A diagnosis of breast cancer is difficult news for anyone to receive. Whether you are the patient, a family member, a caregiver or friend, there is usually one question that rises to the top – what happens next?

For patients at UCHealth Gloria Gossard Breast Care Center, what’s next is usually an introduction to a nurse navigator who will provide clinical expertise and guidance every step of the way on the journey on which the patient is about to embark. Specifically, nurse navigators offer education, emotional support and coordination of care.

“There are patients that will call us more frequently who need more reassurance or assistance, while others are more independent about their care,” said Cynthia MacMaster, a nurse navigator at UCHealth Gloria Gossard Breast Care Center. “Everyone deals with it differently. We are here to support you through your breast cancer journey.”

After a positive biopsy

Results from a biopsy typically take one to three days. This allows two UCHealth pathologists to thoroughly examine the tissue from the biopsy.

“The patient will receive a phone call with the biopsy results,” said MacMaster. Either she, or her nurse navigator colleague, will follow up to answer questions and provide information about next steps.

“Once a patient receives a diagnosis, we can help make the next appointments. We can also make referrals if the patient is choosing treatment out of town,” she said.

While each patient’s treatment plan is different and individualized, MacMaster said there are some general steps patients can expect in the weeks after a positive biopsy.

About one to two weeks after the biopsy, a patient will undergo an MRI to check all the tissue in both breasts. If anything suspicious is seen, another biopsy would be scheduled.

If the MRI results show only the known cancer, the next step would be a surgical consultationwith a breast surgeon, and a plastic surgeon if they choose to have breast reconstruction.

“We want all the diagnostic work completed before the patient meets with the surgeon,” she said. “Genetic testing is another diagnostic option we offer.”

A multidisciplinary “tumor board,” which includes various members of the cancer care team, meets monthly to discuss patient cases and weigh in on treatment plans.

“We are all here to work together and support the patient,” said MacMaster.

In addition to the surgeons, during the next few weeks, a patient can have a nutrition consultation to ensure their diet can support the changes in the body before surgery and throughout the treatment phase.

Both the patient and their family members have access to a social worker for counseling and support groups. Additionally, the patient can access rehabilitation services, massage and acupuncture, and various financial assistance programs.

Timing of the surgery depends upon the size and grade of the tumor, as some patients will undergo chemotherapy first to shrink the tumor, while others might not need chemotherapy or have it after surgery.

After surgery

A patient can expect to meet with a medical oncologist about two weeks after surgery. Decisions on the necessity of chemotherapy, radiation and/or additional ongoing oral medication will depend on multiple factors. This is a conversation the patient and cancer care team will have.

“There are a lot of different treatment options, so it’s an important conversation that will take place between the patient and their cancer care team,” said MacMaster.

If radiation is recommended, the patient will meet with a radiation oncologist to discuss the plan of care for treatment.

A lymphedema specialist, who is either a physical or occupational therapist, works pre- and post-operatively with patients to develop a plan for safe return to activity. This is supported by education about progression through cancer care and reducing the risk of developing lymphedema. Patients see the therapist to reduce excessive post-operative swelling, pain and tightness.

In addition to providing support for patients before and after surgery, as well as during radiation and/or chemotherapy treatments, nurse navigators check in with patients in the months – and even years – after surgery for follow-up appointments and additional mammograms.

“We have heard from patients that having someone like us help them is an invaluable resource,” she said. “We are always available to answer questions regarding their breast health.”

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.