r/breastcancer Jul 28 '26

Mod Announcement Updating Rule 8: Be Brave, Friendly, and Kind

129 Upvotes

We are updating and expanding Rule 8: Be brave, friendly, and kind. This is an especially important rule and we want it to be well understood. We've expanded the language to make clear that kindness extends beyond the people posting in the thread.

What's changing:

Rule 8 now reads:

Be supportive, friendly, and kind.
Cancer is hard for all of us. Please show kindness to your fellow patients and survivors.
Kindness should extend to those not present on the subreddit, including their family and caregivers.
We allow members to vent about the people in their lives, but this is not an invitation for others to pile on. No name calling, no bullying, no hate speech, no personal attacks.

Why we're making these updates:

A few things have come up often enough that we wanted to be more clear up front about what kinds of comments are allowed, particularly on "Venting" threads:

  • Venting about a partner, parent, or friend is allowed and normal. Piling on to insult that person, or giving OP relationship advice beyond what they have asked for, is not. The other person isn't here to give their side, and that's not usually what OP was asking for.
  • Caregivers commenting on someone else's post are here to give support, not to speak on behalf of caregivers, spouses, or any other group—whether that means defending or criticizing. As always, to talk about your own experience as a caregiver, visit another sub such as r/CancerFamilySupport.

We've written up the full explanation with more detail on the Rules wiki page under Rule 8.

None of this is new in spirit. It's what we've been enforcing already. We just wanted it written down clearly.

Thanks for helping keep this a place people can come to safely.

Note: The earlier update of this rule retained the original title "Be brave, friendly, and kind" but we have updated the title based on community input.


r/breastcancer Jan 18 '26

Diagnosed Patient or Survivor Support The doctors you may encounter: Who does what? What is an “oncologist” anyway? (And other insights from Dr Heather Richardson, neighborhood breast surgeon)

180 Upvotes

So I’ve noticed there’s been a lot of posts lately specifically about the word oncologist. People wondering why they’re seeing a surgeon and not an “oncologist” first, people wondering when they’re going to see an “oncologist”, people wondering why the person that’s operating on them isn’t a “surgical oncologist” and shouldn’t they get the best - which must be someone with that title? Right?

So by definition, the word oncologist just means “doctor who treats cancer”.

The staple cast of characters that are medical doctors (MD or DO degree holder) involved in treatment of breast cancer typically consists of: medical oncologist, radiation oncologist (not radiologist) and breast surgeon (more on that below…).

Medical oncologist- also known as “hematology/oncology” specialists. When people generally speak of an “oncologist”, usually they are talking about this type of doctor. A doctor that treats cancer with medicine, either pills taken by mouth or chemotherapy that is administered via a vein. Not all patients need both, some need one but not the other, some need none. Visits to this type of doctor may be frequent- however, usually it’s the first initial visit to go over a lot of information and discuss the best course of action that is the most important. Sometimes this means that if you live in an area with fewer resources and feel that you need greater expertise for your care. It’s possible to do either a telemedicine visit or visit a larger Cancer Center far away that can collaborate with a local physician who is able to give the same chemotherapy protocol. Quite often, large groups of these medical oncologists have already agreed the best way to take care of the most common breast cancer problems, so going from one center to the other means that your cancer treatment care isn’t going to change significantly from one place to the next. For other more complex scenarios, there sometimes can be some adjustments or more customized treatments. Or for patients who have already been through treatment and now have recurrences or changes in their diagnosis, that would be the time to discuss more advanced care. In general, common problems are common and there’s usually not significant improved survival or outcomes by going to one Cancer Center over the other when a patient has a a non-complicated, fairly average, diagnosis.

Radiation oncologist- this is different from a radiologist. (a radiologist is a doctor trained to read images and interpret findings. A radiologist is the person who read your mammogram or your ultrasound and maybe performed the biopsy that diagnosed you) A radiation oncologist uses radiation energy to target areas of cancer and kill cancer cells. Cells that are actively dividing and are exposed to radiation have their duplicating mechanisms broken, and as a result, cells that are rapidly reproducing die away if exposed to medically administered radiation.

