Understanding Breast Cancer Diagnosis: What to Expect

“When someone is diagnosed with breast cancer, the journey isn’t always linear, and it is different for every individual, depending on the type of breast cancer and stage at the time of diagnosis,” according to Dr. Jesse Casaubon.

“There are different types of breast cancers. People react to treatments differently. There are different stages of cancer. People can be diagnosed at any stage,” he says.

There are many different types of treatments, Dr. Casaubon explains. Many times, not only the cancer itself, but the treatments can interfere in a person’s daily life.

How is Breast Cancer Officially Diagnosed?

Facing a breast cancer diagnosis can be overwhelming. There are many ways someone might suspect they have an issue and need to be seen by their healthcare provider. They might find a lump in their breast, have discharge from one or both nipples, or they might see a change in the breast’s or nipple’s shape or texture.

Other times, the person doesn’t find it themselves. The first time there is any question is during a doctor’s exam or an annual mammogram.

“However it is found, it’s scary for people,” says Dr. Casaubon. “The good news is that most times it turns out not to be cancer. Just because a radiologist asks someone to come back for more pictures does not mean something is terribly wrong. They just want to sort out what is going on.”

A biopsy is typically needed to determine if it is cancer and what type. There are two types of biopsies: core or surgical. A core biopsy is a minimally invasive procedure that removes a small amount of breast tissue using a hollow needle to check for cancer or other abnormal cells. A surgical biopsy is more involved and a surgeon removes tissue from the body through an incision in the skin to examine signs of disease.

What Happens If I’m Diagnosed with Breast Cancer?

If a patient receives a breast cancer diagnosis, the person’s medical history is reviewed, diagnostic imaging is done, and biopsy results are discussed. The patient is referred to a surgeon like Dr. Casaubon, who does an examination and discusses treatment options with the patient.

“There are so many more options than ever,” he says. “We’re in an era of patient autonomy. The patient at least considers what they are most comfortable with – surgery, mastectomy, reconstruction. They get to decide to a certain extent, though it is wise to listen to the doctor who is there to save lives.”

Breast Cancer Treatment Options

“We give them all of the information that we can,” he continues. “We decide on surgery and how much we will remove – will it be a lumpectomy, mastectomy, lymph node removal. Then afterward, the patient might be facing chemotherapy, radiation, hormone pills or a combination of all three. The surgeon will guide the entire process.”

Treatments, tailored to each individual’s needs, vary depending on the type of breast cancer, but often surgery, chemo, radiation, and hormone therapy or a combination of some are used. Some patients might actually receive chemo or hormone therapy before surgery to shrink the cancer. Treatments can last anywhere from a year to 10 years of taking certain medications.

The surgeon works very closely with the oncologist, radiologist, pathologist – some doctors the patient may never see – but the surgeon is the gatekeeper.

“Everyone works together, but it’s the surgeon who sits with the patient and lets them know what needs to be done,” he says. “I try to meet a patient where they are emotionally. If they are really scared and nervous, and many are even before they know if it’s cancer, a surgeon doesn’t want to walk into the room all ‘doom and gloom,’ but also doesn’t want to walk in all bubbly. You have to start at neutral. Then, you build from there.”

What Is the Prognosis of a Person with Breast Cancer?

Dr. Casaubon says there is more hope than ever for people diagnosed with breast cancer. That is why he focuses on all the positives, without being overly positive.

“In so many situations now there is a cure,” he says. “That can be so reassuring to a patient. Of course, depending on where they are at, you also have to be realistic and honest.”

Recovery from Breast Cancer Treatment

Dr. Casaubon says breast surgery sometimes comes with complications that have to be dealt with, as do radiation, chemo, and hormone therapy.

“A change in hormones, for instance, can make someone feel sick,” he says. “I don’t sugar coat anything. I tell patients I know it’s going to be hard, but that I will be there. I want to see them succeed and never have to return when it’s all over.”

Dr. Casaubon says it is an exciting time in breast cancer treatment because there are so many options. Once the cancer has been removed, he says the patient eventually returns to the care of a medical oncologist and cancer nutritionist.

“There are a lot of people involved who all want the same thing – for the patient to recover and go on to live their best life,” he explains.

Depending on what the surgery consists of, a patient might decide to have plastic surgery or go the route of custom prosthetics. They might have to work with a physical therapist to regain a wider range of motion.

“There is a decrease in the range of motion after lymph nodes are removed,” he says. “That’s just one of the side effects, but we have team members to help with that.”

Dr. Casaubon says he likes to see his patients come with lots of questions so they are as informed about their bodies and what is happening as they can be. He says sometimes they will bring someone with them, especially if they are feeling scared or worried.

“I love that patients are their own advocates, but I also certainly think it’s a good idea to have someone who supports you through your journey,” he says.

He says support is important, but people should remember that everyone’s path is different, so even if the support person has been through breast cancer before, it does not mean the person they are supporting will follow the same path or even end up on a similar journey.

“It’s all about getting the patient at the moment they are facing their own diagnosis through the journey they need to take,” he says.

Baystate Health does many events connected with breast cancer, including Rays of Hope, survivor events, and so much more.

“Baystate brings together the entire community to support not only their own friends and families, but everyone who needs it so they don’t have to travel the path alone,” he says.