Many people feel intimidated in the health care provider's office - they are not sure what questions to ask, or forget their questions when they are ready to ask them. The following questions will remind you of important questions to ask your health care provider.
Ask a family member or friend to go with you to the health care provider, to take notes, ask more questions and help you recall what was said. When printed, these pages provide room to take notes. Take them along with you and bring a pen. Writing down the answers to your questions allows you to read and think about them later. Feel free to add or delete questions depending on your own situation.
Note: On line: you should be able to print this Web page as several hard copy pages directly from your Web browser, or you can copy and paste needed sections into a text document.
Questions covered....
When going for a mammogram
Screening mammograms (breast x-rays) are for women who are not having any breast problems. The mammogram is able to find breast cancer two years before it reaches the size that can be felt in the breast. A woman should begin screening mammography by age 40. Between ages 40 and 49, she should have a screening mammogram every one to two years and yearly from age 50. A diagnostic mammogram is used to further evaluate a woman with a breast problem or an abnormal finding on a screening mammogram.
Answers to the following questions will help you understand the mammograph procedure.
Q. Is there anything I should do to prepare for my mammogram? (For example, wear a two-piece outfit, do not apply creams and deodorants and schedule the mammogram when the breasts are least sensitive, after your period is over.)
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Q. What will the mammogram show?
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Q. Who gets the report of my mammogram? Can it also be sent to other health care providers who treat me?
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Q. How long does it usually take to receive the mammography report and who will notify me of the results.? (Do not assume no callfrom your health care provider's office means everything is OK. In most cases one should have the results within 10 working days.)
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Q. What is the next step if a problem is discovered on my mammogram?
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Q. Will the mammogram be covered by my health insurance? (Medicare pays for screening mammograms every two years.)
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Q. Are the machines specifically designed for mammography? (Note: These are called dedicatedmammography machines. Do not choose a facility that uses a machine that also takes x-rays of the bones and other parts of the body?)
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Q. Is the person who provides the mammogram a registered technologist?
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Q. Is the radiologist who reads the mammograms specially trained to do so?
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Q. Does the facility provide mammograms as part of its regular practice? (Note: The American College of Radiology suggests choosing a facility that performs at least 10 mammograms a week.)
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Q. Is the mammography machine calibrated at least once a year?
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If you find a lump in your breast
If you find a change in the normal look or feel of your breast during breast self-examination, see your health care provider.
Answers to the following questions will help you understand other tests that may be necessary to diagnose a breast problem.
Q. Will you refer me for a mammogram? When would ultrasound be recommended?
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Q. Can this lump be aspirated (fluid or cells removed with a needle)?
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Q. If further tests and/or treatment are needed, will you refer me to a doctor who specializes in breast problems?
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Q. What non-cancerous conditions can cause breast lumps?
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About breast biopsy
With a surgical biopsy the suspicious area or lump is removed in part or entirely. This may be done in an outpatient setting.
Answers to the following questions will help you understand the procedures involved.
Q. What type of biopsy will I have? Will the entire lump be removed or just part of it? Is a core needle biopsy using either mammography or ultrasound an option?
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Q. Can the lump be aspirated (the fluid drained or a small number of cells removed) with a needle? How reliable is the needle biopsy?
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Q. How long will the biopsy or aspiration take?
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Q. Can the biopsy be done on an outpatient basis? Will I be awake and what will I feel during the procedure?
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Q. How visible will the biopsy scar be?
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Q. Are there any after effects of a biopsy? If so, what are they? (For example, tenderness, pain, skin indentation.)
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Q. When will I be able to return to my normal routine?
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Q. After the biopsy, how soon will I know the results?
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Q. If cancer is found, who will talk with me about treatment and when must I make a decision on treatment choice?
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When breast cancer is diagnosed
The biopsy will show whether the suspicious area or lump is cancerous or not. Tests are also performed on the tissue to determine if the cancer has spread (metastasized) and the risk of recurrence (the cancer returning).
Answers to these questions will help you understand your diagnosis.