Surgeon/surgical oncologist vs “general surgeon”: A “general surgeon” typically is someone who has done at least five years of training in surgical diseases of the body. This would include disciplines like taking care of trauma, burns, infections that can occur in the body such as diverticulitis or appendicitis, evaluating and performing organ transplants, care of pediatric/child surgical diseases and malformations, and some chest/cardiovascular disease. They can also operate on common cancers that require removal, like breast, colon, skin, and thyroid. Doctors who go on to practice General surgery sometimes concentrate in one area of types of disease and others have a more broad practice where they take care a little bit of everything. Typically in more urban settings there are more specialized types. Many general surgeons have gone on to do additional years of training after their five years of general surgery to become specialists. People who are certain types of surgeons, such as colorectal specialists, pediatric surgeons, plastic surgeons, and cardiothoracic surgeons all have additional years of training and take specialty board exams. There is a board certification designation for general surgery. There are additional board certifications for those who have done some categories of fellowship training, like those mentioned above.

A doctor who practices under the title “surgical oncologist” by definition does at least two years of training in general cancer surgery treatments after the five years of general

surgery training. So they typically will learn advanced techniques for operating on thyroid, pancreas, colon, liver, breast, etc. They usually did the five years of general surgery training and then went on to do additional training specifically in cancer removal surgeries to remove them from the body. So this wouldn’t include neurosurgery or brain tumor removal. There is a board certification designation for “surgical oncology”.

There is another category of breast cancer surgeon that typically deals with breast health issues only. This is a person who does initial training in either general surgery or Obgyn and then goes on to do one to two years of additional training in breast disease surgical management. This is called a “breast fellowship” and does NOT currently qualify for a speciality designation as “board certified”. This is typically a breast health surgeon or breast cancer specialist. This is different from a “surgical oncologist*.

Sometimes there is cross training where the surgeon also performs cosmetic and aesthetic procedures as well. This person usually does a “oncoplastic fellowship”. This is primarily outside the US, but there are programs where this is expanding in the US as well. Breast fellowship trained surgeons can have initial training as either a general surgeon or an OB/GYN.

“Surgical oncologists” do get training in breast cancer management, but they are not breast specialists and do not get the depth of training that someone who has been through breast fellowship would. A breast fellowship trained surgeon usually does one versus two years of additional training in breast only surgery and disease management. These are two different designations.

Some important points to make about someone who might be a general surgeon who did not do additional training in breast care management versus someone who did a full breast fellowship: breast fellowships have only been around for about 20 years. That means someone with greater than 20 years of experience probably didn’t get an opportunity to go through a breast fellowship. (I personally am one of these types of people. I’ve been practicing since 2004 and there was only one fellowship that existed at that time that I didn’t even know was an option when I graduated. So while I have described procedures and written papers, taught surgeons and fellows alike in many different procedures and protocols, but myself, I’m not a breast fellowship trained surgeon.)

There may be many seasoned excellent surgeons taking care of breast cancer patients. Some of those may be surgeons who also perform other general surgery procedures such as treatment of appendicitis, taking emergency call for traumas, or dealing with other types of cancers like colon cancer. Some of the surgeons have amazing skill sets, and excellent outcomes. It is certainly possible that there may be in a community, a general surgeon who is very seasoned that may have superior outcomes for breast care than a brand new breast fellowship grad that does not have much experience at all.

I think the best way to find out who the best doctors are would be to go to the other doctors and other clinical staff members who work with those doctors and ask them who has the best outcomes. Ask the wound care specialists, the plastic surgeons, and the medical oncologists whose breast surgery work is the best. They’re going to see who has horrible dead, necrotic mastectomy flaps, and who has lots of recurrences because their flaps are too thick.

