Finding peace and confidence after a breast cancer diagnosis: The gift of a tumor review board

By Donna Dwire, RN, CBCN Dec 14, 2016


Often times, we have friends with the greatest intentions, but when it comes to their style of encouragement and support after a diagnosis of breast cancer, they heighten your anxiety or deflate your confidence in your current cancer treatment plan. That’s why it is important for you to understand your cancer diagnosis report, also called a pathology report, and its details.

As a navigator, I aim to help patients understand the “ingredients” to their cancer treatment “recipe.” Did you know there are over a dozen different types of breast cancer? In addition, there are several different types of treatments utilized to fight breast cancer. To add another layer of complexity, not all patient’s “recipes” require all forms of treatment, i.e. surgery, chemotherapy, radiation and anti-hormonal therapy and medication. The order of the treatments offered is often rearranged from one patient to the next. If you think it sounds complicated, that’s because it is!

So why all the confusion?

The process has many variables with no two cases exactly alike. Your surgeon or medical oncologist will look through your pathology report to determine your unique “ingredients,” such as location of the tumor, tumor size, grade of the lesion (which is different than stage), whether or not the lymph nodes are involved, or if any other organs or areas look involved. Your physician will complete a breast exam to see if the lesion is attached to the skin or chest wall, noting the size of the mass, including its location and size in relation to the overall breast itself, which may change choices available for surgery. When this is all multiplied together — as teachers taught us in 5th grade math — it makes for a lot of different possibilities.

So when your best friend comes up and proclaims, “I had breast cancer, so why aren’t they doing this test for you too?” or “Aren’t you worried they haven’t offered you that treatment?,” take a step back and understand conversations like these with friends and family happen frequently but are often misleading. These conversations can send any newly diagnosed person into a tailspin of worry and doubt. Sigh! Remember, your physician and medical team know what they are doing! They are choosing the program that is best for you and your needs.

Here at Sanford, we also have a multidisciplinary tumor board, which meets weekly to review the prior week’s newly diagnosed cancer cases. Experts in attendance at this meeting include surgeons, oncologists, radiation oncologists, radiologists, geneticists, nurse navigators and research staff. They review the images, pathology and plan of treatment discussed by the physician and patient. Then, they evaluate if there is anything else to be considered, offered or tested for a thorough workup. It’s like having the best of a second, third and/or fourth opinion.

For me, as a cancer survivor, the tumor board gave me a lot of confidence and better prepared me for when my neighbor asked me, “Why aren’t they doing more scans or tests on you? You need X, Y, or Z done at least!” Whew, I was glad I had a team approach for my cancer care! I slept a lot better knowing I had the input of many specialists involved, assuring me we were all on the right path. Such a gift!