Breast Cancer Diagnosis, Treatment, and Support

Breast Cancer Diagnosis treatment and Support
This page was originally published August 1, 2017 and updated December 30, 2023.

Breast cancer has touched so many lives directly or indirectly. Whether you are a patient, caregiver or loved one, we want you to know help is available. From financial resources to transportation and housing, national nonprofits stand ready to assist you during this very challenging time. And while learning about breast cancer diagnosis and treatment might be daunting, gaining knowledge about it is the first step towards empowerment. This article provides you with essential information about breast cancer, its diagnosis, treatment options, and some of the many, many support systems across the USA that exist to help navigate these challenging waters. We believe knowledge is power and understanding is the first step towards control. Please reach out of you need help locating services. ❤️

Diagnostics

While most breast cancers are first detected by either a screening mammogram or a physical exam of the breasts, there are a number of other diagnostic tests and procedures that may be used to confirm the presence of cancer and to determine if it has spread. This can be a confusing and overwhelming time, but understanding the different types of diagnostic tests and what they entail can help make the process a little less daunting. Here’s an overview of some of the most common diagnostic tests used to diagnose breast cancer. The National Cancer Institute’s patient guide is a good resource for more on this topic.

Biopsy

A biopsy is typically the next step after an abnormal mammogram or physical exam. During a biopsy, a small sample of cells is removed from the breast so that it can be examined under a microscope for signs of cancer. If cancer is present, the biopsy can also provide information about the type of breast cancer and how aggressive it is.

There are several different types of biopsies that can be performed, including fine needle aspiration (FNA), core needle biopsy, and surgical biopsy. Your doctor will recommend the type of biopsy that is best for you based on a number of factors, including the size and location of the suspicious area.

Fine Needle Aspiration is the simplest form of biopsy and usually the quickest. A thin needle is inserted into the breast to extract a sample of cells. The extracted sample is then examined under a microscope to check for the presence of cancer cells.

In a core needle biopsy, a larger needle is used to extract a ‘core’ sample of breast tissue. This type of biopsy can provide a more comprehensive understanding of the nature and extent of the cancer. Core needle biopsies are often conducted using local anesthesia and ultrasound guidance to ensure precision.

A surgical biopsy, also known as an excisional biopsy, involves removing the entire lump or suspicious area during surgery. This is the most invasive type of biopsy and is typically performed when the smaller needles can’t access the suspicious area or when earlier tests were inconclusive. A surgical biopsy can provide the most comprehensive information, but recovery can take longer than with less invasive biopsy methods.

After a biopsy, the extracted samples are sent to a lab where a pathologist will analyze them. The pathologist looks for cancer cells and identifies specifics about the cancer, such as the type, grade (aggressiveness), and whether the cancer cells have hormone receptors or other characteristics that could impact treatment options. The results of your biopsy will help form the basis of your treatment plan.

Imaging Tests

Imaging tests such as ultrasounds, MRIs, and PET scans may also be used to diagnose breast cancer. These tests can be used to help determine if a mass is solid or filled with fluid, which can help distinguish between benign and malignant tumors. They may also be used to check if cancer has spread to other parts of the body.

An ultrasound uses sound waves to create an image of the inside of the breast. They are often used in conjunction with mammography, especially in women with dense breast tissue, where it can provide a more detailed picture of the breast or to guide a needle during a biopsy procedure.

An MRI is a type of imaging test that uses magnetic fields and radio waves to produce detailed images of the inside of the breast. It can be particularly useful in certain situations, such as diagnosing invasive cancer in women with dense breast tissue, evaluating the extent of cancer, or screening women at high risk for breast cancer.

PET scans are a type of imaging test that uses a small amount of radioactive material to detect cancer cells in the body. They are often used to check for the spread of cancer to other parts of the body, such as the bones or lymph nodes. It’s worth noting that PET scans are not typically used as a first-line diagnostic tool for breast cancer, but they can provide valuable information in certain circumstances.

