Gathering Information

couple-in-bookstoreWhen a woman hears that she has breast cancer, her first response may be a desire to have treatment—any treatment—immediately. Unlike a heart attack or an appendicitis, breast cancer is not a medical emergency. By the time the tumor is found, it may have been growing for years. You can take several weeks to organize your thoughts, gather information, and make a decision about treatment, without jeopardizing the outcome.

Becoming well informed about breast cancer and about your options is one of the most important steps you can take at this stage. Knowledge of the facts will give you a sense of comfort and control.

Studies have shown that a woman’s degree of satisfaction with the outcome of her treatment had to do less with the results of the treatment, and more with how much information she had when she made the decision. Take your time to gather all the facts you need, so that you can be comfortable with the decisions that will affect the rest of your life.

Breast Patient Navigator Nancy Terveen is an essential part…

Your main source of information will be the professionals caring for you. Make lists of topics you want to discuss, and don’t hesitate to ask any question, no matter how simple it may seem. Ask your support person to accompany you to the medical appointments, so that you have someone to help you take notes, tape record what was said, or ask additional questions.

• Anesthesiologist: Administers drugs or gasses which put you to sleep before surgery.

• Clinical Nurse Specialist: A nurse with training or knowledge in a specific area, such as post-operative care, chemotherapy, or radiation therapy.

• Medical Oncologist: A doctor who administers anti-cancer drugs or chemotherapy.

• Pathologist: A doctor who examines the tissue removed during a biopsy, and issues a report to help you and your doctor choose the most effective treatment.

• Nurse Navigator: A specially trained nurse who will guide you through the maze of treatment options, helping you overcome obstacles with education and support.

• Personal Physician: The doctor who will be responsible for coordinating your treatment. Your personal physician may be a surgeon, radiation oncologist, medical oncologist, or family physician.

• Physical Therapist: A specialist who helps with post-surgical rehabilitation using exercise, heat, or massage.

• Plastic Surgeon: A doctor specializing in cosmetic surgery, such as breast reconstruction after mastectomy.

• Radiation Oncologist: A physician specially trained in using high-energy X-rays for treatment.

• Radiation Therapy Technologist: A technologist who works under the direction of the Radiation Oncologist to administer radiation treatment.

• Social Worker: A trained professional who can deal with social and economic aspects of treatment, such as helping find a support group or solving an insurance issue.

• Surgeon: A doctor specializing in surgery, who will do the initial operation on the cancer.

The Avera multi-disciplinary team…

A lot of information—and, sadly, misinformation—is readily available on the internet. Be sure that the site you are consulting is sponsored by a reputable organization, and does not represent some individual’s bias.

Overview of Treatment Options

With today’s early detection and improved treatment techniques, we can treat breast cancer more successfully than ever before.


The ultimate goal of any cancer treatment is to completely eliminate every single cancer cell from the body. This battle is usually waged on two fronts.

One line of attack uses local treatments: surgery and radiation therapy. Surgery removes the tumor. Radiation kills any cancer cells that might have been left in the breast area after the tumor was removed.

The other line of attack aims to destroys any cancer cells that might have broken away from the tumor, and traveled to distant parts of the body. This approach is called systemic treatment.

Systemic treatment can be in the form of chemotherapy (drugs that kill cancer cells), hormonal therapy (drugs that prevent cancer cells from growing), targeted therapy (drugs that help your body fight off cancer).

Don’t worry if you feel confused by the new words and concepts presented here. Most people do at first. In the following days and weeks, as you explore this book, talk with your healthcare professionals, and gather additional information, you will begin to acquire the knowledge you need to make informed decisions.

Planning your treatment can be overwhelming

Planning your treatment should involve your entire team of specialists, as well as your partner or your loved ones. Don’t let anyone or anything make you feel rushed. With rare exceptions, breast cancer is not an emergency, and you can safely take several weeks to process the information.

“Don’t let anyone rush you.”

The following chart of treatment options shows you how they might be used, alone or in combinations.


Almost always, you will begin with surgery: lumpectomy or mastectomy. If you have a lumpectomy, you will almost always have radiation therapy. If you have a mastectomy you might choose to have breast reconstruction. After either lumpectomy or mastectomy you might or might not have drug therapy (chemotherapy, hormone therapy or targeted therapy), depending on the characteristics of your tumor.

Dr. Julie Reiland: “There is no need to rush your decision.”

The key fact to remember is that it is you who will make the final decision, and all the members of the medical team need to respect it. That’s why it is so important for you to learn all you can about your disease. The more information you can gather before you begin treatment, the more active role you’ll be able to take, and the better you will feel about your decision.

Getting a Second Opinion

conf-siloutheThe treatment of your breast cancer is probably the most important issue you will ever face. For your own peace of mind, now and in the future, you may consider getting a second opinion. You are entitled to evaluate all your options, and no competent healthcare provider will object to your listening to another viewpoint.

At the Avera Breast Center we have created a Second Opinion Clinic. This service allows you to call the Center and request that your diagnosis and treatment plan be reviewed by our team of experts – no matter where you were originally diagnosed.

You will be given an appointment to come to the Avera Breast Center for consultations with key breast cancer specialists, on the same convenient day. Your case will be reviewed by our multidisciplinary team, and a recommendation will be made. Then you can proceed with your treatment at the place of your choice, knowing that all aspects of your case have been thoroughly evaluated, and the course that is best for you has been chosen.