Q. What did my biopsy or needle aspiration show?
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Q. What kind of breast cancer do I have? What is the stage of my disease? What is the size of the tumor? Has the cancer spread (metastasized)?
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Q. What tests were done on the tumor and what were the results? (estrogen and progesterone receptor assays, DNA analysis, S-phase fraction). What effect will the results of these tests have on my treatment options?
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Q. Will the lymph nodes under my arm be checked for cancer? If so, how will this effect my treatment options?
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Q. What tests will I have before surgery to see if the cancer has spread to any other organs (liver, lungs, bones)?
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About treatment choices
In deciding the best treatment plan for a woman with breast cancer, several key factors are examined. These include the size of the tumor, type of cancer, whether the cancer is the underarm lymph nodes, and whether it has spread (metastasized) beyond the breast into such organs as the lungs, liver, brain, or bone.
Answers to these questions will help you determine the best treatment for you.
Q. What are my treatment options? What is the procedure you are recommending for me and why?
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Q. What is your opinion about breast-conserving surgery (lumpectomy) followed by radiation therapy? Am I a candidate for this type of treatment? (Anyone considering this option should also consult with a radiation oncologist.)
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Q. Will I need additional (adjuvant) treatment (radiation therapy, chemotherapy, and/or hormonal therapy) following my surgery? If so, can you refer me to a radiation oncologist for radiation therapy or a medical oncologist for chemotherapy or hormonal therapy?
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Q. Can breast reconstruction be done at the time of the surgery, as well as later? Can you refer me to a reconstructive surgeon?
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Q. If I choose not to have reconstruction, what types of breast prostheses are available?
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Q. How long do I have to make a treatment decision? What will my insurance cover?
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Q. Is there a clinical trial that is enrolling patients with my type of breast cancer? (Clinical trials are research studies that evaluate new treatments and are based on past studies). If so, how can I learn more?
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About reconstructive breast surgery
Reconstruction is an important option offered to women to rebuild the breast and nipple are
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It can be done at the time of the initial surgery (immediate reconstruction) or months to years later (delayed reconstruction). A woman considering reconstruction should consult with a reconstructive surgeon and also discuss the option with her surgeon prior to her breast surgery.
Answers to these questions will help you understand reconstructive surgery.
Q. What are the types of reconstructive surgery? What will my insurance cover?
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Q. What type is best for me and why?
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Q. What chance is there of infection and/or rejection of an implant device? Are there any other risks or side effects to consider?
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Q. When is the best time for me to have reconstruction - immediate or delayed reconstruction?
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Answers to these questions will help you prepare for your reconstruction and follow-up.
Q. How many operations are needed? How long of a hospital stay is necessary for each? How much time is needed for recovery after each? Are there any medications to avoid before surgery?
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Q. Is there much pain after surgery and what body changes, such as swelling, may I experience following surgery and for how long?
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Q. How can I expect the reconstructed breast to look and feel? How will it compare in appearance with my healthy breast? Will anything need to be done to the healthy breast?
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Q. Will I be able to detect a possible recurrence after reconstructive surgery?
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Q. If I do not choose reconstruction, what prostheses, or breast forms, are available and where do I purchase them?
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Before breast surgery
The type of surgical procedure will depend on the stage of the cancer, the type of tumor, the age and physical state of the woman, the woman's preference, and the health care provider's recommendation. Surgery is a form of local treatment for breast cancer.
Answers to these questions will help you prepare for your surgery.
Q. How long will I be in the hospital? Will I need someone to help me when I return home from the hospital?
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Q. How should I expect to feel after the operation? What restrictions will I have on my normal activities?
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Q. Where will the surgical scar(s) be? Will I experience any change in sensation following the surgery?
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Q. Will I have a surgical drain in place when I go home, and if so, how will I care for it? When will it be removed?
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After breast surgery
Following breast cancer surgery it is important that a woman continue to play an active role in her recovery process. This includes both her physical and psychological well-being.
Answers to these questions will help you play an active role in your revovery.
Q. When will I be able to get back to my normal routine?
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Q. Are there any precautions I should take? (For example, if lymph nodes were removed, should I avoid having an injection in that arm or shaving under that arm?) How does the removal of some lymph nodes affect my chances of developing lymphedema?
