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Frequently Asked questions

FAQs addressing: Just Diagnosed, Diagnosis-related, Coping, Statistics,
Treatment, Reconstruction

Breast Cancer Support Begins with Answers to your Questions

If you or someone you love has been diagnosed with breast cancer, the questions may seem endless. Frequently asked questions about breast cancer in general are answered below. Starter questions to ask your doctors are important, too.

If you would like more information or support, visit ABCD’s Resource List or call the Breast Cancer Helpline.

Just Diagnosed

Q: I’ve been diagnosed with breast cancer; what’s next?

You’ll be faced with many decisions you have to make and the answers to your questions may not be clear-cut. It’s likely you have a little time to make decisions, so don’t panic. But don’t delay needlessly either; you should be deciding on your course of treatment in the next week or two, after you’ve gathered the breast cancer support and information you need. If, however, your doctor says your type of cancer requires immediate treatment, your decisions should be made more quickly.

Q: No one in my family’s had breast cancer; how can I have it?

That’s one of the first questions many of us ask, because there is a misconception that most breast cancers are hereditary. In truth, only 5% to 10% of breast cancer is genetically linked.

Q: I’m in my 30s; isn’t that too young to have breast cancer?

Breast cancer strikes women of all ages, although it is true that a woman’s risk of breast cancer increases as she ages. About 78% of breast cancer cases are in women over the age of 50.

Q: Did I do something to get breast cancer?

The causes of breast cancer are not known, but so far, no causal link has been established between breast cancer and any behavior or lifestyle pattern. What’s important now is that you get the breast cancer support and care you need.

Diagnosis-Related

Q: What doctors will I be dealing with?

A surgeon will help you determine which type of surgery to undergo, will perform a surgical biopsy, if necessary, and a lumpectomy or mastectomy to remove the cancerous tissue and recommend further treatment.

A medical oncologist will determine if you are a candidate for chemotherapy and, if so, what dosage and type is appropriate for you.

A radiation oncologist will determine if you are a candidate for radiation therapy and, if so, how that would be carried out.

A plastic surgeon works with a patient to determine the type of reconstruction, if any, a patient will have and performs the reconstruction.

Coping

Q: What can help me get through this breast cancer treatment process?

People have found many avenues for breast cancer support in dealing with this very frightening phase of their lives. Here are some tips from ABCD Mentors:

Take time for yourself.

This is the time to get plenty of rest, eat right and let other people take care of you.

Keep a journal of your cancer journey.

Some people choose to keep a separate journal of the very specific physiological changes they go through and another on their thoughts and fears during the process.

Exercise.

You may not feel like running a marathon, but you will feel better mentally as well as physically if you have some physical activity, such as walking, tai chi or yoga.

Keep things as normal as you can.

Most people with outside jobs find it’s helpful to continue working, although their energy levels might not be high enough for hard chargers to operate at their normal productivity. Many find employers to be very flexible during this time, but make sure you know your rights as an employee.

Read to be informed and to be inspired.

There are many books written by and about breast cancer survivors. A few suggestions from ABCD’s mentors are listed in our Resource List.

Get support from other breast cancer survivors.

There are breast cancer support groups run by most hospitals, as well as other local community agencies, although in smaller communities support groups may focus on cancer in general rather than beast cancer specifically. Via the internet, support can also be found in chat rooms of many kinds.

We believe that One-to-One breast cancer support groups is vital. If you would like the support of someone who has “been there” who is available to you when you need help, you may want to be matched with an ABCD mentor. A mentor will listen to you and share the perspective of one who’s been on a similar journey herself.

Statistics

Q: How many women are diagnosed with breast cancer?

Estimates are that more than 200,000 people will be diagnosed with breast cancer in the U.S. this year.

Q: Do men get breast cancer, too?

Yes, men are diagnosed with breast cancer, but they represent less than 2% of the breast cancer cases in the U.S.

Q: No one in my family’s had breast cancer; how can I have it?

That’s one of the first questions many of us ask, because there is a misconception that most breast cancers are hereditary. In truth, only 5% to 10% of breast cancer is genetically-linked.

Treatment

Q: What is a lumpectomy?

