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diagnosed with breast cancer: managing treatments, support and resources

experts in breast cancer care suggest the first step you take after receiving a breast cancer diagnosis is to reach out to resource programs and support groups to educate yourself about the disease and find out what’s available.

by karen hawthorne
published oct 04, 2023
last updated jun 10, 2024
read time 11 minute read
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read time 11 minute read
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diagnosed with breast cancer: managing treatments, support, resources
breast cancers caught early have a positive prognosis. they are less likely to metastasize or come back after treatment. getty images
“breast cancer can be very isolating, it’s a time when you just want to dig deep and get through the treatment and get through this period of time,” says debi rosenthal, executive director of the cure foundation, a grassroots organization dedicated to supporting the financial needs of breast cancer patients across canada. rosenthal went through colon cancer in her early 40s and understands the upheaval a cancer diagnosis brings. “you devote all of your energy toward surviving and healing, and if you have to carve out anything for any other significant life challenge, i can’t even imagine what it feels like.”
understanding the healthcare journey after diagnosis can help you be more prepared and advocate for the best care possible. as rosenthal stresses, individuals with breast cancer are not alone, but “part of a community.”
the number of young women contacting the cure foundation has risen significantly, with about one-third being young women and those with children under the age of 18, one-third over the age of 60, and one-third new immigrants who come to canada for a better life, “and they get hit with a breast cancer diagnosis and feel they have nowhere to turn.”
one in eight canadian women will be diagnosed with breast cancer in their lifetime, and one in 34 will die from it, according to canadian cancer society statistics. it’s the most common cancer in canadian women, excluding non-melanoma skin cancers, and the second leading cause of death from cancer in canadian women. it can also occur in men, but instances are rare. about 89 per cent of those diagnosed will live for at least five years, and advances in early detection and treatments are credited with helping more women lead fulfilling lives.

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but it’s not easy on many fronts. often women stop working while they’re in treatment, so depending on their health coverage and personal finances, the crisis they’re experiencing can also be financially tough.
rosenthal points out that there are all kinds of additional expenses that a breast cancer diagnosis comes with that have not been budgeted for, like the extra costs of traveling to the hospital and parking at the hospital. many patients she helps need to go through 30 days of daily radiation treatment, and they may live 350 km away from the breast cancer centre, so they need lodging for those 30 days. sometimes they need childcare. then there are medications that are not covered, and items like wigs, prosthetic bras and other pieces of equipment. some younger women choose to freeze their eggs before chemotherapy because the drugs can affect the ovaries, causing them to stop releasing eggs and estrogen.
here’s how you can manage your breast cancer diagnosis.

self-empowerment and finding support with breast cancer

experts in breast cancer care suggest the first step you take after receiving a breast cancer diagnosis is to reach out to resource programs and support groups to educate yourself about the disease and find out what’s available.
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breast cancer canada
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the diagnosis can be a shock and it’s not unusual to feel overwhelmed and uncertain, says dr. raymond kim, medical director of cancer early detection and the bhalwani familial cancer clinic at princess margaret cancer centre in toronto.
“patients may be hearing a lot of unfamiliar terms about surgery and treatment. learning that medical lexicon can help put them at ease.” patients are advised to look at the extensive resources on the princess margaret website and call the information line with dedicated cancer support specialists.
other resources to connect with include the canadian breast cancer network, a patient-directed national organization that voices the concerns of patients through education, advocacy activities, and information sharing (including sources for financial assistance across the country).
young adult cancer canada helps young people deal with their cancer experience through web-based support and in-person retreats and conferences, and empowerink is an organization that sponsors post-mastectomy tattooing events where qualifying applicants are matched with tattoo artists who create tattoos over their mastectomy site.

