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"I Feel a Lump. Now What?"

Step 4: Explore Your Treatment Options

You may be anxious to "get the cancer out," but it's important to obtain a second opinion. "It could make a big difference in your chances of a cure," says Michael Sabel, M.D., an author of a University of Michigan study that found that 52% of women who sought additional input received new advice. Ask your local hospital for the names of breast cancer specialists. Once you have a second opinion you can choose your treatment, which typically will include some of the following elements:

  • Surgery. Depending on the size and extent of your lump, your doctor may suggest breast-conserving therapy, in which your cancer is removed but most of your breast tissue is saved. If mastectomy (removal of your whole breast) is recommended, having a procedure to reconstruct your breast at the same time can ensure the best cosmetic results—and potentially spare you a second surgery. But only 24% of breast surgeons refer their patients to plastic surgeons to discuss options, according to a University of Michigan Medical Center study. "By federal law, breast reconstruction is a medical benefit that must be covered," says lead study author Amy Alderman, M.D. "So speak up and ask your doctor to refer you to a plastic surgeon."
  • Radiation. Typically it's administered for six or seven weeks via an X-ray machine, but there's a newer one-week treatment that delivers radiation directly to the site of the tumor. Called partial breast irradiation, a widely used form is MammoSite. Apart from fatigue, there are few side effects associated with either type of radiation.
  • Chemotherapy. Even women with early stage breast cancer benefit from chemo—they live longer, according to a recent study. Treatments, via an intravenous drip, typically are every two to three weeks for three to six months. Thanks to new drugs, nausea can be avoided. Hair loss and fatigue, however, are common side effects. So is "chemo brain"—memory and attention losses that may last 10 years afterward.
  • Drug therapy. If your cancer is hormone-receptor-positive, you may benefit from tamoxifen, raloxifene, letrozole, or anastrozole, meds that help reduce the chance of a cancer comeback by 50%. Women with early-stage HER2-positive cancers can halve their recurrence risk with trastuzumab, a drug that's administered intravenously once every three weeks for a year.

Chemo Jitters, Conquered

Before leaving for her first chemo treatment early in 2006, Lisa Vitantonio, a 48-year-old retired nurse from Chagrin Falls, Ohio, began furiously cleaning her house. "My husband begged me to stop since we were late," she recalls. "I kept delaying. I was scared." But it turned out she was so well cared for she sometimes mused that her chemo appointments were her "spa" days. "I would lie on a comfortable lounger in a pleasant room for five to nine hours. Staff would come in to make sure everything was fine and to see if I needed anything," she recalls. "I read, slept, journaled, and watched movies."

Copyright © 2007. Used with permission from the October 2007 issue of Family Circle magazine.

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