Cracking the Code: Breast Cancer Vocabulary for the Initial Visit

PJ Hamel Health Guide
  • Does it sound like your oncologist is speaking a foreign language? Here's a layman’s guide to breast cancer’s confusing vocabulary.

    Part I: The Initial Visit.

    You’ve been through the mammogram and the biopsy, and been told you have cancer. Get ready for a whole new vocabulary! I’ll bet your initial meeting with the doctor or radiologist went something like this:

    “Well, it looks like your primary tumor is about 1 1/2 centimeters, which means you’re a prime candidate for a lumpectomy. If we can’t get clean margins, you’ll want to consider mastectomy, and possibly reconstruction. Once we get the report from the pathologist, we can stage your cancer, which will help determine if you need radiation or chemo. I’ll be your oncologist. Dr. Jones is your radiation oncologist, and you’ve already met with your surgical oncologist. Any questions?”

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    “Any questions?! How about, I only understood about half of what you just said!” When you’re having trouble with the basic vocabulary, it’s hard to hear the message. The following terms are some you may hear during the visit or phone call where you get the news: it’s cancer.

    Centimeters and millimeters: Well, gosh, couldn’t they just tell us the size of the tumor in inches? A millimeter is 1/10 of a centimeter, and roughly speaking, a centimeter is about 1/3 of an inch. So a 2-centimeter tumor (written 2cm, if you happen to see your pathology report) is about 2/3 of an inch in diameter. A 2-millimeter (2mm) tumor would be about 1/16 of an inch in diameter.

    Chemotherapy: This is the use of drugs to destroy cancer cells. Often abbreviated to just plain chemo, it’s a term that strikes dread into many a heart. But don’t imagine the worst: chemo has come a long way in a short number of years, and it can be a much less unhappy experience than it used to be. Pharmacology changes and improves all the time, both in what drugs they give you to kill cancer, and in what you take to dispel the side effects. Your best friend’s experience of a year ago won’t be your experience today. Read Chemotherapy 101 for an idea of what to expect.

    Lumpectomy: In a lumpectomy, the tumor is removed, but the rest of the breast is preserved. The surgeon will search for “clean margins” when doing a lumpectomy; in other words, he’ll try to make sure there are no remaining cancer cells in the breast tissue that surrounded the removed tumor. You may have to go back into surgery a few times before you get clean margins; don’t let the stress get to you! The surgeon is doing her job, making as sure as possible there are no cancer cells remaining while also preserving as much of your breast as she can.

    Mastectomy: Removal of the entire breast via surgery is called a mastectomy. If possible and desirable (for instance, if you’re having reconstruction or an implant), the surgeon removes just the breast tissue, preserving the skin. This is called a skin-sparing mastectomy.

    Oncologist–medical, radiation, and surgical: A medical oncologist is a doctor who specializes in the treatment of cancer. Usually your medical oncologist is the one you see for regular, long-term appointments. If you receive radiation therapy, the radiation oncologist is the doctor who determines how, where, and when it’s delivered; the radiation techs are the folks who actually position you on the table, head into the next room, and push the buttons that deliver the treatment. (They’re kind of like the Wizard of Oz–behind the curtain.) A surgical oncologist specializes in cancer surgery; he or she is the one who will remove the tumor(s) from your breast. If you’re having reconstruction, a plastic surgeon will take over from the surgical oncologist to rebuild your breast.

  • Pathologist: This is the doctor who’ll examine the cells in your tumor microscopically, to help determine your treatment. Usually, you don’t meet the pathologist.

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    Primary tumor: The main or largest tumor in your breast–the primary tumor–is the one identified on the mammogram, the one biopsied, and the one the surgeon will remove. Secondary (smaller) tumors may be discovered along the way, but this is the one that got you started down the path.

    Radiation therapy (commonly abbreviated to just “radiation”): Often prescribed as a follow-up to a lumpectomy, radiation is the delivery of X-rays or radioactive materials to the breast area to destroy any remaining cancer cells.

    Stages of cancer: Cancer is “staged” from 0 to 4, with 0 being the least advanced, 4 the most. A number of factors will be used to stage your cancer, which in turn will determine the most effective treatment. Ask your oncologist to explain how he or she arrived at your stage number.


    Next: Breast Cancer's Confusing Vocabulary: the Follow-Up Visit

Published On: September 05, 2006