Newly Diagnosed with Breast Cancer? Some Questions to Ask the Doc

Understanding your 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 diagnosis.

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 afterward?

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 treatment?  Hearing 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.

• This is an excerpt from Surviving Triple-Negative Breast Cancer, which includes additional details on staging and treatment, including chemotherapy, radiation, and surgery.

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