What Questions Should You Ask Your Provider After a Breast Cancer Diagnosis? | Everyday Health

A breast cancer diagnosis, or any cancer diagnosis for that matter, is scary and almost always unexpected. Patients are usually shell shocked and leave that initial visit confused, unable to process the information they’ve been given, and unsure of what to ask.

That’s why, at the end of every presentation I give, I provide patients with a template of potential questions they can ask their physician to start the discussion regarding next steps.

The purpose: to help patients feel empowered and help them begin to think their treatment journey is doable.

More questions may arise later, especially after consultations with other specialists, but this template usually gives patients a great foundation. (I’ve given you a sneak peak of a short version of the answers, too.)

What Are My Treatment Options?

Most people with a new breast cancer diagnosis can expect surgery and radiation therapy at minimum. More than anything, I find that most patients want to know the order in which treatment will occur.

Will I Need More Breast or Body Imaging?

Depending on the extent of the disease and its stage, patients can expect a breast MRI and possibly a PET/CT scan to evaluate the extent of the disease.

Will I Be Able to Save My Breasts?

When trying to determine if a patient is a breast conservation candidate, we look at both how large the tumor is and the size of the tumor relative to the patient’s breast size.

What Do My Breast Cancer Tumor Markers Mean?

For every single breast cancer, we look at the tumor receptors for estrogen, progesterone, and HER2. If they are positive, that means there are more treatment targets to decrease the risk of recurrence, such as hormone blockers and immunotherapy. If all are negative, the breast cancer is called triple negative, and it is usually more aggressive and will require chemotherapy.

What Can I Expect if I Decide to Do Nothing?

In a small group of patients, their breast cancer may never advance. However, for the overwhelming majority of patients, the cancer will advance in size and stage. For this reason, treatment is strongly recommended.

What Does Breast Cancer Screening and Surveillance Look Like After Surgery?

Patients who undergo a mastectomy will not receive routine breast imaging after surgery. In these cases, a physical exam is the primary way to detect new abnormalities. If a patient has undergone breast conservation surgery, I recommend that, for the first one to two years after surgery, they have a mammogram of the breast that had surgery every six months. The unaffected breast stays on the annual schedule.

Can You Explain the Nonsurgical Aspects of My Treatment Plan (Radiation, Chemotherapy, Immunotherapy)?

Depending on the size of a patient’s tumor and if they have positive lymph nodes, they may require chemotherapy before surgery. Not all patients need chemo before surgery. Almost all patients who decide to save their breast will require radiation therapy to reduce the risk of recurrence. Even some patients who undergo mastectomy will need radiation therapy.

What Are the Side Effects of My Treatments?

Side effects of surgery on the breast include pain, seroma (a collection of normal fluid), numbness, possible infection or bleeding, and sometimes a discrepancy in breast size. After radiation, patients may notice skin changes such as darkening or redness, breast swelling, or rib pain. Less common side effects include inflammation of the lung (radiation pneumonitis) and changes to the heart (for radiation to the left side). Side effects of chemotherapy include nausea, vomiting, weight loss, loss of appetite, diarrhea, numbness of the extremities (neuropathy), and hair loss, among others.

Are My Breast Cancer Treatments Covered by Health Insurance?

Yes, breast cancer treatments are covered by insurance, including breast reconstruction.

If I Decide That I Would Like to Have a Mastectomy, Is Breast Reconstruction Covered by Insurance?

Yes.

If I Don’t Have Health Insurance, What Are My Treatment Options?

Many patients are eligible for emergency Medicaid after a breast or gynecologic cancer diagnosis. Also, many hospital systems have funds set aside to help patients with cancer care. You may have to ask your doctor or nurse navigator about available resources.

Do I Need Genetic Testing?

The current recommendation from the American Society of Breast Surgeons is that all patients with a new breast cancer diagnosis undergo genetic testing.

Many other questions will arise while you go through your treatment journey. Hopefully, these questions will be a part of your road map and help you feel confident as you start the process.

Important: The views and opinions expressed in this article are those of the author and not Everyday Health.