Breast Cancer Diagnosis and Treatment Questions
to Ask the Doctor

Medical Author: Jerry Balentine, DO, FACEP
Medical Editor: Melissa Conrad Stöppler, MD

• I may have breast cancer, what questions should I ask my doctor?
• Is the doctor sure I have breast cancer?
• What kind of breast cancer do I have?
• What difference does a precise diagnosis make?
• What has been done to exclude cancer in other areas of the same breast or in my other breast?
• What type of medical team do I need for the most accurate diagnosis?
  • How important is the role of the pathologist reading my slides?
  • Have my slides been reviewed by more than one pathologist?
  • Can I have my biopsy reviewed by a pathologist at another diagnostic center?
• Is my family history relevant to my diagnosis?
• What other studies should be done on my tissue biopsy?
• How urgent is it that I make decisions and begin treatment?
  • Are there controversies in the recommended treatments among reputable experts?
  • How might my treatment affect future risks and follow-up treatment?
  • Should genetic testing be part of the treatment decision process?
• Should I stop taking hormone replacement therapy (HRT)?
• Even though my breast tumor does not have hormone receptors, should I take tamoxifen to reduce the risk of a new tumor?
• I have a ductal carcinoma in situ (DCIS), a type of localized cancer. Why have I been advised to have a mastectomy when other women with invasive cancer have lumpectomies?
• Should I start chemotherapy before surgery?
• If I am advised to have a mastectomy, what are the risks and benefits of immediate breast reconstruction?
• Should my lymph nodes be removed?
• What is a sentinel lymph node biopsy, and what are its benefits and risks?
• Are there any other questions I should ask my doctor?

I may have breast cancer, what questions should I ask my doctor?

If you have received a positive or possible diagnosis of breast cancer, there are a number of questions that you can ask your doctor. The answers you receive to these questions should give you a better understanding of your specific diagnosis and the corresponding treatment. It is usually helpful to write your questions down before you meet with your health-care provider. This gives you the opportunity to ask all your questions in an organized fashion.

Each question is followed by a brief explanation as to why that particular question is important. We will not attempt to answer these questions in detail here because each individual case is just that, individual. This outline is designed to provide a framework to help you and your family make certain that most of the important questions in breast cancer diagnosis and treatment have been addressed. As cancer treatments are constantly evolving, specific recommendations and treatments might change and you should always confer with your treatment team regarding any questions.

Is the doctor sure I have breast cancer?

Certain types of cancer are relatively easy to identify by standard microscopic evaluation of the tissue. This is generally true for the most common types of breast cancer.

However, as the search for earlier and rarer forms of breast cancer progresses, it can be difficult to be certain that a particular group of cells is malignant (cancerous). At the same time, benign conditions may have cells which are somewhat distorted in appearance or pattern of growth (known as atypical cells or atypical hyperplasia). For this reason, it is important that the pathologist reading the slides of your breast biopsy be experienced in breast pathology. Most good pathology groups have multiple pathologists review questionable or troublesome slides. In more difficult cases, the slides will often be sent to recognized specialists with considerable expertise in breast pathology.

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