Talking openly with your health care provider is one of the best ways for you to feel good about the treatment you are getting. When meeting with your provider, you should bring a friend or loved one (co-survivor) with you who will be able to help ask questions and recall the answers later. If it is not possible for someone to go with you, a small tape recorder can record what was said.
Whether you go alone or with someone, preparing a list of questions ahead of time (to bring with you) is important (see "Questions for Your Provider" throughout Understanding Breast Cancer or view the complete list below). Also, our Questions to Ask the Doctor series provides you with questions on a variety of breast cancer issues. Each card (14 total) contains questions to discuss with your provider about a specific breast cancer topic. You can download and print the cards and take them with you to your next appointment. Plenty of space is provided to jot down the answers to the questions. These topic cards are a valuable tool for those who have been recently diagnosed with breast cancer or who may be too overwhelmed to know where to begin to start gathering information. Being prepared can help you remember all of the questions you want to ask. It also helps keep the discussion focused on the issues that are most important. Talking with a health care provider can be hard for some people. It often occurs in an unfamiliar and stressful situation, and some providers may be hurried or unskilled at answering questions. There are many resources to help make these discussions easier. We have outlined a series of steps to help you talk more effectively with your providers in our fact sheet “Talking with Your Doctor”. The National Coalition for Cancer Survivorship and American Cancer Society also have tips on talking with your providers. Below is a list of all the “Questions for Your Provider” found throughout Understanding Breast Cancer. The questions are arranged by topic, so that you can easily find the questions that relate to your situation.
Questions for Your Provider
Choosing a Physician
- What is your medical specialty? Are you board certified in that specialty?
- What percent of your practice is devoted to breast cancer treatment?
- What is the accreditation status of the medical facility where you practice?
- Does your medical center accept my health insurance plan?
- For surgeons: How many times a year do you perform the procedure you are recommending for me? How many times a year is the procedure done at the hospital where you practice?
- Which diagnosis and treatment guidelines do you use as the basis of your breast cancer care?
- Which diagnosis and treatment guidelines does the medical facility use as the basis of its breast cancer care?
Risk Factors and Prevention
For Those with Breast Cancer
- Even though I have already been diagnosed with breast cancer, are there healthy behaviors I can adopt that may prolong my survival?
- What behaviors can my family members adopt to lower their risk of breast cancer?
- How does my having breast cancer affect the risk of my family members?
- Should my family members and I consider genetic testing?
- What are the issues my family and I need to think about when considering genetic testing?
- Which genetic counselor would you recommend to help my family and me decide if genetic testing is right for us?
- How much does genetic testing cost? Does my insurance cover it?
For Those without Breast Cancer
- What steps can I take to lower my risk of breast cancer?
- How can I estimate my risk of breast cancer? How accurate are the methods?
- How do I determine if I have dense breasts? If I do have dense breasts, how does that increase my risk?
- What type of screening should I have? Can you discuss the benefits of digital vs. standard mammograms for me?
For Those at High Risk of Breast Cancer
- I've been told I'm at high risk for getting breast cancer. What should I do?
- Should I take tamoxifen or raloxifene? Do the benefits of these drugs outweigh the risks for me?
- What about prophylactic mastectomy or oophorectomy?
- What about increased screening? What screening tests are best for my level of risk? Can you discuss some of the options (such as MRI, digital mammograms) and when would you recommend them for me?
- Given my medical history, how can I manage my menopausal symptoms? Are postmenopausal hormones a safe way to manage my menopausal symptoms?
Early Detection and Screening
- If age 20 or older and a provider does not perform a clinical breast exam: Would you perform a clinical breast exam today?
- When should I get my first mammogram?
- Is my mammogram scheduled at an FDA Certified Mammography Facility? (Note: This can also be checked at http://www.fda.gov/cdrh/mammography/certified.html.)
- Does the radiologist specialize in breast mammography?
- What is the false positive rate for the radiologist or mammography facility? (This should be no more than 10 percent to meet U.S. guidelines.)