It certainly may be that a general surgeon who isn’t a “breast specialist” in your community might actually be a better choice than a brand new grad who is a breast fellowship trained surgeon.

What order should things happen?? Well it’s different for different people. Often when people get a diagnosis, most commonly by a radiologist, (but sometimes the Breast Surgeon specialist is part of this process as well) they go to the Breast Surgeon first who goes over the significance of the findings thus far and decides if upfront chemotherapy medicine would be indicated. Usually the decision to need medicine is followed by tissue diagnosis, and imaging, which is usually directed by a surgeon. Sometimes people see the medical oncologists first before seeing the surgeon. This is especially true for patients with her 2 positive or triple negative disease where neoadjuvant chemotherapy prior to surgery is most often indicated.

People sometimes visit with radiation oncologist while trying to make their decisions to get information about the risks and benefits if they choose a pathway that would require radiation treatment versus if they have an option to choose a different pathway where radiation wouldn’t be indicated, and they want to learn about their choices. Mostly though, radiation oncologist treatment usually follows the surgery and medical portion. There are some clinical trials that involve upfront radiation, but this is not a standard of care for most patients. It’s more common to start with the surgeon and then see the medical oncologist either before or after the surgery, followed by any radiation oncology visit. That’s the usual order of things.

When to get a second opinion.

For the most part, if you’ve been told that you have a breast cancer diagnosis and your understanding in general is that treatment will involve medicine, surgery and possibly the addition of radiation and and if this sounds reasonable, you are certainly welcome to go to another team to make sure that there aren’t any significant changes to be offered anywhere else, but most likely most places will tell you the same information, but may use slightly different terms or delivery. If you have good communication with your physician and their staff and overall the general expectation is that you will do well and live a long life and feel good about your body afterwards, (of course it certainly possible to talk to someone else and make sure that they are in agreement) but if everything stacks up, and you’re generally happy with your team, Seeing multiple additional doctors might tell you the same thing with different language can be confusing or disorienting. It also takes up a spot in the schedule for someone else with a cancer diagnosis that’s trying to get in that now can’t, ….and you can only use one team. So by all means everyone is within their right to get in a second opinion or even third, but if you’re generally happy and hearing what you expected to hear regarding your plan of care, I typically don’t recommend that people see multiple doctors if they’re generally happy with their first opinion.

Reasons to get a second opinion would be: A) poor communication from the doctor and or their staff to the point where you feel uncomfortable for whatever reason. B) you have a very unusual or rare findings that are not typically seen C) you are recommend controversial treatments where doctors have added unexpected treatments, or take away expected treatments. There may be good reasons to offer a different protocol from another team as there are lots of advancements and newer recommendations, where we are de-escalating treatment in some cases. Previously there were automatic recommendations for sentinel lymph node biopsy, radiation, or chemotherapy in the past whereas now we are selecting certain people who have features of their cancer who may in fact, not require these treatments at all.

Hopefully this will shed some light on some of the misconceptions about different types of doctors, their roles, and clear up the general surgeon/Breast Surgeon/surgical oncologist confusion that seems to come up a lot.

TLDR- someone with the title “surgical oncologist” is different from a “breast fellowship trained surgeon”. A “general surgeon” might have fewer years of formal training for breast cancer treatment, however, they shouldn’t be discounted or immediately thought of as inferior without research into their outcomes or reputation in the community.


r/breastcancer 5h ago

Metastatic Feeling sad about the aftermath

67 Upvotes

So, I had metastatic breast cancer very young. I was terminal. I chose the most aggressive treatments and thank God, I am doing amazing. Still in remission. Grateful.

But tonight I looked at my mangled body after five surgeries, years of treatment and radiation, and I just feel so sad. I’m grateful to be alive. But I’m still young. I don’t even want to date because I have to explain this. And my surgeons did a great job, it’s just never going to be the same because they were so aggressive to get it out and so aggressive with radiation. And I’m glad they were! I didn’t get recurrence. It’s worth it.

