'Know the enemy. Know what you are facing and most of your fears will become manageable. That was the most important thing to me - to educate myself about breast cancer'
After surgery, many women will be referred to a medical oncologist to discuss whether further treatment is needed. You will usually have your first visit with your medical oncologist shortly (within 2-3 weeks) after your breast cancer surgery.
During your appointment, we will:
Explain your surgical results - tumour size and grade, lymph node status, hormonal status, HER2 status and cancer stage.
Figure out the risk of the breast cancer coming back, as well as the need for more treatments (such as chemotherapy, hormonal therapy or radiation therapy)
Arrange additional investigations if needed
Discuss your treatment goals and preferences
Discuss how you can take care of yourself to optimize your overall health
Give you strategies and resources for dealing with pain, depression and side effects
Depending on your surgical results and other considerations like your age, previous chemotherapy if any, your general health and other medical conditions, we will recommend the most suitable treatment for you
Discuss the benefits and risks of treatment, including side effects and possible impact on your work and life
Discuss availability of clinical trials
Answer any questions and concerns that you may have
Your appointment is an opportunity for you to learn as much as you want to know about your disease and the options for your treatment.
What are my breast cancer treatment options after surgery?
Possible treatment options include: Chemotherapy Chemotherapy is a treatment which uses drugs to destroy cancer cells. It is sometimes used after breast cancer surgery to kill any undetectable cancer cells that may be left in the breast or lymph nodes. Chemotherapy can lower the risk of breast cancer coming back. We will consider a number of factors to determine whether and what kind of chemotherapy would benefit you. The higher your risk of recurrence, the more likely chemotherapy will be of benefit. In some cases, characteristics of the breast cancer itself may suggest other more beneficial, less harsh treatments, such as hormone therapy with oestrogen-blocking medications.
Hormone therapy Hormone therapies are drugs used to treat hormone receptor positive breast cancer. Around two-thirds of breast cancers are hormone receptor positive, which means that they need female hormones (oestrogen and/or progesterone) to grow and reproduce. Most women with hormone receptor positive breast cancer will be offered hormone therapy.
Anti-HER2 therapy If your tumour contains a specific tumour marker called HER2, we may recommend anti-HER2 therapy. Trastuzumab (Herceptin) is a targeted therapy drug that is useful only for breast cancers that are growing in response to the HER2 protein. Trastuzumab works by attaching itself to HER2 positive breast cancer cells, destroying the cells or reducing their ability to divide and grow. It is usually used together with chemotherapy initially then by itself for up to 12 months.
Nearly all women feel confused by the difficult treatment decisions they must make. The key is to ask as many questions as you need to help you make those decisions. Remember that we are here to help guide you but ultimately, the decision on which treatment to have lies with you. For a guide on what questions to ask your cancer specialist, read this article.