- If the results of a clinical breast exam or mammogram are suspicious: What follow-up tests do you recommend? What do they involve?
- If you are disabled: Is the mammography equipment at the radiology center able to accommodate women with my special needs?
- If I am pregnant, what type of screening is safe for my baby?
- If I am nursing, what type of screening should I get?
- Are screening tests any less effective for women with breast implants? What, if anything, should I tell screening providers about my implants?
Diagnosis of Breast Cancer
Preparing for a Biopsy
What type of biopsy will I have? Why?
Will the lymph nodes be sampled?
Will a sentinel node biopsy be done? What is the experience of the surgeon, radiologist and pathologist in doing this procedure?
How reliable is a needle biopsy?
Will estrogen and progesterone receptor tests be done? Her2/neu? Others?
How often does the radiologist or surgeon perform the type of biopsy I'll be having? Do they specialize in breast cancer?
How long will the biopsy take?
Will I be awake during the biopsy? Can it be done on an outpatient basis?
How long will it be between my biopsy and any necessary treatment?
If I have a needle biopsy, who will evaluate the samples? How much experience does that person have with breast cancer? Will a
cytopathologist be needed?
When will I get the pathology results?
Where will the biopsy scar be?
Are there any after effects of the biopsy? If so, what are they?
What medications should I avoid before the biopsy and for how long? When can I resume my usual medications?
When will I be able to return to my normal routine?
If cancer is found, who will talk with me about my treatment options? When must I make a decision on my treatment choices?
Will the tissue removed during my biopsy be X-rayed to make sure that all of the suspicious tissue was obtained?
Will my tumor be saved? Where will it be stored? For how long? How can I/ future providers/clinical trials I might participate in access it in the future? For more information on breast pathology practices,
read the Susan G. Komen for the Cure® report.
Getting Biopsy Results and Understanding the Diagnosis
What did my biopsy show?
What kind of breast cancer do I have? What is the stage and grade?
Who will discuss my treatment options with me?
How many lymph nodes were removed, and how many were positive for cancer?
What are the estrogen and progesterone receptor status of my tumor? What is the HER2/neu status? What are the results of other tests?
Will other special tests (such as proliferation rate) be done on the tissue?
Was the entire tumor removed? Were the margins close or positive? If they were close, do I need more surgery?
What other tests should I have to see if the cancer has spread to other organs (such as liver, lungs and bones)?
How much time can I take to decide what type of treatment to have?
What do I need to consider now if I would like to have a child after I have been treated for breast cancer?
Will my tumor be saved? Where will it be stored? For how long? How can I/ future providers/clinical trials I might participate in access it in the future? For more information on breast pathology practices,
read the Susan G. Komen for the Cure® report.
Cancer Stages
- How does the stage of my cancer affect my treatment options?
- How does the stage of my cancer affect my chances for survival?
- Besides my cancer stage, what other factors should I know about that affect my treatment and prognosis?
Treatment-Surgery
Before Surgery
- Am I a candidate for lumpectomy (breast conserving surgery) plus radiation? Will chemotherapy or hormone therapy prior to surgery improve my chances of being able to have lumpectomy?
- Will you do a sentinel node biopsy? What is your experience with this procedure?
- How long will I be in the hospital?
- Will I need someone to help me when I return home from the hospital?
- How should I expect to feel after the surgery?
- What limits will I have on my normal activities? For how long?
- Where will the surgical scar(s) be?
- Will I have any numbness after the surgery?
- Will I have a surgical drain in place when I go home? If so, how will I care for it? When will it be removed?
- What side effects might I expect after surgery? What should I report to you right away?
- How does the removal of lymph nodes affect my chances of getting lymphedema?
- What are the risks of long-term complications or side effects from surgery?
- When should I return for follow-up?
- Will I need other treatments? If so, which one(s)? How long after surgery will I begin the other treatment(s)?
- How does my surgery affect my risk of having local recurrence, distant metastasis or a new breast cancer? Please explain the differences to me.
