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Newly Diagnosed with Breast Cancer

A diagnosis of breast cancer calls for sudden decision making, learning an overwhelming amount of new information at a rapid rate, new concepts and unfamiliar medical language. Few people can think clearly when experiencing strong emotions such as anxiety, fear, sorrow or anger.

However, the time surrounding a new diagnosis is exactly when a person would want to be their sharpest and most focused. To help one achieve a sense of control and support, the Carol Ann Read Breast Health Center provides the following assistance and information.

Pathology Reports
Patient Navigator
COMPASS Program

Pathology Reports

When a sample of your breast tissue is removed during a needle biopsy or during surgery, a pathologist will examine it thoroughly. A pathologist is a doctor that examines tissue and cells under a microscope and writes a report to let your doctor know if the cells are cancerous, and provides a detailed description of the sample.

This report is intended to be read by your doctor, so it is quite comprehensive and written in medical language. If the surgeon wants to have the tissue examined while you are in the operating room, it is called a "frozen section." Some preliminary observations can be reported at this time, but to get a more extensive review, the specimen must be "permanently fixed" which can take 24 hours.

The written report usually takes three days to reach your doctor. This is an estimate. Often the pathologist will wish to use special stains or a new section of the tissue which can take additional days. The time needed for an accurate diagnosis does not affect your treatment. At our center, any tissue which may be cancerous will be reviewed by a second pathologist to confirm the diagnosis.

A dedicated breast pathologist will indicate if your diagnosis is benign or malignant. If it is malignant, the following details will be included in your diagnosis. The pathology report describes the sample in great detail and includes the terms below.

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Definition of Terms Used in Pathology Reports*

Term	Definition
Gross Description	A description of what the sample looks like to the naked eye.
Microscopic Description	A description of what the sample looks like under a microscope and a biological evaluation. If the sample does happen to be cancerous, it will contain information about the size of the cancer, the extent of the disease, and the exact type of the tumor.
Size	The classification of the specimen in terms of size.
Invasive vs. Non-Invasive	Once a cancer cell has broken through the membrane of either a duct or lobule, it is considered to be invasive. Non-invasive cancer is considered in situ because it has stayed in the duct or lobule. Non-invasive cancer cannot spread to your lymph nodes.
Histopathologic Grade	This indicates the type of cancer, the arrangement of the cells and how aggressive the cancer is.
Surgical Margins	The pathologist marks the edges of the sample with ink before cutting it so that when it is examined under the microscope, the closeness of the cancer to the edges of the sample can be measured. This tells the surgeon how close the cancerous cells are to the inked border. Sometimes if the margin is too close to a cancer, more surgery may be needed.
Lymph Node Status	Tumor cells can travel to other parts of the body through lymph nodes and vessels. During surgery, the doctor may remove some of the lymph nodes and vessels to see if the cancer has spread. This part of the report indicates how many lymph nodes were removed and whether cancer cells were found.
Hormone Receptor Status	Breast cancer cells can have a high number of estrogen and/or progesterone receptors. If your cells have a higher rate of estrogen receptors it is considered ER positive, while progesterone receptors would be PR positive. If the receptors are low in number, the cancer is considered ER or PR negative. This is an indication to your doctor which therapies will be more effective.
HER2NEU Status	This can be measured in two ways and indicates how sensitive the cancer cells are to a particular growth factor, possibly speeding up their growth. This is reported as a positive or negative attribute and can help identify which therapy will best affect the biology of your cancer cell type.
Lymphovascular Invasion	Cancerous cells can penetrate the blood vessels and/or lymph channels. The rate at which this is occurring can indicate the proliferation of the cancer cells.
Summary and Diagnosis	Just like it sounds, this is the condensed version of the preceding evaluation, which will be reviewed by your doctor.

* Medical terminology can be overwhelming, so ask your doctor to review your Pathology Report with you. Different institutions use different formats for the report, and sometimes the information can be confusing. Remember that each cancer is different. The pathology report is a personalized description from which future treatments will be based on - including any other clinical information about your general health.

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Patient Navigator

What is a Navigator?

At the Carol Ann Read Breast Health Center our patient navigators are a professional nurse or social worker who has experience working with people with breast cancer and who understands how challenging the journey can be.

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How does a navigator help women with breast cancer?

The Breast Cancer Navigator provides individualized assistance to women with breast cancer and their families so that they are able to understand their diagnosis, determine a treatment plan with their physicians, and receive the support services and resources they need.

Navigators educate, support, advocate for, and guide women with cancer. They also provide information and referrals for cancer resources and community support services. By providing this information and assistance, navigators help women overcome roadblocks to diagnosis and treatment.

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A Breast Navigator Assists Women by:

Helping women learn about treatment options
Providing information and referrals to community services
Providing information about clinical trials
Referring to organizations that can provide financial assistance
Providing information about transportation options
Translating medical terms

How can a Breast Cancer Navigator help me?

Our culturally supportive program includes navigators who speak and read Mandarin, Cantonese, Spanish and Korean. Our multicultural navigator team locates medical and emotional support resources to help you understand your treatment plans, on-site support groups, workshops, classes and breast cancer forums. Their services are provided free of charge.

Tammy Schacher, RN (English)
Mae Cheng, RN (Cantonese/Mandarin)
Alma Loos, (Spanish )
Clara Song, MSW (Korean)

Call 510-655-4000, ext 3638, to talk with a Navigator on the phone or to arrange a time to meet in person.

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COMPASS Program

Have you recently been diagnosed with breast cancer?

There is someone waiting to be your advocate and support person on this journey.

A COMPASS Guide is someone who has been through a similar experience with breast cancer, either themselves or with someone close to them. They can help you navigate the paths you will travel, provide emotional support, and answer questions that you may have. A COMPASS Guide has had this experience herself and knows what it feels like to be in your place. Every member of the COMPASS program is someone who has been through a similar experience with breast cancer and has ended treatment more than a year ago.

COMPASS Guides can provide: compassionate listening; advocacy through the system of medical services; and emotional support based on the guide’s personal experience. Women who are newly diagnosed with breast cancer can contact the COMPASS Program directly or their doctor can refer them to the program. The COMPASS program is here to support you.

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Contact:

If you are interested, please contact: Tammy Schacher, RN at 510-655-4000, ext 3638
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