What questions to ask your physician can be perplexing and frustrating. “What questions can I ask when I don’t even know what’s happening to me?” Breast cancer does not develop overnight. It takes approximately seven years or more for most cancer to become detectable; therefore, you have some time to gather information after diagnosis.
The best place to start is to obtain copies of your own reports and ask your doctors to explain the “abnormal” statements. Write your questions down. Keep phone numbers, names of health care providers, including physicians and their specialties, and insurance information handy to save time and to keep you organized. You will be meeting many people. Learn who can help with what, especially if you have an HMO and need approval from your primary care providers.
Often, in this time of crisis, you become your own advocate. Some women decide to manage their own health care by coordinating several facilities--picking and choosing their breast specialist team from different facilities. Others prefer to have a team of specialists under one umbrella with the Breast Center managing their care. In any case, you should feel part of the team. You should feel comfortable asking questions and offering information important to your life style, emotional well-being and philosophies. Keep in mind your health care providers are interested in these matters as well, but their primary concern is your breast health and keeping you disease free.
Becoming a breast cancer expert in a short period of time can be overwhelming. You will be expected to make decisions and choices that you may not feel comfortable making. Do not be frustrated if there are numerous options and opinions. Additional anxiety may be caused by your misinterpretation of the facts, your imagining a worse situation, or your reading media information that may not pertain to you. Journal your impressions and feelings. Then express your feelings and ask for guidance. Ask family and friends to support you. Think of the future. Do not impulsively react to the moment. Gather your information, consult your surgeon and then make your decisions based on appropriate facts--not emotional responses.
Remember, you are an individual, not a statistic. You have needs special to you. Communicate! Your physician cannot read your mind. If you are not satisfied get a second opinion. -- Nancy G. Toth, R.N., B.S.N. |
Mammography | Biopsy | After Diagnosis | Anesthesiologist |
General Questions | Radiation | Breast Reconstruction | Partner's Questions
The following questions are categorized to follow you through an abnormal mammogram, diagnosis of breast cancer, treatment and follow-up care. You will probably have specific questions relating to your own life style and individual circumstances. The important issue is to ask your questions before you make decisions. You have the time, and you owe it to yourself and your family to get the most comprehensive care possible.
- Is the mammography facility certified, and what does that mean?
- What is the difference between screening and diagnostic mammography?
- Why is my mammogram abnormal?
- What are calcifications and what do they signify?
- What are the assessment categories and what do they mean? (See glossary under Mammography.)
- What is the level of suspicion for breast cancer? (The levels are categorized one through five. Five is the most suspicious.)
- Where in the breast is the abnormal finding?
- Where can I get a second opinion?
- Do I need a biopsy?
- Should I see a breast surgeon?
- When should I get my next mammogram?
- What type of biopsy should I get? Explain the differences, benefits and concerns. (See glossary for types of biopsies.)
- How much tissue will be removed?
- Who will do the surgery and how long will it take?
- Can I have local anesthesia or do I need to be put to sleep with general anesthesia?
- What are the recovery time and possible complications?
- How long before I get the results from the biopsy and who will call me?
- Will I need pain medication and what do you give?
- Will I need time off from work?
- Will I have physical limitations after the biopsy?
- Where will the biopsy scar be and what will I look like afterwards?
- Should I get an appointment with a multidisciplinary team of specialists?
- Will the sensation around my nipple change?
- What type of breast cancer do I have?
- What is the size, grade, and aggressiveness of the tumor?
- What are my options for treatment?
- How much time do I have to make a decision?
- Do you have pictures, literature, and women I can talk to regarding options?
- What do the surgical procedures look like?
- Where can I get a second opinion? How do I get my records, films, slides, etc., for that second opinion?
- What are hormone receptors or oncogenes? Were tests for these done? What do they signify?
- Will I need other tests such as a bone scan, a CT scan of the chest and liver, a chest x-ray, or blood work?
- If I choose a mastectomy can I have immediate breast reconstruction or would it be better to have it at a later time?
- What is the risk of lymphedema in my arm? What can be done for this condition?
- What can be done to prevent lymphedema?
- Why do some women have fatty lumps around their armpits after mastectomy?
- Am I a candidate for lumpectomy? Will I need radiation therapy?