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Q. Are there special exercises I should be doing? What type do you recommend? How long should I continue them? Are there any exercises/activities that I should avoid?
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Q. What problems, specifically, should I report to you?
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Q. Where can I find a breast cancer or cancer support group? Is it led by qualified professionals? (Frequently it is very helpful for a woman and/or her family members to talk with others who have had similar experiences. Select a group led by professional facilitators with the credentials and knowledge of cancer and group dynamics.)
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Answers to these questions will help you prepare for follow-up visits to the health care provider.
Q. Once treatment is completed, who will be responsible for my follow-up care?
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Q. How often should I return for an exam? For lab tests or x-rays? What tests will be done at these times?
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Q. What will the tests tell me?
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About lymphedema (swelling of the arm)
Lymphedema is a build-up of lymphatic fluid causing swelling of the arm. The removal of some or all of the lymph nodes and radiation to the underarm area increase the chance of having lymphedema. It may occur years after your initial breast cancer surgery. Infection and injury to the arm or hand on the same side as the surgery are generally the initial factors causing lymphedema. Therefore is it very important to take steps for the prevention and early detection of lymphedema.
Answers to these questions will help you understand lymphedema.
Q. What are my chances of developing lymphedema?
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Q. If I develop lymphedema, will I be more likely to develop it again?
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Q. Should I keep track of my arm measurements? How will I know if the swelling is caused by the surgery or if it is lymphedema?
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Answers to these questions will tell you what to do to avoid lymphedem
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Q. Will having an injection or blood pressure taken on the affected arm now or years later make a difference?
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Q. What else can I do to avoid lymphedema? (For example, using sunscreen, insect repellent, and garden gloves.)
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Q. If I do get a cut, burn, or insect bite on my affected arm, what can I do to protect myself?
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Answers to these questions will help you understand the treatment for lymphedema.
Q. What is the first step in treating lymphedema?
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Q. Should I wear a compression sleeve? Do I have to wear it at all times, even at night?
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Q. When are manual lymph drainage (MLD) or compression pumps used to treat lymphedema? Explain how these treatments work?
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About radiation therapy
Radiation therapy is a form of local cancer treatment that uses high energy x-rays to destroy cancer cells. It is generally given after a lumpectomy or partial mastectomy to destroy any cancer cells that may be left after the lumpectomy. Radiation therapy may also be used as adjuvant therapy (additional) to help control cancer cells left in the lymph nodes or surrounding tissues.
Answers to these questions will help you understand the reason for radiation therapy and help you prepare for the treatment.
Q. Why is radiation therapy being recommended? Will other therapies be needed?
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Q. How long will each treatment take? How many treatments will I have? How soon should treatment begin?
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Q. Who will be responsible for my radiation treatments? Who will administer them and where?
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Q. Can I come alone or should a friend or relative accompany me?
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Q. What can I do to prepare for my treatment? (For example, wear a two-piece outfit.)
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Answers to these questions will help you prepare for the treatment's effects on your lifestyle.
Q. What side effects may I expect and how long might they last?
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Q. What are the long-term risks of this treatment?
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Q. What are the precautions or restrictions during treatment? After treatment? (For example, skin creams, lotion, underarm shaving, etc.)
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Q. Can I continue normal activities (work, sex, sports, etc.) during treatment? After treatment?
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Q. Will the costs of the treatment be covered by my health insurance?
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Q. How often are checkups and tests required after treatment is completed and which specialist will manage my care?
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About hormone therapy
Hormones can promote the growth of a breast cancer if the cells rely on hormones to grow. Hormone therapy uses other hormones to prevent the growth of hormone-dependent tumors. One of the most common hormone therapy drugs used to treat both primary and metastatic breast cancer is tamoxifen (generic name).
Answers to these questions will help you understand the hormone treatment.
Q. Which hormones are you recommending for me and why?
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Q. What are the hormones supposed to do?
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Q. What are the short and long-term side effects of this hormone treatment?
