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What to Ask Your Doctor About Breast Cancer

Written by Dee Holli — Updated on September 24, 2018

This is an excellent article with great questions to ask your oncologist after being diagnosed with breast cancer. Hearing “This is most likely breast cancer” were some of the worst words a doctor has ever said to me. My surgeon took one look at the ultrasound machine screen and uttered those words to my husband and me. I was numb and barely heard anything he said after that. I had questions, but my mind was reeling from what I was sure was true but had just had confirmed by a specialist. When I saw my surgeon a few days later for my first biopsy, I did ask him a few of these questions, and he answered what applied to his part of my treatment, and then the oncologist he referred me to answered the rest. Talk to your doctor; if you don’t like how they treat you, find another doctor, this is a long journey, and you must trust and respect the doctors working with you to save your life.

Not sure where to begin when it comes to asking your doctor about your breast cancer diagnosis? These 20 questions are a good place to start:

Now that I’ve been diagnosed with breast cancer, are there other imaging tests I will need?

Ask your oncologist whether you will need other imaging tests to determine whether or not the tumor has spread to lymph nodes or other parts of your body.

What type of breast cancer do I have, where is it located, and what does this mean for my outlook?

Ask your oncologist, based on your biopsy, what subtype of breast cancer you have, where it is located in the breast, and what that means for your treatment plan and your outlook after treatment.

How far has my tumor spread?

Understanding what stage of breast cancer you have is important. Ask your doctor to explain the stage to you and find out where else besides the breast any tumors are located.

According to the National Cancer InstituteTrusted Source, the stage of your breast cancer is based on the size of the tumor, whether the cancer has spread to any lymph nodes, and whether the cancer has spread to other areas in the body.

What is the tumor grade?

Particular characteristics of breast cancer cells affect how aggressive your tumor is. These include the amount of tumor cells that are reproducing, and how abnormal the tumor cells appear when examined under a microscope.

The higher the grade, the less the cancer cells resemble normal breast cells. The grade of your tumor can influence your outlook and treatment plan.

Is my cancer hormone receptor-positive or hormone receptor-negative?

Ask your doctor whether your cancer has receptors. These are molecules on the cell surface that bind to hormones in the body that can stimulate the tumor to grow.

Specifically ask whether your cancer is estrogen receptor-positive or receptor-negative, or progesterone receptor-positive or receptor-negative. The answer will determine whether or not you can use medicines that block the effect of hormones to treat your breast cancer.

If your biopsy didn’t include testing for hormone receptors, ask your doctor to have these tests performed on the biopsy specimen.

Do my cancer cells have other receptors on the surface that can affect my treatment?

Some breast cancer cells have receptors or molecules on the surface that can bind to other proteins in the body. These can stimulate the tumor to grow.

For example, the American Cancer Society (ACS) recommends that all patients with invasive breast cancer be tested to see if their tumor cells contain high levels of the HER2 protein receptor. This is important because there are additional treatment options for HER2-positive breast cancers.

Ask your oncologist if your cancer is HER2-positive. And if you haven’t been tested for HER2 protein receptors, ask your oncologist to order the test.

What symptoms of breast cancer might I experience?

Find out what symptoms of breast cancer you are likely to experience in the future, and what symptoms you should contact your doctor about.null

What are my treatment options for breast cancer?

Your treatment will depend on the following:

  • type of cancer
  • grade of cancer
  • hormone and HER2 receptor status
  • stage of cancer
  • your medical history and age

What types of surgical options are available for me?

You may be a candidate for surgical removal of the tumor (lumpectomy), surgical removal of the breast (mastectomy), and surgical removal of affected lymph nodes. Have your doctors explain the risks and benefits of each option.

If your doctors recommend a mastectomy, ask them whether surgical reconstruction of the breast is an option for you.

What types of medical therapy are available for me?

Ask your oncologist if any of the following therapies are available to you:

  • chemotherapy
  • radiation
  • hormone therapy
  • monoclonal antibody therapy

What types of chemotherapy are options for me?

If your doctor recommends chemotherapy, ask them which combination chemo regimens are being considered. Find out what the risks and benefits of chemotherapy are.

It’s also important to ask what the possible side effects of the combination chemo regimens are. For example, if losing your hair temporarily is a concern for you, ask your oncologist whether the medications recommended would cause hair loss or alopecia.

What types of hormone therapy are options for me?

If your oncologist recommends hormone therapy, ask which of these therapies is being considered. Find out what the risks and benefits of hormone therapy are and the possible side effects.

What types of monoclonal antibody therapy are options for me?

