When going for an exam, it will be necessary for you to have information about your family and your own health history. Your doctor will need this information to help assess your genetic predispositon for developing breast cancer. This information will also help your doctor make recommendations about the types of screenings you should have and the frequency. Your personal history will be easy to recite to your doctor, but your family health history will be considerably harder. If necessary, call your parents and make a list for your records. Be prepared to discuss the following [i]:

  • Your age (risk increases with age)
  • Your current weight and/or level of obesity (obesity increases risk for breast cancer)
  • Amount of vigorous exercise you engage in weekly (3 – 5 hours per week decreases risk)
  • Family history of breast or ovarian cancer
  • Your personal history of breast cancer
  • Age of first menarche (early menarche is a risk factor)
  • Age of menopause (late menopause is a risk factor)
  • Age of first pregnancy (first pregnancy after 30 is a risk factor)
  • Birth control pill use (some research suggests a slight increase in breast cancer risk)
  • Previous radiation exposure
  • Current or previous hormone replacement therapy (HRT) use
  • Amount of alcohol use (more than 1 drink per day increases your risk)
  • Precancerous breast conditions (increases risk)
  • Density of your breasts (can make examinations and finding the cancer more difficult)

Questions to ask doctors during breast cancer screenings [i]:

  • I want to perform monthly breast self-exams. Can you show me how?
  • How can I tell which lumps are not normal?
  • How often should I schedule appointments with you or another doctor and what types of exams should I have (physicals, breast exams, checkups, etc.)?
  • What cancer screening tests (e.g., mammography) should I have and how often?
  • Is there anything in my personal or family history that indicates I should have mammograms more often than the usual recommendations?
  • Where should I have my mammograms?
  • Is there anything I should do to prepare for my mammogram?
  • What will the mammogram show?
  • Who gets the report of my mammogram? Can it also be sent to my other doctors?
  • How long will it take to receive the mammography report?
  • What happens next if my mammogram detects a problem?

 

Questions to ask your doctor if given a breast cancer diagnosis [i] [ii] [iii]:

  • Do I need an MRI, CT scan or biopsy?
  • Do I need any additional tests in order to plan my treatment?
  • What tests will I have during my follow-up visits after treatment?
  • Do I really have breast cancer? Have you ruled out other possible causes for my symptoms?
  • What type of breast cancer do I have and what stage is it?
  • Do you know what caused my cancer? Did it start in the breast?
  • Has the cancer spread? Have you ruled out any other cancer elsewhere in the same breast or in my other breast?
  • Is hormone therapy right for me?
  • Do any lymph nodes show signs of cancer?
  • What did other lab tests show?
  • What did the hormone receptor test show? Can I have my biopsy reviewed by another pathologist for a second opinion?
  • Should genetic testing be part of the treatment decision process?
  • Is my family history relevant to my diagnosis?
  • Should I stop taking hormone replacement therapy (HRT)?
  • Should I take tamoxifen to reduce the risk of a new tumor?
  • What treatment options are available for this stage of breast cancer?
  • Will I need to take chemotherapy?
  • How urgent is it that I make decisions and begin treatment?
  • What are the risks, side effects, or complications of these treatments?How long will the treatment take?
  • What do you expect my prognosis to be?
  • What medicines will I be taking? And for how long?
  • Will any of these treatments cause premature menopause or infertility?
  • Are these proven or experimental techniques, methods, or medications?
  • Is this treatment covered by insurance?
  • Can you recommend someone for a second opinion?
  • How should I expect to feel during treatment?
  • Are any changes in diet or lifestyle necessary before, during, or after treatment?
  • Will I need to have a mastectomy?
  • What are the options for breast reconstruction, if surgery is recommended?

Questions about treatment [i] [ii]:

  • Why are you recommending this therapy?
  • What is the goal of my treatment?
  • What are my treatment options?
  • What treatment or treatments do you recommend? Why?
  • How long does the treatment last?
  • Are there controversies in the recommended treatments among reputable experts?
  • What are the expected benefits of each kind of treatment?
  • What are the risks and possible side effects of each treatment? How can side effects be managed?
  • Will my hair fall out? Will it grow back?
  • What about premature menopause and infertility?
  • How can I get a second opinion about my treatment?
  • Who are the members of my treatment team? Can I talk to each of them?
  • How might my treatment affect my future risk of cancer?
  • What can I do to prepare for treatment?
  • Will I need to stay in the hospital? If so, for how long?
  • How much will treatment cost? Will my insurance cover the cost?
  • How will treatment affect my normal activities? Can I continue my usual activities while I’m undergoing treatment? What should I avoid during treatment?
  • If I am advised to have a mastectomy, what are the risks and benefits of immediate breast reconstruction?
  • Should my lymph nodes be removed?
  • Should I start chemotherapy before surgery?
  • Will I have normal sensation in my breasts after my treatment?
  • Should I follow a special diet or make other lifestyle changes to help my recovery?
  • What are the chances my cancer will come back with the treatment programs we have discussed? What would we do if that happens?
  • Are new treatments under study? Am I eligible for any clinical trials?
  • Will the treatment affect my fertility? What if I want to have children later?
  • How do I explain my condition to my family, friends, and colleagues?
  • Should I change my diet or lifestyle? Are there foods, over-the-counter drugs, or supplements I should use or avoid?
  • Are there some alternative breast cancer therapies I can use along with conventional treatment?
  • Where do I go for chemotherapy or hormone therapy?
  • Will I be able to drive myself home after treatment, or do I need help?
  • Can you recommend support groups or counseling?

If surgery is recommended as part of your treatment, you may ask the following questions of your surgeon [i] [ii]:

  • How do I prepare for surgery?
  • Which operation do you recommend for me? Why?
  • Why are you recommending this procedure?
  • What type of anesthesia will I have?
  • What are the risks? How do they compare with the benefits?
  • What happens during and right after surgery?
  • How long will I be in the hospital?
  • Are there any complications?
  • When can I go back to work and resume normal activities?
  • What are the risks of lymphedema?
  • Is breast-sparing surgery an option for me?
  • Can you put me in contact with someone who has had the same surgery?
  • Will my lymph nodes be removed? How many? Why?
  • How will I feel after the operation? How long will I have to stay in the hospital?
  • What will I look like afterwards?
  • How effective will breast reconstruction surgery be if I want it?
  • What other options are there?
  • Can you suggest a plastic surgeon for me to contact?
  • Will I have to have radiation?
  • Should I start chemotherapy before the surgery? Should I take it afterwards?
  • Will I have to do any special exercises or physical therapy to help my recovery?

 

Questions to ask about radiation treatment [i] [ii]:

  • How will my radiation be administered?
  • How long will I have to undergo treatment? How often? How long will each session last?
  • How will I feel during treatment? Will I be able to drive myself to and from treatment?
  • When will we know if the treatment is working?
  • What can I do to take care of myself before, during, and after treatment?
  • How will I look afterward?
  • What are the side effects?
  • What are the long-term effects?
  • How often will I need checkups?
  • What is the goal of radiation therapy?
  • Does radiation affect fertility?
  • What are the risks and side effects?
  • Where do I go for radiation therapy?
  • How long does each session last?
  • How many weeks does treatment last?
  • Does radiation therapy make me radioactive?
  • What should I avoid during treatment?
  • Should I change my diet or lifestyle?
  • Does radiation therapy affect having breast reconstruction?