- Do I need to have my lymph nodes removed? How many are removed?
- What is sentinel lymph node mapping? Am I a candidate for this procedure?
- What will I look like after the lumpectomy or mastectomy? Where will the scars be located?
- What should I do to prepare for surgery? How long will I be off work?
- What are the restrictions after surgery?
- Will I need physical therapy for my arm? When can I exercise?
- Will I need visiting nurses to help me with my dressings or drains?
- Will I have drains when I go home and how do I empty them? How long do they remain?
- Will I have pain? How much pain should I expect? What can I take to relieve it?
- What should I take with me to the hospital?
- Can my family visit me?
- How often will I have appointments with the surgeon?
- Will I have something to relax me the night before surgery?
- What are the side effects of anesthesia?
- Will I have a tube in my throat?
- Can I have IV sedation rather than general anesthesia?
- What should I tell my children, my family, or my partner?
- Will I be able to have more children?
- Can I take vitamins, herbs, or something to make me relax and sleep?
- When will I be able to resume my sexual activity?
- Will my chest feel different, be painful, feel funny?
- Do you have a list of places where I can be fitted for a prosthesis?
- Do you suggest complementary therapies such as Tai Chi, meditation, or acupuncture?
- Do you have a list of support groups, resource centers, or educational groups?
- What are clinical trials, and am I a candidate?
- When, where, and by whom will my follow-up care be done?
- What is the reason for radiation therapy?
- What are the side effects of treatment?
- Will my skin change? Will it be burned?
- Can I miss a radiation treatment?
- How many treatments do I need and who will give them to me?
- Will I be sick from the radiation and unable to work?
- How will I be marked? Will the marks come off in the shower or while swimming?
- Can I exercise, sunbathe, or wear tight-fitting clothes?
- Can I have children after treatment?
- If I had radiation before, can I have it again?
- Will I be in pain, and if so what can I take to relieve it?
- Can I use sunscreens?
- Will the size of my breast change from the radiation?
- Will the nipple change from the radiation and will it be more sensitive to touch?
- What are the types of surgery and what would be best for me?
- What are the complications with a saline implant; TRAM-flap or Free flap (both abdominal tissue); luteus flap (muscle from back); gluteus flap (buttock tissue); and any other options?
- Can I have breast reconstruction immediately or should it be delayed?
- How many breast reconstructions of this type have you performed?
- How long will surgery take and what is the recovery time?
- Will my insurance pay for breast reconstruction, nipple reconstruction and an areola tattoo?
- Will I have pain and what can I take for it?
- Can I see pictures of the different surgeries and talk with women who had them?
- What will the scars look like?
- How is nipple/areola reconstruction done?
- Can cancer be detected after I have breast reconstruction?
- Do I still need to get a mammogram for my remaining natural breast?
- Is there an effective breast exam for a reconstructed breast?
- What will be my physical limitations after reconstruction?
- Can I carry a baby to term after TRAM-flap or Free flap surgery?
- Can I expect to have my belly button repositioned in its natural location?
- What are the side effects of radiation on my reconstructed breast?
- Will I have feeling in the reconstructed breast and in the area where tissue was removed for breast reconstruction?
- Will the breast surgeon and the reconstructive surgeon work together even if I decide to delay reconstruction?
- What is the risk of developing a hernia after TRAM-flap surgery?
- If I choose or require bilateral mastectomies, what are my options?
- What are the caregiving issues postoperatively at home?
- Can I stay with her in the hospital, overnight, if necessary?
- Are there physically sensitive areas after surgery to be concerned about?
- Will the surgery have an impact on my partner’s enjoyment of sex?
- Will she be off work and have specific limitations after surgery? How long?
- How do I help my partner with her emotional needs? What do I say?
- What can I do for her to make her feel better and to let her know I care? (See section on Sexuality and Breast Cancer.)
- What can I tell my children about their mother’s breast cancer?
- Are there support groups for partners, and where can I get information about them?
Excerpted from the SHOWME Book/2nd Edition: A Photo Collection of Breast Cancer Survivors' Lumpectomies, Mastectomies, Breast Reconstruction and Thoughts on Body Image; 2001 The Milton S. Hershey Medical Center; used by permission |
