I Have Breast Cancer, Now What?

Hearing the words, “you have breast cancer,” can bring out a range of emotions. People may feel scared, overwhelmed and likely have questions.

Breast cancer is the most common cancer found in women after skin cancer. The American Cancer Society estimates that about 287,850 new cases of invasive breast cancer will be diagnosed in women this year.

Phelps Health Medical Oncologist/Hematologist Kan Huang, MD, PhD, MS, who is board-certified in internal medicine, oncology and hematology, discusses what to expect after receiving a breast cancer diagnosis.

Imaging tests are usually the first step in detecting breast cancer. Mammograms, breast ultrasounds and breast magnetic resonance imaging (MRIs) may find an abnormality.

A breast biopsy (when a sample of breast tissue is removed and tested) is the only definitive way to make a diagnosis, according to Dr. Huang, who specializes in treating patients with breast, lung, colorectal and skin cancers as well as hematologic (blood) disorders.

Stages of Breast Cancer

Each case of breast cancer is usually assigned a stage, from 0 to 4. As a general rule, the lower the stage, the better the outcome for the patient.

Stage 0 breast cancer is a noninvasive cancer that hasn’t spread. Breast cancer in stages 1-3 is more advanced. While cancer in these stages may have spread to lymph nodes, they haven’t spread to other organs. Stage 4 is an invasive cancer that has spread outside of the breast to other organs.

The stage of a patient’s breast cancer may determine the type of treatment used, but other considerations are taken into account, too.

“Breast cancer treatments are personalized and depend on several factors, including type of breast cancer, stage, the patient’s general health and age as well as genetic test results,” Dr. Huang said.

Types of Breast Cancer Treatments

Breast cancer treatment often requires oncologists (doctors specializing in different areas of cancer) to work together to create a patient’s overall treatment plan. This plan may include one or a combination of the following different treatments:

• Surgery: Some breast cancer patients may have surgery to remove the cancer. A lumpectomy is an operation to remove a part of the breast where the cancer is located, and a mastectomy is a type of surgery to remove the entire breast.
• Radiation Therapy: Breast cancer patients may undergo radiation therapy, which uses high-energy rays (similar to X-rays) that kill the breast cancer cells.
• Chemotherapy: With chemotherapy, patients are usually given special medicines (usually by pill or IV) to kill the cancer cells.
• Targeted Therapy: Oncologists may recommend treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow.
• Hormonal Therapy: Some breast cancer patients may be given medications that block cancer cells from getting the hormones they need to grow.

Some types of chemotherapy, like adjuvant chemotherapy, is given after surgery to help kill any cancer cells that might have been left behind but can’t be seen on mammograms, breast ultrasounds or CT scans.

Other types of chemotherapy, like neoadjuvant chemotherapy, is given before surgery to shrink the cancer. By using this type of chemotherapy, patients could potentially have less extensive surgery and a better chance of a positive outcome

Dr. Huang also noted that palliative chemotherapy is often used on the most advanced stage of breast cancer that can’t be cured. This type of treatment is meant to extend or improve the patient’s quality of life.

“A breast cancer treatment plan is highly individualized, and not all patients require radiation or chemotherapy to treat their cancer,” Dr. Huang said.

Patients can be treated for breast cancer at Phelps Health, meaning they don’t have to travel far for care.

Side Effects of Breast Cancer Treatments

Depending on the type of treatment patients receive, they may experience some side effects. Since each case of breast cancer is unique, each person may notice different side effects.

Common side effects of chemotherapy may include the following:

• Tiredness
• Increased risk of infection
• Nausea
• Constipation or diarrhea
• Mouth sores
• Neuropathy (nerve damage)
• Hair loss and more

Dr. Huang noted that not all breast cancer patients will lose their hair during breast cancer treatment.

Breast Cancer Risk Factors

One in eight women will develop breast cancer during her lifetime. Certain risk factors, like being over age 55 or inheriting certain gene mutations, may increase a woman’s chance of developing cancer.

However, other risk factors that women can change may help reduce their possibility of getting breast cancer.

“Smoking and drinking large amounts of alcohol could also associate with an increased likelihood of having breast cancer,” Dr. Huang said.

Quitting smoking and drinking less alcohol can lower a woman’s chances. Also, eating a healthy diet with plenty of fruits and vegetables and exercising for at least 30 minutes per day for 5 days a week can help lower a person’s risk of breast cancer.

Most women who get breast cancer don’t have a family history of the disease, but women who have close blood relatives (mother, sister or daughter) with breast cancer have a significantly higher risk of developing the disease.

Dr. Huang recommends people who have a family history of breast cancer talk to their doctor about lowering their risk.

“Our team can help estimate a patient’s lifelong risk of having breast cancer by reviewing family history and other medical history. We also offer genetic testing,” she said.