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Q. Is there a generic form of this hormone? Is it as effective as the name-brand?
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Answers to these questions will help you prepare for the treatment itself.
Q. How soon after surgery should the hormone therapy be started? How long will I be taking the hormones?
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Q. In what form and how often will the treatment be given?
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Q. Will I be given the hormone therapy along with other forms of treatment?
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Q. Are the costs of the hormone treatment covered by my health insurance?
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About breast cancer chemotherapy
Chemotherapy is the use of chemicals (drugs) designed to destroy cancer cells. It is generally given as adjuvant (additional) therapy following surgery (primary therapy) to reduce the risk of recurrence and prolong one's survival. In some cases it is given before surgery (neoadjuvant therapy).
Answers to these questions will help you understand the reason for chemotherapy.
Q. Why is chemotherapy recommended for me?
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Q. What is the significance of cancer found in the lymph nodes? How many lymph nodes do I have under my arm and how many are involved (have cancer cells in them)?
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Q. If my lymph nodes are not involved, should chemotherapy or hormone therapy still be considered?
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Answers to these questions will help you understand the drugs involved and their effects.
Q. What drugs will I be taking? Why have you chosen these particular drugs for me?
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Q. What are the possible side effects of this type of chemotherapy? Are they permanent? What are the long-term risks?
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Q. Which side effects should I report to the health care provider immediately?
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Answers to these questions will help you prepare for your treatment and follow-up.
Q. How soon should chemotherapy be started?
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Q. In what form and how often will the treatment be given? Will I need someone to accompany me?
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Q. How long will each treatment take? How many treatments will I have?
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Q. Can I continue to work, exercise, etc. during these treatments? Are there special precautions I should take while on chemotherapy or afterwards?
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Q. Will the cost of the treatment be covered by my health insurance?
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About bone marrow transplant
This is an intensive treatment option for women who have been diagnosed with high risk metastatic and/or recurrent breast cancer. The treatment plan consists of collecting the bone marrow and/or peripheral stem cells, high dose chemotherapy, and reinfusion of bone marrow and/or peripheral stem cells. The chemotherapy dose is extremely high in an effort to overcome resistance that the cancer cells may have developed to chemotherapy. Because the doses of chemotherapy are so high, the woman experiences many side effects, the most important of which is destruction of her bone marrow.
Bone marrow is the source of production of all blood cells, so it is critical that the woman has a supply of marrow to receive after the chemotherapy treatment. The purpose of bone marrow transplant is to prolong the woman's survival.
Questions to discuss with your oncologist:
Q. Why is bone marrow transplant a treatment option for me?
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Q. Can you refer me to a bone marrow treatment center for evaluation? (Call your insurance company to find out if the center is on their accepted list).
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Q. Can you recommend a bone marrow transplant clinical trial that I may be eligible for?
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Questions to discuss with the marrow transplant center personnel:
Q. What are the short-term and long-term risks of this therapy?
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Q. What are the clinical eligibility requirements for this treatment?
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Q. What are the financial eligibility requirements for this treatment? Are there any options offered by this center if my insurance does not pay for this bone marrow transplant?
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Q. What are the steps involved in the collection and reinfusion of bone marrow?
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Q. How long will I be hospitalized? How long will I need to recover/stay off work?
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If someone you love has breast cancer
You are probably now feeling shock and fear. Cancer doesn't happen to just one person in a family. Its impact is felt by the whole family. Your emotional support will play a key role in how well a loved one is able to cope. Sharing this experience will make it easier to feel closer to each other. The most important thing you can do for her is to listen and respect her feelings.

Suggestions on how to help:
Accompany her to health care provider visits
Provide moral support
Cook or coordinate meal delivery
Take care of the children
Do the grocery shopping
Help with house cleaning
Do the laundry
Water the plants
Screen telephone calls
Handle insurance needs
Offer to care for pets
Drive car pool
Keep a list of phone calls, gifts, flowers, and meals provided
Coordinate rides to treatment
Be a good listener
Give lots of hugs
Openly share your feelings
Be there for her
Continue to provide support after treatment is completed
Respect her need for privacy

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