Each of these imaging tests has its advantages and limitations, and your doctor will recommend the most suitable options based on your specific circumstances. It’s important to ask your doctor about the benefits and risks of each test, so you can make an informed decision about your care.

Laboratory Tests

Blood tests are not typically used to diagnose breast cancer, but they may be ordered at some point during your treatment to check things like hormone levels or your liver function. Your doctor may also order what’s called a tumor markers test, which measures certain substances in your blood that may indicate the presence of cancer. However, tumor marker tests are not definitive and should not be used on their own to diagnose cancer.

Genomic Tests

In some cases, doctors may also use genomic tests to gather more information about the cancer’s characteristics. These tests analyze the activity of certain genes in the cancer cells, which can provide additional information about prognosis and help guide treatment decisions. Two such tests are Oncotype DX and MammaPrint. These tests are especially helpful for determining which patients with certain types of early-stage, hormone receptor-positive breast cancer are likely to benefit from chemotherapy.

HER2 Tests

HER2 is a protein that promotes the growth of cancer cells. In about one of every five breast cancers, the cancer cells make an excess of HER2 due to a mutation in the HER2 gene. HER2-positive breast cancers tend to be more aggressive than other types of breast cancer. Tests to measure HER2 are very important because HER2 positive cancers can be treated with drugs that specifically target this protein.

Hormone Receptor Status

Hormone receptor status is a key piece of information that can guide treatment options. Certain types of breast cancer are fueled by the presence of hormones like estrogen and progesterone. If lab tests show that the cancer is “hormone receptor-positive,” that means hormones help the cancer grow. These cancers can often be treated with hormone therapy. If the cancer is “hormone receptor-negative,” however, hormone therapy is unlikely to work, and different treatment options will be considered.

All these tests together provide a more comprehensive picture of the nature of the breast cancer, which is crucial in developing the most effective treatment plan. The types of testing recommended for you will depend on your individual situation. More information on diagnostics can be found here on the NCI website. If you have any questions about any of the diagnostic tests you’ve been asked to undergo, don’t hesitate to ask your doctor for more information. It is important to work together to get the care you need.

Treatment

Your specific treatment plan will vary depending on the stage and type of breast cancer you have, as well as your overall health and your own personal treatment goals. According to current National Comprehensive Cancer Network (NCCN) guidelines, the most common treatments for breast cancer are surgery, radiation therapy, chemotherapy, and hormone therapy.

Surgery

Surgery is usually the first line of treatment for breast cancer. The type of surgery depends on the stage of the cancer and other factors. For early-stage cancers, a lumpectomy (removal of the tumor) may be recommended. For more advanced cancers, a mastectomy (removal of the entire breast) may be necessary.

A lumpectomy, also known as breast-conserving surgery, involves removing the tumor and a small margin of healthy tissue around it. This procedure aims to conserve as much of the breast as possible while ensuring the removal of all cancerous cells. Following a lumpectomy, radiation therapy is usually administered to kill off any remaining cancer cells and reduce the chance of recurrence.

A mastectomy, on the other hand, involves the removal of the entire breast. There are several types of mastectomy procedures, including a simple or total mastectomy (removal of the entire breast tissue), a double mastectomy (removal of both breasts), and a radical mastectomy (removal of the entire breast, lymph nodes, and chest muscle). The type of mastectomy chosen depends on the size, type, and stage of the cancer, as well as personal circumstances and preferences.

For many women, the removal of a breast can have significant psychological impacts, affecting their sense of femininity and self-esteem. As a result, some women choose to undergo reconstructive surgery post-mastectomy. This can be done immediately after the mastectomy or at a later date. The process involves using a woman’s own tissue or synthetic implants to rebuild the breast.