- Tell me about breast reconstruction. When do I have to do it if I decide I want it? What are the risks? What about prosthesis options? Who else should I see to discuss/plan for reconstruction or prosthesis?
- What do I need to consider before treatment if I would like to have a child after I have been treated for breast cancer?
- Does my insurance cover this surgery?
- Will my tumor be saved? Where will it be stored? For how long? How can it be accessed in the future? For more information on breast pathology practices, read the Susan G. Komen for the Cure® report.
After Surgery
- When will I be able to get back to my normal routine? Does this include work? Exercise? Ask about specific jobs or activities that you do.
- Are there any precautions I should take?
- Are there special exercises I should do? Which ones? How long should I do them? Should I see a physical therapist?
- Are there any exercises I should avoid?
- What problems should I report to you right away?
- Where can I find a support group for people with breast cancer (or cancer in general)?
- Should I continue to see my internist/general practitioner and gynecologist during my treatment?
- Who will be responsible for my follow-up care when treatment ends?
- How often should I return for an exam, other tests or X-rays?
- Do I need to meet with a medical and radiation oncologist? If not, why not?
- What do I need to consider if I would like to have a child after I have been treated for breast cancer?
- Will my tumor be saved? Where will it be stored? For how long? How can it be accessed in the future? For more information on breast pathology practices, read the Susan G. Komen for the Cure® report.
Treatment-Radiation Therapy
- Why are you recommending radiation therapy for me?
- How will radiation therapy affect my risk of having local recurrence, distant metastasis or a new breast cancer? Please explain the differences to me.
- How long will each treatment take? How many treatment sessions will I have?
- Can I come alone, or should a friend or relative come with me?
- What clothes should I wear to the therapy sessions?
- What side effects should I expect, and how long might they last? What symptoms need medical attention?
- Who do I call/contact if I have problems or questions about my treatment? What about on holidays or during the weekend?
- Can I wear a bra during the course of radiation treatment?
- What are the long-term risks of this treatment?
- What precautions should I take during treatment?
- What problems should I report to you?
- Can I continue normal activities? What activities should I avoid?
- Where can I find a support group for people with breast cancer (or cancer in general)?
- Should I continue to see my internist/general practitioner and gynecologist during my treatment?
- How often will I have check-ups and tests after treatment ends? Which provider will manage my care?
- Who will be responsible for my follow-up care when treatment ends?
- Will insurance cover my treatment?
- What do I need to consider before treatment if I would like to have a child after I have been treated for breast cancer?
Treatment-Chemotherapy
- Do you recommend chemotherapy for me? Why or why not?
- How will chemotherapy affect my risk of having local recurrence, distant metastasis or a new breast cancer? Please explain the differences to me.
- What was the hormone receptor status of my tumor? Was it estrogen receptor-positive or progesterone receptor-positive (ER+ or PR+)? How does this affect my treatment plan?
- What was the HER2/neu status of my tumor? How does my HER2/neu status affect my treatment plan?
- Was cancer found in the lymph nodes? How many of my nodes had cancer? How does this affect my treatment plan?
- Should I have chemotherapy even if my lymph nodes do not have cancer?
- Are there extra tests that could or should be done on my tumor to decide whether I should have chemotherapy, such as OncoType Dx?
- What chemotherapy drugs do you recommend? Why have you chosen these drugs for me?
- What are my estimated risks of recurrence and chance of survival with these drugs? How do these compare with those for other therapy options, including a plan without chemotherapy?
- What are the side effects and long-term risks of chemotherapy?
- Which side effects should I report to you right away?
- How and how often will the treatment be given? Will I need someone to come with me to the treatment sessions? Will someone need to drive me home?
- How long will each treatment take? How many treatments will I have?
- What medicines will you give me to help reduce the side effects of chemotherapy? How and when should I take them?
- Can I continue to work, exercise, etc. during these treatments? Are there special precautions I should take while on chemotherapy or afterwards?
- Can I have sex during chemotherapy?
- Are there any other medications or complementary therapies I should avoid during my treatment?
- Should I continue to see my internist/general practitioner and gynecologist during my treatment?
