman asks her physician this basic question, she is often frustrated with the vagueness of the response. The problem is that the treating physician does not have enough information following the initial biopsy to make an accurate prediction of survival. Until the tumor and lymph nodes have been removed and analyzed, an accurate prediction of survival is not possible. Learn more about pathology reports.

The most important predictors of survival are the size of the invasive component of the tumor, and the status of the regional lymph nodes. When there is no invasive tumor present (i.e. only ductal carcinoma in-situ, or DCIS), the survival rate is 100%. When the invasive tumor is less than 11 mm in diameter and the nodes are negative, the 10-year survival approaches 95%.

As the tumor enlarges and the number of involved lymph nodes increases, the potential for cure is reduced. However, dramatic improvements have been made in the medical treatment of breast cancer (i.e. chemotherapy and hormone therapy), and many new treatments are on the horizon. There is now reason for optimism in even the most advanced cases. This is why the coordination of your care with a medical oncologist is very important.

The time that elapses before a woman is informed about the details of her prognosis is typically 7-14 days after the removal of the tumor and the under arm lymph node(s). It usually takes this long to analyze the tumor and to receive a pathology report on the various tumor markers that also influence prognosis. A woman and her family will usually have a detailed consultation with the oncologist to discuss her prognosis, and more importantly, what steps should be taken to maximize her chances of survival. After this detailed discussion, a woman chooses the option that is best for her.