Talking With Your Doctor About Breast Cancer Treatment
Learning you have breast cancer can prompt a range of emotions.
However, it's important to approach breast cancer treatment in a careful, thoughtful way.
Talking to your doctor about how to treat the cancer is one of the most important conversations you will have.
Your best treatment options are based on such factors as:
- The type and stage of your cancer
- Whether your cancer is hormone sensitive
- Whether your tumor harbors specific gene mutations
- Your overall health and age
Knowing the stage of your cancer helps guide you to the best treatment for you. Cancer staging is based on the size of your cancer, its location in your breast, and whether it has spread to any lymph nodes or areas beyond your breast. Here are questions to ask your doctor:
What is the stage of my cancer?
What are the treatment options for my stage of cancer?
How soon do I need to start treatment?
Do we need other tests and other cancer specialists to help us decide on the best treatment?
Your treatment depends on your specific situation, but having some basic information about the major options will help you feel more in control when you talk to your doctor.
Talking About Breast Cancer Surgery
Most women have some type of surgery as part of their treatment. Here are the most common surgery options:
Lumpectomy. This surgery removes only the tumor and a small amount of breast tissue.
Partial mastectomy. This surgery removes part of your breast. Lumpectomy and partial mastectomy are breast-conserving surgeries. They are usually for early-stage breast cancer.
Total mastectomy and modified radical mastectomy. A surgeon will remove your whole breast, the lymph nodes under your arm, and sometimes part of the muscles under your breast. These surgeries are usually for more advanced stages of cancer.
Breast reconstruction surgery. This may be an option if you need to have a breast removed. You might have this surgery at the time of your mastectomy, or you might have it at a later date.
Talking About Radiation, Hormone Therapy, and Chemotherapy
Many women with breast cancer have surgery plus a combination of these therapies:
- Chemotherapy. This treatment involves taking drugs to treat cancer, either before or after surgery. You can take chemotherapy as pills, injections, or infusions through an IV. Your doctor may recommend chemotherapy before surgery if shrinking your tumor would improve your surgery results.
- Targeted molecular therapy. This medicine is usually administered by IV infusion. It targets specific behaviors of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than chemotherapy to harm normal, healthy cells.
- Radiation therapy. This treatment uses high-energy X-rays to kill cancer cells. If you have breast-conserving surgery, your doctor will probably recommend radiation therapy after surgery. You may also have radiation therapy after a total or radical mastectomy.
- Hormone therapy. This is an option when your type of breast cancer has receptors for female hormones that make your cancer grow faster. Hormone therapy blocks these hormones from attaching to your cancer cells. Doctors can use this treatment for all stages of hormone-sensitive cancers.
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- A Woman’s Guide to Breast Cancer Treatment. California Department of Health Care Services. http://www.mbc.ca.gov/Publications/Brochures/breast_cancer_english.pdf
- Breast Cancer Treatment–Patient Version. National Cancer Institute. http://www.cancer.gov/types/breast/patient/breast-treatment-pdq#section/all
- Treatment of invasive breast cancer, by stage. American Cancer Society. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-treating-by-stage