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See also our genetics and breast cancer, breast cancer trials and breast health pages.
On this page: Decision-making steps | Talking with doctors, family and others | Menopause and fertility | Taking part in a clinical trial | Recovery and follow-up care | Research into breast cancer
Sometimes it's hard to decide on the right treatment. Some people like to be involved in deciding about their treatment, others prefer to be guided by their doctors. You have the right to find out what a suggested treatment means for you, and the right to accept or refuse it.
Waiting for test results and for treatment to begin can be difficult. While some people feel overwhelmed with information, others want as much as they can find. Understanding your illness, the treatment and side effects will help you make your own decisions.
Here are some helpful steps to think about when you need to decide about treatment.
‘I think once you're in a hospital room, just before surgery, you realise that you're on your own. You're there and you're it. So while I had wonderful support, you really have to make decisions for yourself.'
When your doctor first tells you that you have cancer, it's very stressful and you may not remember much. You may want to see the doctor a few times before deciding on treatment. If your doctor uses medical terms you don't understand, it's okay to ask them to explain something again.
Before you see the doctor, it may help to write down your questions. Taking notes or recording the discussion can also help (but check with your doctor first). Many people like to have a family member or friend go with them, to take part in the discussion, take notes or simply listen.
Once you've discussed treatment options with your doctor, you may want to talk them over with family or friends, nursing staff, the hospital social worker or chaplain, your religious or spiritual adviser, a Cancer Support Group, or a Cancer Connect volunteer or cancer nurse via the Cancer Council Helpline on 13 11 20. Talking it over can help sort out the right course of action for you.
Getting a second opinion from another specialist can be a valuable part of your decision-making. It can confirm or clarify your doctor's recommended treatment plan and reassure you that you've explored all your options. Some people feel uncomfortable asking their specialist for a second opinion, but specialists are used to patients doing this.
You can get a second opinion even if you've already started treatment or still want to be treated by your first doctor. Your original specialist or family doctor can refer you to another specialist and can send your initial results to that doctor.
You have the right to be treated by the doctor you prefer.
Some treatments for early breast cancer cause your periods to stop (menopause) and can affect your ability to become pregnant (fertility).
Menopause may be temporary or permanent. If your periods stop permanently, this will cause an early menopause. Some of the symptoms of a temporary or permanent menopause include hot flushes and sweats, trouble sleeping, vaginal dryness, passing urine more often, lower sex drive, tiredness, sleeplessness, dry skin, aches and pains, mood swings, poor concentration, weight gain and loss of confidence and memory. Not everyone has every symptom and they can range from very mild to more severe.
Talk to your breast care nurse or your doctor about ways to manage such symptoms. You may be able to change medication if you find symptoms difficult to manage, or you may prefer to take no medication.
If fertility is important to you, talk to your doctor before treatment starts about your risk of infertility and discuss ways it might be preserved. You may be able to store eggs for use in the future.
When people learn that they may be permanently infertile they often feel a great sense of loss. You may be devastated that you won't have your own children or more children, and you may worry about the impact of this on your relationship. Even if your family is complete, you may experience distress.
As well as talking to your partner, talking to a counsellor, breast care nurse or oncologist can be helpful.
If you are or may be pregnant, or if you hope to become pregnant in the future, a diagnosis of breast cancer can be especially difficult.
If you are pregnant, you will need to know whether tests and treatment may be harmful for you or your baby. Some treatments are considered to be safe for pregnant women but some are not safe. If you are pregnant, your whole treatment team should consult about the best way to manage your treatment, to limit the risk to your baby and increase your hope for recovery.
Some treatments for breast cancer can cause early menopause. If you have not been through menopause and hope to become pregnant in the future, talk to your doctor, who may refer you to an obstetrician or fertility specialist. If you face the loss of your fertility, you may wish to seek further counselling. Contact the Cancer Council Helpline on 13 11 20.
Your doctor may suggest you consider taking part in a clinical trial. Doctors conduct clinical trials to test new or modified treatments and see if they are better than current treatments.
Before deciding whether or not to join the trial, you may wish to ask your doctor:
If you are unsure about joining a clinical trial, ask for a second opinion from a specialist who is not involved in the trial.
If you decide to join a randomised clinical trial, you will be given either the best existing treatment or a promising new treatment. You will be chosen at random to receive one treatment or the other.
Being in a trial gives you important rights. You have the right to withdraw at any time; doing so will not jeopardise your treatment for cancer.
We've developed a clinical trials database to make it easier for people affected by cancer and health professionals to find suitable clinical trials.
Your doctors may want to examine you every 3 months for the first year after your treatment, every 6 months between the 2nd and 5th years of your treatment, and once a year after that. They will examine you and ask about any symptoms you have had, and will answer any questions you have. Most women will have a mammogram every year.
Your doctor may order other tests or scans if it is thought they are needed.
‘I became involved in volunteer work, both as part of the support group and providing telephone support to newly diagnosed women. It is important to me that other young women who face a breast cancer diagnosis don't feel isolated. I also started to work part time: this life balance made more sense.'
The Cancer Council's booklet Life after cancer: a guide for cancer survivors is for people who have finished active treatment. It is available on this website or telephone 13 11 20.
Early detection and better treatment have improved survival for women with breast cancer. Research for breast cancer is ongoing.
The following advances may still be under investigation in clinical trials and may not be approved or available at this time.
Cancer Council Victoria supports participation in clinical trials. They are the most accurate way to determine the effectiveness of promising new treatments or new ways of combining cancer treatments.
Always discuss treatment options with your doctor.
Reviewed by:
Assoc. Prof. John Boyages, Exec. Director NSW Breast Cancer Institute, Westmead Hospital
Lynn Buglar, Breast Physician, BreastScreen NSW
Sally Crossing AM, Breast Cancer Action Group NSW
Cynthia Murphy, Breast Cancer Action Group NSW
Esperance Coelho, Cancer Council NSWDr Amanda Hordern, Cancer Council Victoria
