Breast cancer

Question 1

Should I get a BRCA genetic test, and what does a positive result mean?

Accepted Answer

A genetic test checks your BRCA1 and BRCA2 genes. It can show if you carry inherited changes that raise your breast cancer risk. Your care team can help you decide if testing is right for you. BRCA1 and BRCA2 genes can sometimes develop changes. A change raises your risk of breast cancer. It also raises your risk of ovarian cancer and other cancers. These changes are inherited — meaning they pass through families. Breast cancer caused by inherited gene changes is called hereditary breast cancer. If you carry a BRCA change, your care team may suggest steps. These steps may help lower your risk. Options may include medicines. Some people at very high risk choose surgery on healthy breast tissue. Talk to your care team about what makes sense for you.

Question 2

What is breast reconstruction, and when can I have it done?

Accepted Answer

Breast cancer surgery sometimes removes all or part of the breast. A mastectomy — surgery to remove the breast — is one common option. A lumpectomy removes the tumor and some tissue around it, but keeps the breast itself. Which surgery is recommended depends on factors like the stage of the cancer, the size of the tumor, and the size of the breast. Our current sources do not include details about breast reconstruction. Your care team is the best place to ask about what reconstruction options may be available to you and when they can happen.

Question 3

What is HER2-positive breast cancer, and why does it matter?

Accepted Answer

HER2 is a protein involved with cell growth. It sits on the outside of all breast cells. When breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body. Doctors use a HER2 test to measure this protein in your cancer cells. The results help your care team decide which treatment is best for you. Targeted therapy is one option — it uses drugs to attack specific cancer cells with less harm to normal cells. Talk with your care team about your HER2 result and what it means for your plan.

Question 4

What tests and scans will I need?

Accepted Answer

Your care team uses several tests to look at breast tissue and guide the next steps. A physical exam checks your breasts and armpits for lumps or anything unusual. Imaging tests—a mammogram (an X-ray of the breast), an ultrasound, or an MRI—let providers see inside the breast. A biopsy removes a small piece of tissue so it can be studied closely. Blood chemistry tests measure substances like proteins and enzymes in your blood. If cancer is found, a sentinel lymph node biopsy checks whether cancer has reached nearby lymph nodes. Some people also have genetic tests or hormone receptor tests on the cancer cells. Ask your care team which tests you need and why.

Question 5

What is triple-negative breast cancer—is it harder to treat?

Accepted Answer

After a breast cancer diagnosis, doctors test the cancer cells. One test checks HER2, a protein on the outside of breast cells. Too much HER2 can make cancer grow faster and spread more easily. Another test checks for estrogen and progesterone receptors in the cancer tissue. High levels of these receptors can also make cancer grow more quickly. These results help your care team choose the right treatment. Options include surgery, radiation, chemotherapy, and hormone therapy. Hormone therapy blocks cancer cells from getting the hormones they need to grow. Targeted therapy attacks specific cancer cells with less harm to normal cells. Immunotherapy is another option. Ask your care team what your results mean for you.

Question 6

Can I keep my breast, and will the cancer come back?

Accepted Answer

Whether you can keep your breast depends on your cancer. A lumpectomy removes the cancer and some normal tissue around it. It does not remove the breast itself. A mastectomy removes the whole breast. Your care team will run tests. The results help decide which treatment is best for you. Treatment may also include radiation, chemotherapy, hormone therapy, or immunotherapy. Healthy lifestyle habits may also play a role. Talk with your doctor about what each option means for your care.

Question 7

What do the different breast cancer stages mean?

Accepted Answer

Staging tells your care team how far your breast cancer has spread. This guides your treatment plan. To find the stage, your doctor orders imaging tests. Your doctor may also do a sentinel lymph node biopsy. This biopsy checks whether cancer has spread to the lymph nodes. There are two broad categories. "In situ" means the cancer has not spread beyond where it started. "Invasive" means it has spread outside the breast. Invasive cancer may reach nearby tissue and lymph nodes. Or the cancer may spread to other parts of the body — this is called metastasis. It moves through the blood or lymph system. Staging helps your doctor choose the right treatment. Ask your care team what your stage means for your care.

Question 8

What's the difference between a lumpectomy and a mastectomy?

Accepted Answer

The main difference is how much is removed. A lumpectomy removes the tumor and some normal tissue around it, but leaves the breast itself in place. A mastectomy removes the whole breast. There are different types of mastectomy. A total mastectomy removes all breast tissue and the nipple. A modified radical mastectomy also removes lymph nodes under the arm and often the lining over the chest muscles. Which surgery is used depends on the stage of the cancer, the size of the tumor, the size of the breast, and whether lymph nodes are involved. Talk with your care team about which option may be right for you.

10 questions to ask your care team about Breast cancer

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