know the importance of early breast cancer treatment and regular follow-ups

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breast cancer is an abnormal growth that forms in breast tissue that may spread to other tissues and organs, which means early detection is critical to saving lives. a key part of diagnosing breast cancer is identifying its stage, ranging from stage 0 to stage 4, depending on the size of the tumour and how far it may have spread.
stage 0 and stage 1 are early-stage cancers, while stage 4 is the most advanced because it’s spread to other areas. the stage of cancer is determined by a number of factors including imaging tests, the size of the tumour and the analysis of tissue samples that are taken during surgery or a biopsy.
this information is part of your pathology report that also looks at hormone status of the cancer cells, whether they have proteins called receptors that receive signals from hormones that drive cancer cell growth.
breast cancer can be estrogen-receptor positive (er+) or progesterone-receptor positive (pr+) where hormonal therapies can benefit. the human epidermal growth factor receptor 2 (her2) protein plays a role in breast cancer as well. her2-positive breast cancers, estimated at 20 per cent of cases, happen because cells overproduce the protein, leading to uncontrolled division and growth of cancer cells. the canadian breast cancer network is a comprehensive resource for information on breast cancer stages, types and pathologies.
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breast cancers caught early have a positive prognosis. they are less likely to metastasize or come back after treatment. statistics canada reports that data from the population-based canadian cancer registry from 2010 to 2017 shows the five-year net survival for female breast cancer was 99.8 per cent when diagnosed at stage 1, dropping to 91.9 per cent at stage 2, then 74 per cent at stage 3 and 23.2 per cent at stage 4.
the chance that breast cancer will recur is most prevalent within five years, so close follow-up is necessary. women with breast cancer also have a higher risk of developing cancer in the opposite breast, as well as cancer of the ovary, uterus and colon.
overall, kim says that better detection strategies are leading to earlier treatment and intervention, and healthcare providers are seeing more stage 0 cancers.
kim is a geneticist expert in hereditary and high-risk cancer who is investigating more precise ways of monitoring women at high-risk of breast cancer. family history is a strong predictor and women who have a mother, daughter or sister who have experienced breast cancer, for example, are about twice as likely to develop breast cancer.
“through rapid diagnostic clinics, we have a very quick route to consultation for patients,” kim notes of the expedited process at most cancer centres in canada. “more advanced technology and imaging has allowed us to customize a surveillance plan for patients at high-risk.” he also credits the use of liquid biopsies, an emerging diagnostic tool that analyzes biomarkers in the blood and other fluids to reveal information about the tumour genetics and response to therapy.
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other high-risk scenarios for women include mutations in the brca1 and brca2 genes which are strongly associated with the development of breast or ovarian cancer: carriers face a five-to 20-fold increased risk of developing these cancers, and intensive screening and risk-reduction strategies are recommended. women with inherited brca mutations are also at increased risk of what’s called triple-negative breast cancer, a rare form of invasive breast cancer that accounts for roughly 15 per cent of invasive cancer cases.
science continues to evolve the understanding of breast cancer pathology and intervention. stanford university researchers recently have shown that women who don’t have brca mutation but have relatives who do are at no higher risk of breast cancer than relatives of patients with other types of breast cancer.
kim is particularly interested in cell-free dna screening, also known as circulating tumour dna, as potential blood-based biomarkers for both predictive information and treatment monitoring. fetal cell-free dna screening has been a cornerstone of pre-natal diagnoses of abnormalities for years but has been under-recognized in oncology because of technology limitations and associated costs. a 2022 paper in the british journal of cancer reviewed the current cancer clinical trials for cell-free dna analysis which authors say holds promise, “as a powerful tool not only to provide better patient follow-up and real-time treatment-response monitoring, but as a much-needed approach to improve cancer screening and early diagnosis.”
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connect with your breast cancer care team

