Diagnosing Breast Cancer: What to Expect

If you notice a lump in your breast or are informed of a suspicious finding on your mammogram, your next step is typically a referral to a breast surgeon. The surgeon will conduct a clinical breast exam and may order additional imaging, such as a mammogram or ultrasound, as well as a breast biopsy to determine the nature of the findings. Together, you and your surgeon will discuss four possible outcomes:

• Benign Breast Disease: The cells appear normal, and there is no cancer present.
• Atypia: The cells look abnormal but are not cancerous. Close monitoring and follow-up with your breast surgeon are recommended.
• Ductal Carcinoma in Situ (DCIS): Cancer cells are present but have not invaded surrounding tissue or spread to other parts of the body.
• Invasive Carcinoma: Cancer cells are present and have spread to surrounding tissues.

You will typically receive your biopsy results within three to five days, with results shared over the phone.

If cancer is detected, your breast surgeon will schedule a follow-up appointment to discuss the diagnosis, create a personalized treatment plan, and plan for surgery. We recommend bringing a family member or friend with you to this important appointment for support. Pre-surgical testing, including blood work, chest X-ray, and an electrocardiogram (ECG), will be ordered by your surgeon. Depending on your specific case, additional imaging such as a CT scan, MRI, or bone scan may also be necessary.

At every stage, our team is here to support you and ensure you receive the care and information you need.

Part of your treatment plan will include working with a medical oncologist and a radiation oncologist.

• A medical oncologist prescribes chemotherapy, immunotherapy, and hormonal therapy, and closely follows patients from diagnosis into survivorship. Depending on course of treatment, chemotherapy and immunotherapy takes five to twelve months to complete. Hormonal therapy is taken for five to ten years.
• A radiation oncologist specializes in radiation therapy to cure or reduce symptoms of cancer. Radiation therapy is typically given daily (Monday through Friday) for four to six weeks.

After your surgery, the surgical samples will be sent for further testing to analyze the cancerous tissue. You will receive a call from your breast surgeon within three to five days once the results are available. In some cases, based on the findings, additional surgery may be needed to ensure that all cancerous tissue has been removed.

Your surgical pathology report will include important details about your cancer, such as the type, grade, stage (which includes tumor size and lymph node involvement), and margin status (indicating whether the cancer was completely removed). For invasive cancers, pathologists will perform additional tests to identify prognostic and predictive markers that can help guide your treatment. These include:

• ER (Estrogen Receptor): A protein that binds to estrogen in the body. Tumors that are ER-positive are more likely to respond to hormone therapy.
• PR (Progesterone Receptor): A protein that binds to progesterone in the body. Like ER-positive tumors, PR-positive tumors are more likely to benefit from hormone therapy.
• HER2 (Human Epidermal Growth Factor Receptor 2): A protein that promotes the growth of cancer cells. There are targeted therapies available to block HER2, which can help stop the growth of HER2-positive cancers.

These results are crucial for developing a personalized treatment plan tailored to your specific diagnosis. Your healthcare team will work with you to determine the best course of action based on these findings.

Learn more about breast cancer surgery at Emerson Hospital.

Your breast surgeon will communicate findings to your care team to coordinate next steps and develop a care plan to meet your needs,

The typical order of treatment after surgery is → Chemotherapy → Radiation therapy → Hormonal therapy

The order of these therapies may be switched or eliminated altogether depending on the type of cancer you have. The therapy is tailored to you, and a multidisciplinary team of specialists will guide you through process.