WHAT YOU NEED TO KNOW NOW
Modern therapy means that in most cases breast cancer can be effectively treated with a combination of different types of treatment that may involve surgery, drugs (like chemotherapy, hormone pills, biologic therapy) and radiation. Your health care team will work together to come up with the best treatment plan for your specific circumstance. Not all breast cancers are the same; therefore, your treatment plan will be unique to you and your situation.
The biopsy you had will provide information about your specific cancer and some of its characteristics to help develop your treatment plan. It does not provide all of the information about the size or stage (how far it may have spread away from the lump itself), and sometimes the information changes when the final surgery is performed.
Dx is a common medical abbreviation for diagnosis.
Carcinoma refers to cancer that forms in the skin or tissue lining of organs.
Histologic subtype refers to the type of tissue that the cancer originated from. In breast cancer, you will hear of three common subtypes: invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) or invasive mammary carcinoma (IMC). The word “invasive” only means that the cancerous cells have moved out of the duct or lobule into the breast tissue; it does not mean it has moved elsewhere in the body. The term “ductal” or “lobular” tells us which part of the milk duct the cancerous cells have come from. Sometimes, if the cell of origin is not clear, it is called “mammary carcinoma” or “NOS” (not otherwise specified). There are less common types, such as metaplastic, but these do not tend to affect the type of surgery you will have.
Cores refer to the pieces of tissue that were removed during biopsy by a needle and the size of the needle that was used.
Grading refers to how aggressive the cancerous cells look under the microscope (does not refer to where it has spread in the body). There are 3 grades (1-3), with 1 being the least aggressive and 3 being the most aggressive.
Lymphovascular invasion refers to whether or not the cancerous cells have entered the blood or lymphatic tissues in the tumour
Lymph nodes are located under the armpit and are responsible for filtering the lymphatic system (fluid and cells). Cancer cells that have left the breast often get caught in the lymph nodes, so you will receive either a sentinel lymph node biospy (SLNB) or a axillary lymph node dissection (ALND) to assess the level of involvement. See Surgery for more information.
ER estrogen receptor and PR progesterone receptor tells whether or not the tumour is affected by hormones in your system, such as those produced by your ovaries or those that you may take (such as the birth control pill).
Her-2 neu is a special receptor that some breast cancers have. If it is positive, a biologic treatment targeted to this receptor can be given (i.e. Herceptin).
Metastasis refers to the spreading of cancer cells past the primary site of the breast. This often occurs in the bones, lungs, liver and brain. When this happens, the breast cancer is classified as Stage IV or Metastatic. To learn more about this stage, see the Metastatic pathway.
Non-invasive breast cancer, also referred to as ductal carcinoma in situ (DCIS), is stage 0 breast cancer. This means the cancer cells have not spread throughout the breast tissue. Refer to the DCIS page for more information.
Outpatient surgery refers to surgeries that do not require overnight admission to a hospital. Most breast cancer surgeries are performed as outpatient procedures.
WHAT YOU NEED TO DO NOW
If you are working, there is no need to stop working if you feel up to it, but this is the time to take care of yourself.
At this point, you may be preparing to tell your loved ones about your diagnosis. This is a personal decision but confiding in someone may provide you with some emotional support.
You may also decide that participating in clinical trials is the right choice for you. Again, this is a personal decision, but many options are available.
HOW YOU MIGHT BE FEELING
At this stage you will start to process the information and begin the process of coping with the diagnosis emotionally and physically.
You may feel scared, angry, sad and out of control. Many people begin to experience anxiety as well. These feelings are common, normal and expected. Your personal and medical support team can help you work through these feelings, and you may find that reading other women's stories is beneficial. There are also online community networks for you to join for support.
Many women feel that the cancer is growing every second, spreading rapidly, and that every new pain or feeling in the body is a sign of the cancer. This is a very normal reaction to the news, and while it feels like treatment can’t happen fast enough, the important thing to remember that the majority of breast cancers do not spread like that and that the very first cell was probably there months or even a year or so ago.
WHO IS THE TEAM AT THIS POINT
You will be seeing a surgeon, nurse and radiologist throughout the diagnosis stage. Depending on your treatment plan, you may see a medical and/or radiation oncologist, fertility specialist, psychologist/psychiatrist and genetic counselor as well.
Ideally, you should prepare for your appointment and bring along someone who knows you well and can be a second set of ears during the consultation. You might consider recording your appointments on your smart phone as well.
Be sure to ask plenty of questions to help yourself gain the best understanding of your situation.