- Where can I find a support group for people living with breast cancer (or cancer in general)?
- Who will be responsible for my follow-up care once treatment ends?
- How often should I return for an exam, X-rays or other tests?
- Will the cost of treatment be covered by my health insurance?
- If I lose my hair during chemotherapy, where can I buy a wig? When should I do this? How do I get reimbursed from my insurance company?
- What do I need to consider before treatment if I would like to have a child after I have been treated for breast cancer?
Treatment-Hormone Therapies
- Do I need hormone therapy? Why or why not?
- What tests were done on my tumor? What were the estrogen receptor status and progesterone receptor status of my tumor? How do these affect my treatment plan?
- Which hormone therapy do you recommend for me and why?
- What is the hormone therapy supposed to do?
- How will hormone therapy affect my risk of having local recurrence, distant metastasis or a new breast cancer? Please explain the differences to me.
- What are the short- and long-term side effects of this hormone therapy?
- Is there a generic form of this hormone? Is it as effective as the name brand?
- How soon after surgery should the hormone therapy be started? How long will I be on the therapy?
- In what form and how often will the treatment be given? For how long?
- Will I be given the hormone therapy along with other forms of treatment?
- Will other tests or exams be needed? If so, which tests and how often will they be needed?
- Will I be given a baseline bone density test if I am to use aromatase inhibitors in my treatment plan? How will you follow my bone density status? What can be done to help reduce bone loss while taking aromatase inhibitors?
- What signs and symptoms should I report to you?
- Should I continue to see my internist/general practitioner and gynecologist during my treatment?
- Who will be responsible for my follow-up care once treatment ends?
- How often should I return for an exam, other tests or X-rays?
- Are the costs of the hormone therapy covered by my health insurance? If not, are there financial assistance programs that will help cover the costs?
- Where can I find a support group for people living with breast cancer (or cancer in general)?
- What do I need to consider before treatment if I would like to have a child after I have been treated for breast cancer?
- Will my tumor be saved? Where will it be stored? For how long? How can I/ future providers/clinical trials I might participate in access it in the future? For more information on breast pathology practices, read the Susan G. Komen for the Cure® report.
Treatment Options for LCIS
- Is LCIS breast cancer?
- What are my treatment options? Which therapies do you recommend for me and why?
- Should I consider taking tamoxifen or raloxifene?
- Is there a clinical trial enrolling people with LCIS? If so, how can I learn more?
- What will my long-term follow-up care be? Who will oversee that care?
- What are my chances of getting DCIS or invasive breast cancer?
Treatment Options for DCIS
- Is DCIS breast cancer? How does DCIS differ from invasive breast cancer?
- What are my treatment options? Which therapies do you recommend for me and why?
- What is my prognosis?
- Am I a candidate for lumpectomy (breast conserving surgery) with radiation therapy? When will the radiation oncologist discuss my radiation treatment with me?
- For those having mastectomy: Will I need radiation therapy? If I have radiation therapy, when will the radiation oncologist discuss my radiation treatment with me?
- For those having mastectomy: Can breast reconstruction be done at the time of surgery, as well as later? How much later can it be done? Can you refer me to a reconstructive surgeon?
- For those having mastectomy: If I choose not to have reconstruction, where can I get a prosthesis? Will my insurance cover the cost?
- What procedures will my insurance cover? (If you health care provider does not have this information, ask your insurance company directly.)
- Is there a clinical trial enrolling people with DCIS? If so, how can I learn more?
- Is my DCIS estrogen receptor-positive or -negative? Will hormone therapy be recommended for me? What are my choices of hormone therapy?
- Were my surgical margins clean?
- Will the tissue removed during surgery be saved? Where will it be stored? For how long? How can I, future providers and/or clinical trials I might participate in access it in the future? For more information on breast pathology practices, read the Susan G. Komen for the Cure® report.
- What is the plan for my long-term follow-up care? Who will oversee that?
- What are my chances for recurrence? For developing invasive cancer?
Treatment Options for Early Breast Cancer
- Will a sentinel node biopsy be done?
