diagnosis is key to understanding your treatment. To decide the right path for you, use the
questions below as the start of your discussion. Always ask how a treatment affects you
specifically—if your doctor sounds like he is offering a cookie-cutter
approach, it is time for a second opinion.
No two women are the same; no two diseases are identical.
What clinical stage is my tumor? And
what are the implications of that stage? Early stage breast cancer is typically stage 1 and 2. Stage 3 means either a larger tumor or affected lymph nodes. Stage 4 is metastatic breast cancer, meaning the disease has spread beyond the breast and nodes, usually to the bones, lungs, brain, or liver.
What kind of surgery do you recommend and why? Why is that choice specifically better for
me? If your surgeon recommends a
mastectomy, ask for data that show that this approach is better for you than a
lumpectomy. If, in contrast, you worry
that a lumpectomy is enough, ask for data on its effects on your specific
Do I need chemotherapy? If so, should I have it
before or after surgery? If I have it
before, and the tumor responds to the chemo, what surgery would you plan
What is my prognosis with chemo?
What is my prognosis without chemo? How will my individual risk be reduced? What is my individual risk of recurrence
without chemo, what is my risk of recurrence with chemo?
What chemo drugs do you use and why?
Do you have literature on
those drugs, their effects, and their side effects? If he says, “We have taken care of the side
effects,” as one doctor told me, challenge that statement.
They have not taken care of the side effects.
What type of radiation do you suggest? Is
accelerated partial breast irradiation an option? What is its success potential in my specific
case? Is whole breast radiation
better? If so, why?
What about reconstruction? Will I need
it? Do you recommend it? If so should I have it done immediately or
should I delay it until after treatment?
Can I talk to other women who have gone through this
from actual women is good. This does not
necessarily mean a support group—it means being able to call a smart woman who
has already walked this road and talk with her about how that feels.
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