Beating Breast Cancer
Your Treatment Plan
After you've chosen a medical team and treatment plan, you will most likely have scheduled your surgical procedure by the end of the first month. While experts stress that getting on the operating table as fast as you can is neither necessary nor recommended, most oncologists agree that six weeks is about the longest you should wait. The sooner you get your plan in place, the less anxious you will feel.
During your procedure--either a lumpectomy (also known as breast conservation) or mastectomy--doctors will also perform what's called a sentinel node biopsy, to see if the cancer has spread to your lymph nodes, a part of your immune system that traps cancer cells and bacteria.
Once your operation is over, doctors will perform more tests on the tissue that was removed to learn even more about your cancer. There are almost as many types of breast cancer as there are patients, so comparing your case to someone else's may not be as helpful as you'd think. Doctors have to consider the size and location of the tumor, the stage of the disease, the tumor's grade, hormone receptor status, HER2/neu status, and whether or not the cancer has spread to your lymph nodes or other parts of the body. The pathology reports come back in bits and pieces, which will mean a lot of anxious waiting for you. Always request copies of every report, and make sure your hospital has performed each of these tests. According to Weiss, labs usually hang on to the tissue for awhile, so even if a particular test wasn't done, you can still ask for it.
From those tests, your medical team will be able to determine if another surgery is required, and whether you will proceed with chemotherapy or hormone therapy and radiation. Radiation, which is now considered standard treatment to prevent cancer from returning, comes later for those being treated with chemo.
Treatment, from start to finish, will generally last about six to nine months. Most women will continue to work during that time. "Her main time off is to keep all of her appointments, in order to get all of her opinions during those first few weeks," says surgical oncologist Peter Pressman, MD, FACS, author of Breast Cancer: The Complete Guide. "That takes more time than anything else. People are motivated to continue their lives, and they do."
"It's a chaotic time in those first 30 days," agrees Weiss. "Women have no clue what to do, and they are scrambling for comfort and knowledge and confidence. They are totally disoriented."
But the good news is, it will end. This period of uncertainty and chaos will feel a lot better once you have a plan in place. So give yourself those 30 days to make your treatment decision, and to put a plan in place, so you're starting to implement it. And if you're feeling overwhelmed by the amount of information out there, remember that your plan can always be changed later on. "You're never stuck," says Weiss.