Monoclonal antibodies block binding of substances to receptors on the surface of the tumors. If your oncologist recommends therapy with monoclonal antibodies, ask your doctor what therapies are being considered.

Find out what the risks and benefits are and what the possible side effects of the monoclonal antibodies are.

What types of radiation therapy are options for me?

Find out what the risks and benefits of radiation are for your cancer, and what the possible side effects are.

Will I need to take off time from work for any of the therapies. And when would I be able to go back to work?

Ask your oncologist if the side effects of your treatment will require you to take time off from work during or after treatment. And let your employer know in advance what your healthcare team recommends.

What is my outlook after treatment?

Your outlook after treatment depends on the following:

  • your medical history
  • your age
  • type of tumor
  • grade of tumor
  • location of tumor
  • stage of the cancer

The earlier your stage of breast cancer is at the time of diagnosis and treatment, the greater the likelihood that the therapy will be successful.

Are there any clinical trials for treatments that I can participate in?

If you have an advanced stage of breast cancer, you may want to think about clinical trials. Your oncologists may be able to point you in the right direction, or you can take a look at http://www.clinicaltrials.gov/ for more information.

Why did I get breast cancer?

This question may be impossible to answer, but it never hurts to ask. There may be risk factors like family history or lifestyle practices such as smoking cigarettes. Obesity can also increase the risk of getting breast cancer.

What things can I do at home to improve my outlook after treatment and improve my quality of life?

Ask your oncologist if there are lifestyle changes you can make. Recommended changes may include:

  • making changes to your diet
  • lowering stress
  • exercising
  • stopping smoking
  • reducing alcohol intake

These things will help speed your recovery from treatment and increase your chances of a better outcome.

What resources for support are available to me?

Getting help and support is important during this time. Think about attending local support groups for things like financial issues and getting practical support like finding transportation if needed. You’ll also be able to get emotional support from advocacy groups like the American Cancer Society.

If you have any questions for me, please do not hesitate to reach out to me. I will answer as honestly as I can regarding what I have experienced, and if I can’t answer, I will try to point you in the right direction.

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Radiation Treatments 1 & 2

First, I want to let you know that I do not have any pain in the area where I have my radiation treatments. A lot of people assume that I have pain during and or after treatment and I do not. I do not have any burns or irritated skin either. According to my radiation oncologist I should not experience any of the above.

I received my schedule on Thursday when I went in for my first treatment and the final part of the SIMs appointment. My doctor had told me 10 to 14 treatments, so I was happy that she decided on 10. So my first treatment was a few days ago on Thursday, and my last treatment will be on April 26th. I go in every weekday, Monday through Friday, with weekends off.

Thursday was rough. It was a longer appointment because they had to x-ray me and finish plotting for the coordinates to set the machine for my treatments. I had to have both arms up over my head for that whole process which was almost an hour. By the time they were done, I was crying because the pain was so bad in my left arm. It felt like my arm was being ripped out of the socket. I tried so hard not to cry, but the pain was unbearable. I was so embarrassed, and I apologized to the techs; they were very kind and stayed with me and rubbed my back to try to get me to calm down. I don’t remember it hurting that much when I went through the same process in 2019, so I was shocked that the pain was that bad. Luckily the pain didn’t last long and went away about an hour after I got home.

On Friday, my arm hurt again because it went through so much on Thursday. It seems like they are taking longer to get everything set up once I am on the table. They are not only setting the machine for my coordinates, but they are also moving me around so the markers on my body line up as well. Luckily with all of the plotting out of the way, I only have my treatment when I go in now, nothing extra from here on out except a visit with my doctor each Monday.

I’m sure when I return on Monday for treatment #3, I won’t have any more issues with pain. I will try to keep my movement as limited as I can in my left arm over the weekend. The excessive pain I am experiencing is only in my left arm and that is because I had 18 lymph nodes removed from under my left arm during my cancer removal surgery in April 2019. I realize that it has been four years since that surgery but when there are that many lymph nodes removed there are multiple nerves that are cut and disconnected, so at least in my case, I have never regained full mobility and I am still numb in the upper part of my arm over to half of my breast. I have learned to live with the numbness over the years. I can feel pressure but that is all, so it took awhile for me to be able to find the right pressure to shave under my arm and not cut myself. In my opinion it is a small price to pay for my surgeon saving my life and me being alive today.

