10 Questions to Ask After Your Breast Biopsy

When your breast biopsy results in a diagnosis of cancer, you may be overwhelmed and are unsure where to even start. There are some key questions that are helpful to ask in order to have all the information necessary so you can make informed treatment decisions.

Here is a list of questions of some of the most important questions to ask after a breast biopsy. Since many people forget the questions once they're in the doctor's office, you may want to print this out and bring it with you the next time you see your doctor. You can also add other questions that come to mind. Far too often people forget to ask their most pressing questions if they depend on their memory alone. After all, it's difficult enough to think of everything you wanted to know, even when you don't have the emotions of a cancer diagnosis running through your head.

1
What Type of Breast Cancer Do I Have?

radiologist looking at a mammogram
What type of breast cancer do you have?. Ashraf Shazly / Stringer / Getty Images

Breast cancer is not just one disease. In addition, there are both invasive and preinvasive forms of the disease.

The first question to ask is whether your biopsy reveals cancer, precancerous cells, carcinoma in situ, or cells which do not appear to have cancerous changes (benign cells).

Cancers which have spread beyond what is known as the basement membrane are considered invasive or infiltrating breast cancer. This does not mean that a breast cancer has spread and stage 1 to stage 4 breast cancers are all considered "invasive." In contrast, non-invasive breast cancers are those which have not spread beyond the basement membrane and are referred to as carcinoma in situ or stage 0 breast cancer.

There are many types of breast cancer, and in fact, every breast cancer is different at a molecular level. But most breast cancers are broken down into one of four basic types:

2

mammotome
What size is your breast cancer?. Credit: BSIP / Contributor / Getty Images

Tumor size is an important part of staging breast cancer and it affects your treatment decisions. Breast imaging allows for an estimation of tumor size but the final measurements will be determined by a pathologist after the tumor is removed surgically.

In TNM staging of your tumor, the T represents the tumor size. Tumor sizes are broken down as follows:

  • T0: The cancer is confined to the breast ducts
  • T1: The tumor is less than 2 centimeters in diameter
  • T2: The tumor is between 2 centimeters and 5 centimeters in diameter
  • T3: The tumor is larger than 5 centimeters in diameter

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3
Is There Only One Tumor?

Mammography examination
How many tumors do you have? Sometimes second tumors are found on MRI or surgery. Credit: Media for Medical / Contributor / Getty Images

A mammogram is often the first test that shows an abnormality in one breast. Before treatment for breast cancer begins, both breasts should be carefully imaged to ensure that the diagnosis and plan for treatment is appropriate and comprehensive. Sometimes a breast MRI will be done to get a different kind of image of the breasts, which can sometimes find abnormalities missed on a mammogram.

4
What is the Grade of My Tumor?

Mammography examination
What is the grade of your breast cancer?. Credit: Media for Medical / Contributor / Getty Images

Tumor grade is a measure of how aggressive the cancer cells are behaving. A pathologist will examine the cancer cells for several characteristics, and give the tumor a grade of 1, 2 or 3, with 3 being the most aggressive and 1 being the least aggressive.

5
What Was My Proliferation Score (Ki-67)?

breast biopsy
What is the proliferation score on your breast biopsy?. Credit: BSIP / Contributor / Getty Images

If your cancer is high-grade, it may be given a Ki-67 tumor marker test.

Your score on this test helps predict the way your tumor will respond to chemotherapy and what your chances of recurrence after treatment may be.

6
What is My Cancer's Hormone Status?

breast tumor
What is the hormonal status of your breast cancer?. Credit: BSIP / Contributor / Getty Images

Most breast cancers are driven by estrogen, progesterone or both of those hormones. Understanding the test results is important, because this information affects your treatment as well as your follow-up care. If your hormone tests come back negative, you may have triple negative breast cancer for which new treatments are being developed.

7
What is My Her2/neu Status?

Herceptin, a drug for HER2/Neu positive breast cancer
Is your HER2/Neu status positive or negative?. Credit: Jeff J Mitchell / Staff / Getty Images

HER2 is a protein (a growth factor) found on the surface of some breast cancer cells in large amounts. Growth factors in the body can bind to these receptors telling the cell to grow and divide.

Just as treatments for estrogen receptor positive breast cancer can interfere with the growth of breast cancer cells to improve survival, HER2 targeted therapies can interfere with the ability of growth factors to interact with HER2 receptors and cause growth of a tumor.

8
Which Type of Surgery Do You Recommend? Why?

woman with breast cancer
What type of surgery should you have for your breast cancer? There are many factors which go into making this decision. Dominique Faget / Staff / Getty Images

Surgery will be done to remove as much of the cancer as possible. Discuss with your doctor whether you should have breast-conserving surgerys such as a lumpectomy or a mastectomy. Be sure to tell your doctor if you have a family history of breast cancer, as that may affect your choices.

Choosing between a mastectomy and lumpectomy is sometimes challenging, and their are advantages and disadvantages to each procedure. It's important to understand that this is a very personal decision, and what another women might choose is not necessarily the best choice for you.

9
Should I Have Chemotherapy Before Surgery?

woman with breast cancer in the hospital
Should you have chemotherapy before your breast cancer surgery?. Credit: Dominique Faget / Staff / Getty Images

In some cases, chemotherapy may be given before surgery to shrink the tumor. That might make the difference between a lumpectomy and a mastectomy.

You can also ask about whether or not you should have chemotherapy after surgery, but this recommendation could change based on findings during surgery such as whether or not you have any positive lymph nodes.

10
Are There Other Tests I Should Have Before Treatment?

mammogram
Are there any further tests you need after your breast biopsy?. Credit: BSIP / Contributor / Getty Images

Some tests may determine which treatments will most effectively kill your cancer and prevent recurrence. Other tests may be needed to check on the health of your major organs and bones.

It can be overwhelming just facing the primary treatments for breast cancer, but it's important to follow up on other recommended tests as well. For example, heart tests may be recommended if you will be having a type of chemotherapy which can affect your heart, and a bone density test may be recommended if you will be taking a hormonal therapy which can increase the risk of osteoporosis.  

Even if these tests feel like so much extra to cope with while wanting to get on with treatment, they can be very important. In some cases, they can help you and your doctor choose the best treatment options for you specifically.

As a final note, the best thing you can do to make your treatment as successful as possible is to be your own advocate in your care. Check out these tips on being your own advocate in your cancer care.

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