In addition to breast surgery, lymph node surgery may be performed to determine if cancer has spread beyond the breast. This can include a sentinel lymph node biopsy (removal of a few key lymph nodes) or an axillary lymph node dissection (removal of many lymph nodes).

The decision to undergo any surgical procedure should be made in conjunction with your healthcare team, and considerations should include the stage and type of cancer, your overall health, and personal preferences.

Radiation

Radiation therapy is typically used after surgery to lower the risk of the cancer coming back. Radiation therapy can be given externally (from a machine outside the body) or internally (from radioactive material placed in or near the tumor).

External Beam Radiation Therapy (EBRT) is the most common form of radiation treatment used for breast cancer. The patient lies on a table while a machine moves around the body, directing high-energy rays at the breast. This form of treatment typically takes a few minutes, and is usually given five days a week for a specified number of weeks.

Internal radiation, or brachytherapy, is another type of radiation therapy used to treat breast cancer. During this procedure, a radioactive source is placed inside the body near the cancer cells. This can be done using a thin tube (catheter) or a device that is temporarily placed in the breast. The radiation damages the DNA of the cancer cells, which helps to stop them from dividing and growing.

Chemotherapy

Chemotherapy can be used to shrink tumors before surgery, after surgery to lower the risk of the cancer coming back, or as a standalone treatment for advanced cancers. It is typically given intravenously (through an IV), but can also be given in pill form.

The goal of chemotherapy can be curative, aiming to completely eliminate the cancer, or palliative, aiming to relieve symptoms and improve the quality of life in advanced stages of the disease. Chemotherapy can be administered in various ways, including intravenously (IV), orally (pills), or via injection.

There are several different types of chemotherapy drugs used to treat breast cancer, and they’re often used in combination for increased effectiveness. Some of these include Anthracyclines (like Doxorubicin), Taxanes (such as Paclitaxel and Docetaxel), and Alkylating agents (like Cyclophosphamide). The choice of chemotherapy drug or combination of drugs depends on the type and stage of the breast cancer, previous treatments (if any), and the overall health of the patient.

Each person’s experience with chemotherapy can be different, and it’s essential to maintain open communication with your healthcare team throughout treatment. They can provide valuable insights, help manage side effects, and adjust your treatment plan as necessary.

Hormone Therapy

Hormonal therapy is a type of cancer treatment that works by either reducing the amount of hormones in the body or by blocking their action. It is typically used to treat hormone-receptor-positive breast cancers that are either estrogen-receptor-positive or progesterone-receptor-positive.

Hormone therapy is a critical component of treatment for hormone-receptor-positive breast cancers. This form of therapy is designed to either lower the levels of estrogen and progesterone in the body or block their action, thereby inhibiting the growth and multiplication of cancer cells. Hormone therapy is usually used after surgery but can sometimes be used beforehand to shrink the tumor, making it easier to remove.

There are several types of hormone therapies used in the treatment of breast cancer. These include Selective Estrogen Receptor Modulators (SERMs) like Tamoxifen, which blocks the effects of estrogen on breast cancer cells, and Aromatase Inhibitors (AIs) such as Anastrozole, Letrozole, and Exemestane, which lower the amount of estrogen in the body.

Another form of hormone therapy includes the use of Estrogen-Receptor Downregulators (ERDs), such as Fulvestrant, which work by blocking and damaging estrogen receptors. For premenopausal women, treatments like Ovarian Suppression drugs or surgery to remove the ovaries are also considered.

The decision to use hormone therapy and the type of therapy selected depends on several factors, including the type and stage of the cancer, the patient’s age and menopausal status, and other health conditions. It’s crucial to have a comprehensive discussion with your healthcare team to understand the potential benefits and risks, and to make an informed decision about your treatment strategy.

Your specific treatment plan will depend on many factors, including the stage and type of breast cancer you have. Be sure to talk to your doctor about all your treatment options and review the current NCCN guidelines so that you can make informed decisions about your care.

