What to Know: Your Questions Answered After a Breast Cancer Diagnosis

October is Breast Cancer Awareness Month, a time dedicated to increasing understanding of the disease, promoting early detection, and supporting those affected by breast cancer.

Receiving a breast cancer diagnosis can feel overwhelming, and patients often face a variety of medical, emotional, and practical questions. Here are the top questions patients ask, along with tips on how to address these concerns.

What Type and Stage of Breast Cancer Do I Have? What Does That Mean for Treatment?

Breast cancer is first classified by its histology (like ductal carcinoma in situ [DCIS], or invasive ductal carcinoma [IDC]), and then by its receptor status, which is key to treatment selection. These include hormone receptor (HR) status (estrogen receptor/progesterone receptor [ER/PR]) and human epidermal growth factor receptor 2 (HER2) status.

The stage (stage 0 to stage 4) describes the cancer’s size and how far it has spread (to lymph nodes or distant organs). Early-stage cancer (stage 1 or stage 2) is typically curable, while stage 5 (metastatic) is managed as a chronic, but treatable, illness. Your type and stage form the blueprint for your personalized treatment plan, which may include surgery, radiation, chemotherapy, targeted therapy, or hormone therapy.

“Really understanding what their cancer is, what stage it is, and what the goals of treatment are is really important. Sometimes we gloss over those basics and dive right into what the drugs are that we're going to use and how they work, but taking a step back and [asking], ‘What is the disease I have? And what can I expect in terms of treatment long term?’ is a helpful starting point,” Dr. James W. Smithy, melanoma medical oncologist and cellular therapist at Memorial Sloan Kettering Cancer Center, stated in an interview with CURE on the importance of understanding your disease.

“The diagnosis of breast cancer is made, and then the breast cancer is taken and [tested] for receptors that classify the breast cancer into [specific] groups. They’re stained for the HER2 receptor, the estrogen receptor, and the progesterone receptor. Occasionally, to determine the HER2 status, the tumor sample needs to be sent for a more specialized test called FISH in which the test is really looking at how many HER2 receptor copies there are inside the cancer cell,” Dr. Nadine M. Tung, from Beth Israel Deaconess Medical Center, added on the topic in another interview.

What are My Surgical Options, and Will I Need a Mastectomy?

Surgery is a cornerstone of breast cancer treatment, but the choice between removing the whole breast (mastectomy) or just the tumor (lumpectomy, or breast-conserving surgery) is a major concern.

In most cases, you will have a choice, provided the tumor is small relative to your breast size and there are no contraindications.

The decision is collaborative, factoring in the size and location of the cancer, genetic testing results (BRCA1/2mutations may favor mastectomy), and your personal preferences regarding body image and long-term surveillance.

Will I Need Chemotherapy, and How Will I Manage the Side Effects?

The word ‘chemotherapy’ can provoke understandable anxiety due to its association with harsh side effects.

Not all patients require chemotherapy. The need is determined by your tumor's biology (receptor status, grade) and whether cancer cells have spread to the lymph nodes. For many hormone-receptor-positive, HER2-negative cancers, advanced genetic tests on the tumor (like Oncotype DX or MammaPrint) can determine the recurrence risk and whether chemotherapy will provide a significant benefit.

If chemotherapy is indicated, know that modern treatment protocols and supportive care have drastically improved the management of side effects like nausea and vomiting, hair loss, and fatigue.

There are now precision tools to spare many patients the rigors of chemotherapy, focusing its use only on those who stand to gain a meaningful survival advantage.

Experts from both UCLA Health and Northside Hospital Cancer Institute sat down for an interview with CURE to discuss how to manage side effects associated with breast cancer treatment.

What Can I Do to Prevent Recurrence and Improve My Outcome?

Patients want actionable steps to participate in their recovery.

You are not a passive recipient of treatment; you are an active participant in your survivorship. Multiple large-scale studies have shown that positive lifestyle changes directly impact recurrence risk and overall survival:

• Maintain a Healthy Weight: Obesity is a known risk factor for recurrence, particularly for hormone-receptor-positive breast cancer.
• Regular Physical Activity: Aim for 150 minutes of moderate-intensity aerobic exercise (like brisk walking) per week. Exercise reduces cancer-related fatigue, boosts mood, and is linked to lower recurrence rates.
• Nutrition: Focus on a balanced, plant-rich diet (like the Mediterranean diet). Avoid excessive alcohol consumption.
• Adherence to Therapy: Complete the full course of adjuvant (post-surgery) treatments, especially long-term hormone therapy, which is one of the most powerful tools against recurrence.

Engaging in these healthy habits is a tangible way to improve your overall well-being, and give yourself the best possible chance for a long, healthy life after a breast cancer diagnosis.

References

1. “Questions Patients Should Ask After a Cancer Diagnosis,” by Brielle Benyon. CURE; July 24, 2024.https://www.curetoday.com/view/questions-patients-should-ask-after-a-cancer-diagnosis
2. “Breast Cancer Diagnosis: Addressing Questions and Concerns.” CURE; Dec. 4, 2018. https://www.curetoday.com/view/breast-cancer-diagnosis-addressing-questions-and-concerns
3. “Mitigating Side Effects During Breast Cancer Treatment,” by Darlene Dobkowski. CURE; Nov. 11, 2024. https://www.curetoday.com/view/mitigating-side-effects-during-breast-cancer-treatment

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