As always, thank you for being here and supporting me. 💕

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Radiation Oncologist Appointments

Last Wednesday, April 5th, I had an appointment with my Radiation Oncologist. The office I go to had just been purchased by the hospital where my Medical Oncologist and Surgeon have their offices. Because of the purchase, I had to wait a bit and fill out all new paperwork, eight pages, before I could see my doctor. My husband could not go with me because his office forgot that someone was going on vacation, and they needed him to train a new employee and cover for the person who was out. I was OK with this only because I was meeting with the same doctor I had in 2019 for radiation, so I was comfortable going alone.

Once my paperwork was done, I had a relatively long wait until the PA came to get me to weigh me and take me to an exam room. She then took my blood pressure, temperature, and heart rate. She reviewed a few details from my paperwork, chatted with me briefly, and then the nurse came in to see me. The nurse took a look at my paperwork and then asked me about my surgeries and previous treatments of both chemo and radiation and let me know that my doctor would be in soon.

My doctor knocked on the door and then opened it a little and looked at me with a sad face, and I responded with my sad face and told her that I was happy to see her but not for the reason why. She came into the exam room and hugged me. We sat down, and she asked me what had been going on since the last time I saw her, which was after I had the biopsy of the tumors in my neck done by my surgeon, and the results came back positive for caner. I explained that when I had my PET Scan in March 2022, they found a tumor on my 8th rib on the left side of my back. We talked about the PET Scans I had in July and November 2022 and the most recent one two weeks before my appointment with her.

I asked her how many treatments I would have, and she said 10 to 14. I wondered if I would need to use the medicated lotion I had the last time I had radiation, and she said no. I was relieved because I couldn’t reach where the tumor was located to apply cream due to the limited mobility in my left arm. She said that I would not have any burns this time and I should not have any pain at the treatment site. She told me that she recently had a patient with a tumor very close to the exact location as mine, and the only issue she had was in the last two days of treatment when she was eating, she could feel her food moving through her esophagus. The location of my tumor and the esophagus are very close together, which I wasn’t aware of. I asked her what I could expect my results once my treatment was over. She said that the radiation would kill all cancer cells and that there should be no trace of my tumor left.

I will most likely not know my results from the radiation treatment until my next PET scan, which is in July. Due to having had a PET scan a few weeks ago and then have 10 to 14 treatments by the end of April, it would be too much radiation exposure to have a PET scan any sooner than my regular 4-month scan.

At the end of my appointment, she said that I would have to come back on another day for my SIMs appointment. The soonest appointment she had was the next day at 8:00 am, so I told her I would come back then. I chose that appointment because the next one available would have been yesterday, April 10th, which would have delayed my starting treatment by another week. So, if all goes well, I should start treatment this Thursday, April 13th. I do not have my start date confirmed yet as I am waiting on the office to call me and schedule my first treatment appointment. Once I go in for the first treatment, I will have my other appointments scheduled, and they will all be at the same time every day, Monday through Friday.

The reason why it takes so long to schedule my first treatment is that my doctor needs time to look at the CT that was done at her office, the PET scan images, and the report from a few weeks ago, as well as any notes from my medical oncologist. Once she has reviewed everything, she will determine the exact amount of treatments I will need and what my doses of radiation will be. If I remember correctly, the treatments start at a specific dosage at the beginning and increase as I go through each treatment.

So the following day, I had my SIMs appointment, and that is where they did a CT and marked the exact location for the radiation treatments. After the CT, they placed me in the same position I needed to be on the table so they would know where to line up the radiation machine to my body. Due to mobility issues with my left arm, they had to inflate a pillow made from thick paper to put behind it so I had the support I needed to put my arm back to the handles at the top of the table. For comparison, in 2019, when I had radiation, I had to have support then as well, but substantially more because my mobility was much worse than it is now. Once I was positioned correctly, they marked three locations on my body with clear stickers with x’s. I specifically asked that they not tattoo me as they did last time because that was a nightmare for me, and I had to have laser treatments to get rid of the tattoos after my treatment was over.

Sorry this post was so long, but I wanted to combine both appointments in one post vs. doing two. I will update you when I know when my appointments will be, how many treatments I will have, and when my last treatment will be when I once again get to ring the bell!

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Difficult News

I was going to write this blog post earlier in the week, but I have been overwhelmed with so many thoughts and emotions since I met with my oncologist on Monday, March 27th.

On March 21st, I had my most recent PET Scan. Everything went fine with the scan, as usual. I sat next to a sweet 80-year-old lady in the waiting room. She started to chat with me because she was complaining about the wait, and I told her that the wait could be long sometimes; it depends on what type of imaging you are there for and how many appointments there are. She asked me why I knew that, and I explained that I come in every four months for a PET scan since I am a stage 4 cancer patient. She asked me a few more questions and then handed me the book she was reading and told me to keep it. The book is by Zig Ziglar, Embrace the Struggle, Living Life on Life’s Terms. I haven’t started reading it yet, but I will soon.