Free National Support Programs

A cancer diagnosis is never easy to hear. It can be a shock to the system that turns your whole world upside down. If you or someone you know has recently been diagnosed with breast cancer, it is important to know that there are free nationwide resources available to help with both the financial and emotional challenges that come with the disease. Here are just a few of the zero-cost national programs available to breast cancer patients in the USA. Our complete directory just for breast cancer patients is available here. ❤️

Financial Support Programs for Breast Cancer Patients

The Donna M. Foundation is a national nonprofit serving breast cancer patients throughout the USA. Grants are available for housing expenses, transportation expenses, medical co-pays, groceries, and more. Eligibility is based on financial need and medical proof of diagnosis will be required. To apply for this free grant program, please complete the online form here.

The Angela Andrade Foundation is a national nonprofit organization that awards monetary grants of up to $1800 to metastatic breast cancer patients who are permanent residents of the USA. Awards are offered four times per year and are provided based on financial need and funding. To apply, please download and complete the request form on the website here.

The UBCF Grant Program is open to women and men in the USA in active breast cancer treatment or in remission up to 5 years. This program includes gift cards and other financial support programs uniquely developed for each recipient’s needs. Documentation of diagnosis and treatment status is required. To apply, please complete the online form on the United Breast Cancer Foundation website here.

❤️ Click this link for a directory of financial programs just for breast cancer patients in the USA.

Emotional Support for Breast Cancer Patients

The ABCD Free Peer Support Program provides free one-to-one peer mentoring and support for anyone in the USA affected by breast cancer – including patients, families, and friends. Free one-to-one support from a volunteer who is matched based on similar circumstances and understands the journey. The services are free, confidential, and available 24/7. Enroll online using this form.

The American Cancer Society coordinates the Reach to Recovery program which provides free support via phone or in-person services for anyone in the USA dealing with a possible breast cancer diagnosis, recurrence, or advanced-stage breast cancer. To locate a volunteer in your area, call toll-free (800) 227-2345 or visit this link to connect online.

The TNBC Helpline provides free professional support services to patients and families in the USA coping with a diagnosis of triple negative breast cancer.  The staff includes oncology social workers with specific knowledge of triple negative breast cancer and are experts in guiding patients and families to resources that match each person’s individual needs including financial, emotional, and education support services. For more on this free pro support helpline, please visit this link or call (877) 880-8622 (10AM-6PM M-Th ET) to get immediate assistance over the phone.

❤️ Additional professional and peer support for breast cancer patients available at zero cost here.

Free Wigs for Breast Cancer Patients

Sharsheret Best Face Forward 2.0 provides a free national wig program for breast and ovarian cancer patients in the USA. Eligibility is based on financial need. Proof of household income under 600% of the Federal Poverty Level and verification of a diagnosis are required. To apply for this free wig program, please complete the form here.

The Pink Wig Project provides a fun and sassy pink wig at no cost to cancer patients in the USA who are in active treatment. If you currently receiving cancer treatment and are looking for a pretty, feminine, and bold new look, visit the website to learn more about this wonderful program. To request your free wig, please complete the online form here.

Pink Heart Funds is a nonprofit organization that provides free human hair wigs for any woman in the USA who is experiencing hair loss from chemotherapy or radiation. If you have cancer treatment-related hair loss, please visit this link to choose your style and order your free wig online.

❤️ Additional no-cost wigs, hats and wraps can be found here in our national directory.

More Help for Breast Cancer Patients

A cancer diagnosis brings so many challenges, but it’s important to know that there are resources available to help you through it – both financially and emotionally. Organizations like the ones above can help. These generous nonprofit groups provide financial help and offer a safe space for you to share experiences, vent your frustrations, and give and receive support during and after diagnosis. No one should have to go through this journey alone – there is help available. Reach out today for the assistance you and your family deserve. Please visit our national directory for many more free programs, products and services just for breast cancer patients in the USA. ❤️

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