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Large Tumor / Locally Advanced

The size of the tumor is one of the things your doctor will look at in the staging process. Any tumor over 5cm is considered large in size and if combined with positive lymph nodes is considered locally advanced or Stage III. A tumor less than 5cm  with a large palpable  lymph node or with 4 or more positive lymph nodes, is also considered locally advanced and therefore will be treated the same as a large tumor. At this stage you will have two treatment options, either surgery first or chemotherapy first.

Any surgery recommended to remove cancer will depend on the size of the tumor, where the tumor is located, and the type of cancer. In a successful surgery, there will be no tumor cells in the margin and healthy non-cancerous cells around the cancerous tumor. If no cancer cells can be detected in this margin, then the cancer has been completely removed.

Additional surgery that rebuilds the shape of the breast is called reconstructive surgery and is done by a plastic surgeon or breast oncologist with experience in breast surgery. The surgery performed to remove the cancer may have an impact on your reconstruction options and it is important to speak up and communicate your desired end result as early as possible, when you may have the most options.

Your surgeon may want you to see a medical oncologist to shrink a large tumor using neoadjuvant chemotherapy before surgery. Neoadjuvant chemotherapy can shrink the tumor and stop the cancer from spreading. It may even kill the tumour entirely leaving no tumour cells visible on the final surgical pathology. This is called a pathological complete response (pCR). Some large tumors may shrink enough in size to allow for a lumpectomy when you previously required a mastectomy.

IMPORTANT:  If you are interested in having children someday, you must speak to your doctors about fertility preservation as soon as possible after diagnosis. Some aspects of breast cancer treatment (for example chemotherapy and hormonal therapy) can affect your ability to have children. It’s very important that your medical team knows that you would like information about fertility preservation options and that this is included in any discussion about your treatment plan.

Welcome to the BTC Treatment Decision ToolHave you or someone you love recently received a diagnosis of breast cancer?

Whether you received a diagnosis yesterday or three months ago, you are likely dealing with an upheaval in your life as you’ve known it. Perhaps you have also started the process of meeting with your doctors to discuss what treatment options are available, and which therapies (or combination of therapies) will be the best for you. It is a lot of information to sort through and make sense of.

So we’re here to help.

The team at Be the Choice are a diverse group of women and men who have had experiences with a breast cancer diagnosis and treatment. Some of us have undergone treatment for breast cancer, some of us have provided care for a loved one who has been through treatment, and some of us are physicians and other health care professionals who provide treatment to breast cancer patients.

United in our concern that all people who receive a diagnosis of breast cancer should have access to comprehensive, state-of-the-art treatment information in a comfortable and user-friendly format, we designed this interactive treatment decision tool.

How to use:

Your diagnosis of breast cancer has come with an assessment of your unique clinical and hormonal characteristics. These should be carefully discussed with your medical team and deliberated carefully in advance of any treatment decisions.

This tool will enable you to get to know the “big picture” as well as the “individual picture” behind any breast cancer treatment decision, and to become an active participant in determining your own treatment process. You are the ultimate decision-maker in this process. We hope that you will use the information on this website to inform and empower yourself.

What this tool is not designed to do is deliver individual treatment recommendations. It should be used as a way to get a sense of the full range of treatments available to you as well as what your own treatment plan might look like given your unique profile.