So, you’ve just been told you have breast cancer. The stress of hearing the words "You have cancer" is bad enough. Now try learning a whole new vocabulary immediately In hopes that you won’t be TOO confused, here are some words and terms you’ll probably hear (and will definitely want to understand) over the next few weeks:
Adjuvant therapy: You’ll hear this used frequently once you’ve had your surgery. It simply means all the other treatments you might have other than surgery, including radiation, chemotherapy, and hormone drug therapy. When you hear "adjuvant therapy," think "What I’ll have other than the lumpectomy or mastectomy."
Centimeter and millimeter: Tumors are always measured in the metric system. The doctor who gives you your diagnosis will tell you your tumor is "5 centimeters" or "8 millimeters.“ A centimeter is about 1/3 of an inch. A millimeter is about HALF of 1/16 of an inch” in other words, pretty darn small. You’ll have to do a bit of math in your head, but it’s worth it to be able to visualize just what size that tumor really is.
Lumpectomy, a.k.a. breast conservation surgery: This is a surgery where only your tumor and some surrounding breast tissue is removed. It’s generally same-day surgery; you’ll be in and out in several hours, and back home the same day.
Lymph nodes: These are tiny, bean-shaped filters in your body that collect bacteria, waste products, and other unwanted materials. They also collect cancer cells. When you have breast cancer, the lymph nodes under your arm those closest to the cancer will be examined to see if they contain any cancer cells. If they do, the doctor will know the cancer has spread outside your breast, and your treatment will therefore probably be more involved.
Mastectomy: The removal of your entire breast. You’ll have a mastectomy if the tumor is too large for a lumpectomy, or if a number of small tumors make a lumpectomy unfeasible. You may also choose to have a mastectomy rather than a lumpectomy, if you feel it’ll set your mind at ease. Cancer may recur in the same breast if you’ve had a lumpectomy; with a mastectomy, since all the breast tissue is gone, your chance of a same-breast recurrence is practically nil.
Oncologist: This is a doctor who specializes in cancer treatment. You’ll become VERY familiar with your oncologist: (s)he’ll supervise your treatment, and then continue to see you for regular checkups. It helps to have an oncologist you like and trust; if you don’t feel you’re striking up a good relationship with your oncologist, you might think about asking for a different one, because you’ll be dealing with this person for years.
Pathologist: This is the doctor who examines your tumor and lymph nodes under the microscope, and gives your oncologist LOTS of information about your particular cancer, based on the tumor. The pathologist determines the exact size of your tumor; its grade, type, and stage, all of which help determine the seriousness of your cancer; hormone sensitivity (which helps establish whether or not you’ll take long-term drugs after treatment, and what kind of drugs); and whether the cancer has spread to your lymph nodes.
Radiologist, radiation oncologist, and radiation: People often confuse the terms "radiologist" and "radiation oncologist." A radiologist is someone who creates and interprets pictures of areas inside the body: e.g., the person who reads and interprets your mammogram. A radiation oncologist is the doctor who supervises your radiation treatment, if you have it. Radiation is treatment with high-energy rays that destroy any cancer cells left in the breast area after surgery. It’s most often given to women who’ve had a lumpectomy, although sometimes women who’ve had a mastectomy also have radiation, especially if the cancer has spread to the lymph nodes.
Reconstruction: How the plastic surgeon rebuilds your breast after a lumpectomy or mastectomy. Not all women who have surgery also have reconstruction; in fact, most women who have a lumpectomy won’t need any reconstruction. You may also choose not to have reconstruction, even with a mastectomy; alternatives are to simply remain flat, or wear a pad in your bra (called a prosthesis). Types of reconstruction include implants (saline or silicone); or "autologous:" reconstruction done using other parts of your body, usually fat and muscle from your abdomen ("tram flap") or back ("lat flap").
Type and stage: These are two things you’ll never forget about your breast cancer. Your oncolgist will tell you right away what type and stage of breast cancer you have; they’re the way you’ll communicate your personal brand of cancer to other survivors. It’s the universal first topic when you’re striking up one of those waiting-room conversations: "What type do you have? What stage?"
"Type" refers to what kind of breast cancer you have, which is turn is based on what part of your breast is involved, and how far along the cancer is. DCIS (ductal carcinoma in situ) is a "type" of breast cancer: cancer of the milk ducts that hasn’t spread into your regular breast tissue. (This is a "good" type of cancer, in that it’s considered about 99% curable.) Inflammatory breast cancer (cancer involving the lymph system) is another type, as are IDC (invasive ductal carcinoma), and ILC (invasive lobular carcinoma).
"Stage" is one of the main factors that dictates your treatment. It’s based on the following: size of tumor; lymph node involvement; and spread of cancer outside the breast. Stage can range from 0 to 4, with 0 the least serious, 4 the most. A typical stage might be "II-a" (for some reason, the stage is always given in Roman numerals). Stage is often what determines whether or not you’ll have chemotherapy. It’s also a broad indicator of how serious your cancer is.
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.