This past Monday, I went to see my oncologist for my regular 30-day appointment and to get my PET scan results. My blood looks pretty good for me anyway, and I was happy to see that my ANC was 1.4, which is excellent considering that the low number in the acceptable range is 1.5, so that is the highest my ANC has been in months! So we were very happy with my blood panels.

Then we moved on to my PET Scan results. Unfortunately, my tumor has grown. It is roughly 1/3 of an inch larger, which is a slight increase but nonetheless an increase. My oncologist immediately said that I would need radiation treatments to stop the growth of my tumor and hopefully kill it. Luckily I will be going back to see the same radiation oncologist I saw in 2019 for my treatments which is great because I trust her and adore her. I will likely have three weeks’ worth of treatments or 15 sessions. I don’t know all of the details yet, but I will find out when I have my consultation and plotting appointments next Wednesday, April 5th. Matt will be going with me to my appointments next Wednesday, so it will be nice to have him with me because I will be there for half the day.

Understandably, I am overwhelmed with my thoughts and emotions. I am wondering what is next after radiation. My oncologist made it sound like I may not be taking iBrance while I am going through radiation, so that I will ask about that on Wednesday. He also said that he wants to keep me on iBrance for years, but if it proves ineffective, I may have to go through chemo infusions again, and he has told me it will be much tougher this time vs. 2019. So I plan on getting some of my questions answered because, by the time I go in for my appointment next Wednesday, my oncologists will have discussed what is going on with me and the next steps.

I wish I had better news to share but cancer is tricky and you never know what it will do, especially when it is as aggressive as mine has been.

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Ultrasound-Guided Biopsy: **WARNING: SENSITIVE MATERIAL**

So here we are again, another biopsy, just shy of a few weeks from three years ago when my surgeon did my first biopsy and diagnosed me with breast cancer.

This time I was only in pain when my surgeon gave me the shot of lidocaine. He kept asking me if I was OK because the needle was in for a little bit as he moved it around at different angles to numb the area around the mass. I was facing away from him so he couldn’t see my face for a reaction, so I appreciated him asking me how I was doing multiple times, as it was just another example of what a kind and caring doctor he is.

I had to lay on my right side so he could easily get to the mass because it was at an odd angle on my neck. Since I was lying on my side, I was able to watch the ultrasound monitor and see him put each needle in the mass, collect a sample, then pull the needle back out. As he put each sample into a small container with a tiny amount of saline, his assistant closed each container; there were three in total. He said that the mass is about 1 centimeter, so I hopefully caught it early enough.

All in all, everything went fine. I should have the results back at the latest on Tuesday. I couldn’t help but notice that my surgeon told me that he was taking the samples over to the lab personally, right away. Yes, that did concern me a little, his urgency, and that only made my gut feeling about all of this feel more valid. He also told me that he spoke with my oncologist and that if my results are positive, my oncologist will order the PET scan asap.

Minor bruising today, along with a small hematoma. I am very, very sore, but you would be too if you had four needles poked in you!

My gut feeling is based on these events, are they coincidences? This mass is very much like the first one three years ago in many ways. It feels the same and looks the same on the ultrasound, and there is something else, each time I have had pain in another part of my body before finding a mass. I first had pain in my neck, shoulder, and shoulder blade a few weeks before finding my tumor. I thought I had slept funny, but as the days went by, the pain did not go away. This time, around Thanksgiving, I had terrible pain on the outside of my ear, going up the side of my head to the top of my head. As I said in a previous post, my oncologist ordered an MRI of my head, but it was clear, so we had no explanation for my pain. I was in agony until about two weeks ago when the pain suddenly stopped, and I now have found another mass.

I will update as soon as I have the results…prayers! 💕

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Appointment With My Oncologist

When I had my appointment with my oncologist on August 5th, I was hoping that my red blood cell count would finally be in the normal range, but it isn’t quite there yet. I wasn’t too surprised as I have been tired lately and not feeling the greatest. At this point, nothing but time will help, so I am trying to be patient.

I am still having a lot of issues with my memory. It seems like only my short-term memory is being affected, but it is starting to drive me crazy. My oncologist asked me if I am still “fuzzy,” and I said that yes, I am still having issues. So, I am taking a week off Anastrozole to see if it helps clear my head or not.

Once I have my next appointment in December, I will finally be on a different schedule with my oncologist. I will switch from seeing him every three or four months to every six months. I am making progress, and it feels good!

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