most often, your family doctor is your first contact in your breast cancer journey, who refers you to a cancer specialist or diagnostic assessment program. if you don’t have a family doctor, you can make an appointment at a screening centre without a doctor’s referral, according to the canadian cancer society. if the screening shows something of concern, a patient navigator will talk to you about the test results and follow-up with referral to oncology specialists.
as one nova scotia healthcare consultant told cbc, “be your own patient navigator by keeping track of when screenings are required and following up for test results after they’re done.”
when you’re referred to a diagnostic assessment program, you’ll be connected to a multidisciplinary team for tests, consultation and a treatment plan. ask to connect with an oncology social worker to help put you in touch with local, provincial and federal government resources for financial assistance, and services for peer support and mental health therapy. research has shown a higher prevalence of depression, for instance, among breast cancer patients and its impact on quality of life.
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your multidisciplinary team may include a surgeon who specializes in breast cancer surgery, cancer doctors, nurses, radiologists and allied health professionals. another professional on the team is a plastic surgeon for consultation about breast reconstruction – something that used to be considered well after the initial surgery and other treatments, says dr. toni zhong, a plastic and reconstructive surgeon at the university health network (uhn) in toronto, director of the uhn breast reconstruction program and belinda stronach chair of uhn breast reconstructive surgery.
“breast cancer is still very much a surgical disease. it needs to be surgically removed. so the most important and immediate person that patients need to see right away is a breast oncology surgeon,” zhong says. “now they also get a referral to see someone like me. breast reconstruction is one of the frontline treatments for breast cancer. we’re no longer an afterthought.”
most patients with early breast cancer have a lumpectomy to remove cancer or abnormal tissue from the breast, which usually is followed with radiation therapy to kill any cancer cells that might remain. another option is a mastectomy, which removes all or a large portion of breast tissue. depending on the individual case, a mastectomy may not require radiation therapy. but if radiation is part of the treatment, patients are at higher risk for surgical complications because tissues don’t heal well around radiation sites. cosmetic scar revision or breast reconstruction after radiation treatment isn’t advised. zhong notes that advocacy for women’s treatment choices has led to informing women that breast reconstruction needs to be considered as part of early surgical treatment.
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“in the past, a lot of the research had been directed at improving survival, now research is also targeted at improving quality of life after breast cancer,” she adds. “so much of what we do in breast cancer reconstruction is to help rebuild their self-image and there’s a lot of psychology around that.”
zhong has headed research into patient-reported outcomes after surgery with surveys that looked at quality of life and body image, finding that those who undergo breast reconstruction report better quality of life and sense of wholeness and wellbeing. and patients who have reconstruction at the same time as their mastectomy surgery report even higher wellbeing scores and satisfaction.
she also highlights newer technologies that are improving breast surgery recovery, targeting skin necrosis where the breast skin is thinned out because of tissue removal. when there isn’t enough blood flow to the thinner skin, it can wither and scab over. now patients can go into a hyperbaric oxygen chamber that delivers a high concentration of oxygen to skin to help stimulate recovery.

understand your breast cancer treatment

depending on the breast cancer stage, there are localized treatments for cancer that include surgery and radiation, and systemic therapies that are delivered to the entire body, like chemotherapy and hormone therapy – with different options, experts advise asking your care team what’s involved and what you can expect. the canadian cancer society has helpful questions to get you prepared. there are also clinical trials that test the safety and effectiveness of a medical treatment that you can look into for possible participation.
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communication can be a hurdle for many patients who might feel lost in the system, according to all.can, an international non-profit working to improve the efficiency of cancer care. in august 2023, all.can canada released three case studies to spotlight innovative practices in canada in diagnostic assessment programs and oncology nurse navigators. everyone’s cancer journey will have its own challenges, but there have been significant strides forward in many care services.

manage your day-to-day with breast cancer

“supportive care helps people meet the physical, practical, emotional and spiritual challenges of breast cancer,” says the canadian cancer society. how you cope with what’s often described as your “new normal” is unique to the individual. most importantly, take time for self-care. that means developing a lifestyle routine that incorporates physical activity, lots of rest, good nutrition, and opportunities for social connections. be your own advocate and keep on top of your medical tests, follow-up appointments and ongoing therapies.
navigating the healthcare system effectively will help build your resilience and relationships for support. ask questions and start conversations. as zhong says, “i love spending lots of time with my patients, understanding where they come from, their values and preferences. those relationships are very rewarding.”
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reach out to the canadian breast cancer network and the canadian cancer society for more information. healthing.ca would like to hear from you! share your own experiences navigating the canadian healthcare system with breast cancer.
karen hawthorne is a toronto-based writer.
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karen hawthorne
karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

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