Many patients ask how they know if they are getting the appropriate treatment for their breast cancer. No two patients are alike and therefore treatment decisions are based upon your unique situation and the type of cancer you have. This is one reason why it is important to get a second opinion on your pathology diagnosis since all of your treatment decisions are based upon that diagnosis. Many patients also choose to get a second opinion from a specialized breast surgeon, medical oncologist, or radiation oncologist to determine what type of treatment options are best suited to them.

Here’s an example of two patients who both have “breast cancer”: One is a patient with a small focus (say 4 mm) of low grade ductal carcinoma in situ without necrosis. She may only have a surgical biopsy to get adequate margins and may or may not get radiation therapy or subsequent endocrine therapy based upon the characteristics of her cancer. The second patient has a 1.2 cm invasive carcinoma and may require a larger surgical biopsy, and her doctor may recommend she receive chemotherapy/endocrine therapy and radiation therapy to her breast. Both patients could also opt for mastectomy and radiation therapy may then be skipped in both cases.

So it’s all about the stage and pathologic characteristics of your cancer, such as the grade, the status of your lymph nodes, whether your cancer is estrogen and progesterone receptor positive, and whether it over-expresses HER2.  All of these things and more play into the decision-making process. No two cancers are alike and breast cancer doctors try to tailor their treatment to you and the uniqueness of your cancer.

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