It might have started when you felt a lump. Or maybe you simply went in for a routine mammogram only to find out something wasn’t quite right this time. Your doctors ordered a biopsy, and the results confirmed your greatest fear.

Finding out you have breast cancer can feel like a punch in the gut. There are probably a million questions running through your mind: What just happened? How did this happen? Am I going to be okay? You are feeling scared, anxious, overwhelmed —maybe even angry. Or you may go completely numb. Whatever you are feeling, it’s “normal” (whatever that is.)

Every woman’s journey is unique. We are not physicians, we’re merely sharing our experiences in the hopes it brings you some calm, order, and a little motivation to advocate for yourself during this time. 

1. You Will Meet With a Breast Surgeon 

Your OB/GYN or referring physician will recommend a breast surgeon for you to meet with right away. That surgeon will tell you more about your diagnosis, explain the typical treatment path for your specific circumstance and give you options for reconstruction, if applicable.

2. You Will Undergo Genetic Testing

Genetic testing offers important information that will inform your physician's recommendation. They want to determine if your case is hereditary (BRCA positive) or not,  that result triggering a variety of decisions. You’ll be referred to a genetic counselor for a simple blood or saliva test and family tree discussion. 

You will be asked about cancer incidence in your immediate family and close relatives (grandparents, aunts/uncles, and cousins), which will help to better understand your risk factors. 

You may have the option to test for just the BRCA gene or a full panel cancer gene screening. The more extensive test looks for gene mutations associated with over 200 types of cancer. 

This test actually clued our own Virginia into the fact that she carries the ovarian cancer gene, which often goes undetected until an advanced stage, but more on that later…

3. You Will Have an MRI

An MRI, or magnetic resonance imaging test, will be ordered to determine the size of your tumor/s and whether or not the cancer has spread to your lymph nodes (i.e. the pathway to other parts of your body).  

*For premenopausal women, it’s important to nail the timing of this test with your menstrual cycle, typically days seven through fifteen of your cycle; however, these guidelines can vary depending on the testing center. 

The bottom line is that there’s a limited window each month to get this test, otherwise the results might not be legible due to hormonal interference. Virginia took the test twice because the results couldn’t be read the first time, and even the second time was still fuzzy. She wasted a lot of time and energy dealing with scheduling and insurance approvals for a second test, so try to avoid this if you can.

4. A Treatment Plan will be Made

Once all your results are in, the breast surgeon will determine the course of your surgery.

Depending on how advanced your case is, you will likely need a consultation with a medical oncologist to set a plan. If your cancer is staged at 0 or I, typically you will have surgery first and then a call will be made about chemo once your pathology results are in. 

After your surgery, the tissue removed will be further analyzed for various factors including tumor size, type, and grade.

If you are immediately staged at 2, 3, or 4, your doctor may prescribe neoadjuvant chemotherapy (chemo before surgery) to help shrink the size of the tumors before your operation.

Either way, the treatment path will be based on your individual circumstances, test results, and risk factors. It’s best not to try to predict what your treatment will be in advance of your reports. The wait is nerve-wracking and excruciating, especially since these appointments and tests can take several days or even weeks to complete.

If you feel like you can’t deal, here are a few coping strategies to help get you through:

• Read books from credible sources about the disease, treatment plans and outcomes. We highly recommend, “Breasts: The Owner's Manual: Every Woman's Guide to Reducing Cancer Risk, Making Treatment Choices, and Optimizing Outcomes Hardcover” by Dr. Kristi Funk (surgeon to Angelina Jolie and Sheryl Crow)
• Make a few dietary changes to promote optimal conditions for healing
• Start exercising for your physical and mental health
• Do things to take your mind off your diagnosis and that bring you joy, like watching movies, going to a concert, getting outdoors in nature, or playing games
• Confide in a few trustworthy people so you don’t feel alone. This can be a partner, family member, friend, or coworker. Obviously your health is a very private matter, but holding it in can be too much to bear.
• Connect with other women who have had the disease. A simple conversation can go a long way in helping you understand what to expect. Ask your physicians if your hospital has a resource for this.  The American Cancer Society and Imerman Angels also have mentorship programs that connect you with volunteer survivors who are there to support you.