By Susan M. Love, M.D. and M. Ellen Mahoney, M.D., F.A.C.S.

Many of us will care for someone with breast cancer at some point in our lives.  Nearly one in eight women in the United States will be diagnosed with breast cancer over the course of her life and nearly 80% of new cases occur in women over age 50.  Breast cancer, a malignant growth that forms in breast tissue, is generally discovered by the individual or a physician through a physical exam, a mammogram, or an ultrasound.

Symptoms of breast cancer may include an abnormal lump in the breast or under the arm, changes in the breast itself, and pain and tenderness. Men can also develop breast cancer, but as a group represent less than 1% of all cases.  

Responding to Diagnosis

When someone is diagnosed with breast cancer, she is often in a state of disbelief.  “It is cancer” are words that no one ever wants to hear.  The diagnosis is especially difficult to accept when one realizes that cancer isn’t easily eradicated.

Breast cancer occurs when our cells go awry—a fact that some people interpret as their body betraying them. As your loved one works to understand and acknowledge the reality of the diagnosis, there are several ways to support her:

            - Ask “what do you need me to be for you?”

• Accompany her on medical appointments to provide support.  
• Ask questions—often someone with a medical condition is reluctant to challenge the doctor, but you can and should. Review the questions in advance with your loved one to make sure that you are aware of her or his concerns.
• Take notes—so you can share information with each member of your loved one’s multi-disciplinary team of physicians.  It is often useful to tape record the visit for later review.
• Search for information—look to trusted Websites for resources to help guide and counsel you, such as www.drsusanloveresearchfoundation.org.
• Assist your loved one in keeping a file and collect pathology, surgery, and x-ray reports that you obtain from healthcare professionals.  In addition, your loved one may want to keep a written record or journal on her diet, her physical and emotional responses to therapy, and her general wellbeing. This information can be useful to your loved one’s medical team.
• Encourage your loved one to examine a variety of treatment options. It is normal to feel you must rush into a procedure to remove the cancer, but it is important to slow down and talk about options with your physician before choosing a treatment. You may also want to consider getting a second opinion.
• Have a positive attitude—recognize that many women (most if caught early) do not die from breast cancer. Also, breast cancer can often be treated without removing the breast.

Selecting Your Medical Team

If your loved one is diagnosed with breast cancer, one of your first action steps is to find a breast cancer surgeon she trusts.  Often, your loved one’s primary care physician or obstetrician/gynecologist can recommend someone. Other times women turn to friends and family members for referrals. The doctor selected should be one who involves your loved one in decision-making and listens to her concerns.  If you or your loved one does not like the doctor, or the doctor for whatever reason does not seem to be a good fit, do not hesitate to change doctors.

Here are some important characteristics to look for when selecting a physician:

• Board certification in his/her medical specialty
• Number of similar surgeries performed each year for the past five years
• Part of a multi-disciplinary team—surgeon, radiologist, and oncologist
• Interest in hearing information you’ve researched in terms of diagnosis, treatment and related subjects, and encourages you to ask questions 
• Knowledgeable about new clinical trials and therapy options
• Has a “positive connection” with your loved one

Making Decisions

Newly diagnosed breast cancer patients are usually frightened and nervous. It can seem like the number and complexity of important decisions facing them can add to their fear and be overwhelming. As a caregiver, you can support your loved one by serving as a sounding board and helping them make decisions, such as:

• Selecting treatment—surgical options include lumpectomies (removing the lump and lymph nodes) and mastectomies (removing one or both breasts). Treatment is based on many factors including the type of breast cancer and its stage of development. Radiation and chemotherapy are usually used in conjunction with surgery to treat breast cancer.
• Seeking a second opinion from another physician.
• Deciding on a surgical facility—generally, surgeons recommend a hospital where they practice, but patients can also request treatment at specific facilities.
• Understanding expenses for the surgery and follow-up treatment, including the amount covered, or not, by health insurance.
• Choosing an appropriate time to discuss your loved one’s diagnosis with family and friends.
• Scheduling surgery, post-surgical treatment, and care, as well as planning time off from work.
• Arranging care for children during your loved one’s hospitalization.

Coping with the Future

Breast cancer treatment is painful both physically and emotionally. After surgery, incisions need to heal and the wound kept clear of infection. If a woman has had her breast removed she may feel disfigured and unattractive. Breast cancer surgery usually makes it difficult for a patient to lift her arm or find a comfortable way to sleep for weeks after the surgery. Chemotherapy and radiation are also stressful processes for the body to endure.

Your loved one will need your ongoing assistance and support to accomplish everyday activities ranging from bathing to eating to driving, among others. Plan to engage a support network of family members, friends, and neighbors to help you with household tasks, as you provide care for your loved one.  And, while difficult days may lie ahead, take comfort in knowing that the worst is most likely behind you and the one you love.  

Know that more women are surviving breast cancer today, because of earlier detection and treatment.  Seek out support groups for your loved one and also for you.  It is always helpful to share your experiences.

For more information about caring for a loved one with breast cancer, as well as new research in the field, visit:

Dr. Susan Love Research Foundation

National Breast Cancer Coalition

American Cancer Society

Young Survival Coalition 

Y-ME National Breast Cancer Organization