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 focussed. To help one achieve a sense of control and support, the Carol Ann Read Breast Health Center provides the following assistance and information.

Breast Cancer Notebook

View the Breast Cancer Notebook - Sutter Health website

The information in this notebook was developed by cancer specialists and educators from Alta Bates Summit Medical Center and others throughout the Sutter Health family. The notebook represents our combined and in depth experience of caring for thousands of women with breast cancer across Northern California. The more you know about breast cancer and your treatment options, the better prepared you will be to make informed decisions that are right for you.

We encourage you to use the notebook as a place to organize your thoughts and record questions to discuss with your health care team. We hope the notebook helps you through your journey.

The COMPASS Program

"COMpassionate Peer Advocacy Support Services For Newly Diagnosed Breast Cancer Patients"
The COMPASS program provides direction at this time of great need by offering a "compass" to help women find direction through the support of peer navigators. The definition of a "navigator" in this program is specifically someone who has been through a similar experience with breast cancer, either themselves or with someone close to them, and is at least one year away from treatment. The COMPASS Program helps newly diagnosed patients direct precious energy towards understanding as much as possible about the disease and medical terminology, boost their immune system, and become free to concentrate on their wellness strategies.

The services provided by the COMPASS volunteer navigators are focus on providing compassionate listening, advocacy through the medical system, and emotional support based on the navigator’s own experience. Navigators do not make decisions for the patient, but they help them gather the information they need to make their own decisions. Navigators also connect patients to other Alta Bates Summit Medical Center services, providing assistance and acting as a liaison as needed.

Patient referrals to the COMPASS Program come from physicians, medical office staffs, and patient self-referrals. All patients are contacted by the Breast Health Center Managers to assess their patient/family needs. Thanks to a generous donation from the Orinda 9 Tees of the Orinda Country Club, there is no charge for this program. To learn more, call the Carol Ann Read Breast Health Center at (510) 869-8735.

What Our COMPASS Guides Say
"I gain as much from this program as the women that I am assisting." - Barbara R.

"The support has been mutual, as I find myself looking forward to talking to the women that I am matched with -- they listen to my story more than I expected them to want to hear. We have instant credibility having faced the same diagnosis. There are questions like, 'Did you feel like this?' or 'When did you...?' There is great value in trying to pair people with a guide with similiar clinical and demographic background." - Jett S.

Understanding Your Pathology Report

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.

The pathology report describes the sample in great detail and includes:

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.