In a lumpectomy, a surgeon cuts out the tumor and a certain amount of tissue around the tumor (called margins), conserving much of the breast tissue. Women with smaller tumors are generally the best candidates for this surgery. Lumpectomy is usually followed by radiation.

Q: What is a mastectomy?

In a modified radical mastectomy, the most common type of mastectomy today, the entire breast is removed.

Q: How can I decide whether to have a lumpectomy or mastectomy?

This may be your first major decision. Your doctor may make a recommendation based on your tumor and breast size and characteristics, but in most cases, the decision will be up to you. For some women, sparing the breast is extremely important; for others, eliminating all the breast tissue gives greater peace of mind. Studies have concluded that a lumpectomy followed by radiation is comparable to a mastectomy in terms of long-term survival.

Q: What do lymph nodes have to do with it?

During a lumpectomy or mastectomy, lymph nodes usually will be taken from under the arm to help diagnose your disease. If it’s determined that cancer cells have spread to the axillary (underarm) lymph nodes, it’s more likely they’ve spread elsewhere in your body as well. The number of nodes that are “involved” is a factor in determining the stage of your disease.

Q: What is a sentinel node biopsy?

In this procedure, a surgeon injects a dye into the area around the tumor and tracks it to the lymph node closest to the tumor. This node is cut out and examined. If it is cancer free, the patient may avoid having any axillary lymph nodes removed and lessen her chance of getting lymphedema. A sentinel node biopsy is ideally performed by a skilled and experienced surgeon.

Q: What is lymphedema?

When lymph nodes are removed, the normal lymph drainage can be impaired, leading to an accumulation of fluids and swelling of the arm. Lymphedema can occur right after surgery or months or years later, and can be triggered by an infection or pressure on that arm.

Q: What is radiation?

Radiation is used to destroy cancer cells that may remain after surgery in the breast, chest wall or armpit. Radiation also can be used to shrink a tumor before surgery. Generally, radiation treatments are given five days a week for six or seven weeks. Newer radiation therapy, which can be used for some women, involves radiating only a portion of the breast and may last only a week.

Q: What is chemotherapy?

Chemotherapy is what’s called a systemic treatment, meaning it is aimed at eliminating any cancer cells that may have spread through the body’s system. In chemotherapy, anti-cancer drugs are injected into the bloodstream or taken orally over a period of approximately six months. They are given in cycles, with time in between for the body to recover from the toxic effects.

Side effects of chemotherapy may include nausea, hair loss, fatigue, mouth sores and changes in menstrual cycles. Chemotherapy also may bring on premature menopause and infertility, generally in women closer to menopause age.

Q: What is tamoxifen?

Tamoxifen is another systemic treatment and was the first widespread hormonal therapy for breast cancer. It is an anti-estrogen, effective against breast cancers that feed on estrogen. It is taken orally, usually for five years. This drug has been shown to reduce the chances of breast cancer returning after surgery and also may be used to treat breast cancer that has spread to other parts of the body (metastatic breast cancer).

Tamoxifen may cause an increase in a woman’s risk for endometrial (uterine lining) cancer and blood clots in the deep blood vessels of the legs and groin. Other side effects include hot flashes, night sweats, mood swings and cataracts.

Q: What are aromatase inhibitors?

Aromatase inhibitors are newer hormonal treatments, used in postmenopausal women to stop estrogen production in other parts of the body. They include anastrazole (Arimidex), exemestane (Aromasin) and letrozole (Femara). Aromatase inhibitors have been used to treat metastatic breast cancer and recent studies have shown success in earlier breast cancer as well.

Reconstruction

Q: What is reconstruction?

Reconstruction restores the appearance of the breast after a mastectomy. There are several types of reconstruction, using implants or tissue from elsewhere in the body. A plastic surgeon performs this surgery.

Q: Do I need to decide on reconstruction right away?

This is another decision you may choose to make early in the process. If you’ve chosen to have a mastectomy, you may want to have immediate reconstruction. Reconstruction can be delayed, but some women prefer to combine it with a mastectomy to avoid another hospital stay and recovery period. You should discuss the medically appropriate time for reconstruction for you with your doctor.