- What kind of tumor do I have? Estrogen/progesterone receptor positive/negative? HER2/neu positive/negative? How do these affect my treatment plan?
- What is my prognosis?
- What are my treatment options?
- Were my tumor margins clean? If not, what more will be done?
- What treatments are you recommending for me and why?
- Am I a candidate for lumpectomy (breast conserving surgery) plus radiation? Will chemotherapy or hormone therapy prior to surgery improve my chances of being able to have lumpectomy?
- If I have lumpectomy, will you refer me to a radiation oncologist to discuss radiation treatment?
- Can breast reconstruction be done at the time of the surgery, as well as later? How much later can it be done? Can you refer me to a reconstructive surgeon?
- If I choose not to have reconstruction, what types of prostheses are available? Where can I find them?
- Will I need other treatment after my surgery?
- How long do I have to make a treatment decision?
- What procedures will my insurance cover?
- Is there a clinical trial enrolling people with my type of breast cancer? If so, how can I learn more?
- What will my long-term follow up care be? Who will oversee that care?
- What do I need to consider before treatment if I would like to have a child after I have been treated for breast cancer?
- Will my tumor be saved? Where will it be stored? For how long? How can I/ future providers/clinical trials I might participate in access it in the future? For more information on breast pathology practices, read the Susan G. Komen® for the Cure report.
Treatment Options for Locally Advanced Breast Cancer
- Will a sentinel node biopsy be done?
- What kind of tumor do I have? Estrogen/progesterone receptor positive/negative? HER2/neu positive/negative?
- What are my treatment options? Which treatments do you recommend for me and why?
- Am I a candidate for lumpectomy (breast conserving surgery) plus radiation?
- When will I meet with a radiation oncologist to discuss radiation treatment?
- Can breast reconstruction be done at the time of the surgery, as well as later? How much later can it be done? Can you refer me to a reconstructive surgeon?
- If I choose not to have reconstruction, where can I find prostheses?
- Will I need other treatment after my surgery?
- How long do I have to make a treatment decision?
- What procedures will my insurance cover?
- Is there a clinical trial enrolling people with my type of breast cancer? If so, how can I learn more?
- What will my long-term follow-up care be? Who will oversee that?
- What do I need to consider before treatment if I would like to have a child after I have been treated for breast cancer?
- Will my tumor be saved? Where will it be stored? For how long? How can I/ future providers/clinical trials I might participate in access it in the future? Learn more about breast pathology practices.
Complementary Therapies
(For those who are currently using or considering using complementary therapies to ask their health care provider.)
- How do you feel about complementary therapies?
- What therapies have others with breast cancer found helpful?
- Have you ever referred someone to a CAM practitioner?
- What's the best way to find a certified CAM practitioner?
- I am using ______ (name therapies). Should I stop using/taking them during and/or after my treatment?
- Should I let you know before I start a complementary therapy? Which complementary therapies should I avoid and why?
- Is ______ (name therapy) safe? Is there research that shows it is safe? Will it interfere with my breast cancer treatment?
- Are there side effects with ______ (name therapy)?
- Is there a clinical trial studying ______ (name therapy)?
After Treatment
- Can you suggest a counselor or support group that can help me adjust to life after treatment?
- Can you suggest ways my spouse/partner and I can address issues related to our post-treatment sexual relationship or refer me to a psychologist or counselor who specializes in these issues?
- What do I need to consider if I would like to have a child?
- What is the best way for me to treat my menopausal symptoms?
- Tell me about lymphedema and my chances for getting it. What signs or symptoms of lymphedema should I watch for and tell you about?
- Which health care provider is in charge of my follow-up care?
- What is the schedule of follow-up visits?
- What symptoms, possibly related to my treatment or to my cancer, should I be aware of and discuss with you?
- Should my relatives or I consider genetic testing?
- What are the issues our family needs to think about when considering genetic testing?
- Which genetic counselor would you recommend who can help my family and me decide if genetic testing is right for us?
Updated 08/18/09
