Coping and support

A breast cancer diagnosis can be overwhelming. And just when you're trying to cope with the shock and the fears about your future, you're asked to make important decisions about your treatment.

Every woman finds her own way of coping with a breast cancer diagnosis. Until you find what works for you, it might help to:

• Learn what you need to know about your breast cancer.
  If you'd like to know more about your breast cancer, ask your doctor for the details of your cancer — the type, stage and hormone receptor status. Ask for good sources of up-to-date information on your treatment options. Knowing more about your cancer and your options may help you feel more confident when making treatment decisions. Still, some women may not want to know the details of their cancer. If this is how you feel, let your doctor know that, too.
• Talk with other breast cancer survivors.
  You may find it helpful and encouraging to talk to other women with breast cancer. Contact the American Cancer Society to find out about support groups in your area. Organizations that can connect you with other cancer survivors online or by phone include the Breast Cancer Network of Strength and CancerCare.
  
• Find someone to talk about your feelings with.
  Find a friend or family member who is a good listener or talk with a clergy member or counselor. Ask your doctor for a referral to a counselor or other professional who works with cancer survivors.
• Keep your friends and family close.
  Your friends and family can provide a crucial support network for you during your cancer treatment. As you begin telling people about your breast cancer diagnosis, you'll likely get many offers for help. Think ahead about things you may want help with, whether it's having someone to talk to if you're feeling low or getting help preparing meals.
• Maintain intimacy with your partner.
  In Western cultures, women's breasts are associated with attractiveness, femininity and sexuality. Because of these attitudes, breast cancer may affect your self-image and erode your confidence in intimate relationships. Talk to your partner about your insecurities and your feelings.
• Take care of yourself.
  Make your well-being a priority during cancer treatment. Get enough sleep so that you wake feeling rested, choose a diet full of fruits and vegetables, make time for gentle exercise on days you feel up to it and find time for things you enjoy, such as reading or listening to music. If you need to, be prepared to relinquish your role as caretaker for a while. This doesn't mean you're helpless or weak. It means you're using all your energy to get well.

Prevention

Breast cancer prevention for women with an average risk
Making changes in your daily life may help reduce your risk of breast cancer. Try to:

• Ask your doctor about breast cancer screening. Ask your doctor at what age you should begin routine clinical breast exams and mammograms. Most guidelines recommend women with an average risk begin annual mammograms to screen for breast cancer at age 40. Talk to your doctor about the benefits and risks of screening and together you can decide what breast cancer screening strategies are right for you.
• Become familiar with your breasts through breast self-exams. Ask your doctor to show you how to do a breast self-exam to check for any lumps or other unusual signs in your breasts. A breast self-exam can't prevent breast cancer, but it may help you to better understand the normal changes that your breasts undergo each month and identify any unusual signs and symptoms.
• Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to less than one drink a day, if you choose to drink.
• Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven't been active lately, ask your doctor whether it's OK and start slowly.
• Limit postmenopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with your doctor about the benefits and risks of hormone therapy. Some women experience bothersome signs and symptoms during menopause and, for these women, the increased risk of breast cancer may be acceptable in order to relieve menopause signs and symptoms. To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.
• Maintain a healthy weight. If your current weight is healthy, work to maintain that weight. If you need to lose weight, ask your doctor about healthy strategies to accomplish this. Reduce the number of calories you eat each day and slowly increase the amount of exercise. Aim to lose weight slowly — about 1 or 2 pounds a week.

Breast cancer prevention for women with a high risk
If your doctor has assessed your family history and other factors and determined that you may have an increased risk of breast cancer, options to reduce your risk include:

• Preventive medications (chemoprevention). Estrogen-blocking medications help reduce the risk of breast cancer. Options include tamoxifen and raloxifene (Evista). These medications carry a risk of side effects, so doctors reserve these medications for women who have a very high risk of breast cancer.
• Preventive surgery. Women with a very high risk of breast cancer may choose to have their healthy breasts surgically removed (prophylactic mastectomy). They may also choose to have their healthy ovaries removed (prophylactic oophorectomy) to reduce the risk of both breast cancer and ovarian cancer.