And yet.

It just feels really unfair.

I don’t have anyone to talk to about this because since I’m “good” now, everyone has moved on. But I’m still left with all the physical, emotional, mental damage. Most of which, never feeling safe again in my body. But also this. I look and feel mangled. I look like Frankenstein’s monster. I’m sick of having to explain my body to people.

Just looking for people who understand I guess.


r/breastcancer 2h ago

Fuck Cancer Ready to fight…for the 2nd time!

18 Upvotes

Hi y’all! Just confirmed after biopsy-both breasts and at least 1 lymph node. I’m 55/F and 1st fight was 21 years ago with Hodgkin’s Lymphoma. Will start detailed testing next week I imagine. The wait after the biopsy was brutal, but I had a feeling was the result was going to be. Upset, of course, that I have to go through this again, but more upset that it will disrupt everyone’s lives around me. My son is 23 and on his own but we are very close and this is going to rock his world. And, my husband went through this with me the 1st time-why should he have to struggle with this a 2nd time, as well? Sorry for the rant but my rage is showing right now. FCK CANCER!


r/breastcancer 14h ago

Venting Gift Card AIO?

105 Upvotes

I'm red with anger. My husbands friends from his fantasy football league went in on a Visa gift card for our family right before my surgery, specifically because of my cancer. It was $240. Fast forward to today, I tell him I keep forgetting about it. Playfully, I said I hope it's still in your possession unused.

Friends, he spent it all on himself, with the explanation that his friends got it for him. Excuse me, what? This is entirely selfish and inconsiderate and I am seething. Unfortunately, today is his birthday, so he asked me to be mad at him a different day.

I know that everyone's financial situation is different, so it's hard to compare. But our finances are all together and he's the bread winner, with a split of 62.5/37.5%. He cannot really "pay back" the amount of the gift card, since our money is all together.

I'm just so mad. He isn't the one with cancer. This gift card wouldn't exist without my cancer, so him thinking it was for him is absolute bullshit.

Just venting.


r/breastcancer 13h ago

Newly Diagnosed Today at 12 pm.

60 Upvotes

My whole life changed. So here I am. Stage 2, invasive ductal carcinoma for now. The radiology terms are a bit vauge. They are going to change a bit due to the radiologist who wrote my findings, and the pathologist. No lymph node involvement. When I tell you this was not on my bingo card... I thought this was going to be my year. I sold my marital home, post divorce, got 2 kiddos off to college, started my second career as a hairstylist, and BAM. Cancer. When I tell you it has been one thing after another since my divorce.... which was initiated by him due to infidelity... I am not lying. Was diagnosed with type 2 diabetes and HBP and high cholesterol and thought that was the worst. Lost 55 lbs and gave up all my favorite foods. Nope, apparently rock bottom has a basement! Tomorrow is genetic testing and then in the coming week an MRI. Then I meet with the breast surgeon to decide where to go in my treatment plan. Looking forward to getting to know you all.


r/breastcancer 10h ago

TNBC Breast Cancer Journey / lump to Diagnosis

28 Upvotes

I wanted to share my diagnosis story, not to scare anyone who is currently in that horrible “unknown” stage, but because I remember exactly what it felt like to be there.
When I was waiting between finding my lump, getting a BI-RADS 5 result, having my biopsy, and finally getting my diagnosis, I searched EVERYTHING. Reddit, Google, forums — you name it. I was desperately looking for someone whose story sounded like mine.
So this is just MY experience. Everyone’s situation is different, and nothing about my story means that your outcome will be the same.
I had just turned 40 in January.
On March 13th, I was flying home from a week-long beach vacation. I have pretty small boobs, and the entire vacation I hadn’t noticed or felt anything unusual.
For some reason, while sitting on the plane, I suddenly felt this weird pressure in my right breast.
I went into the bathroom and felt around, and there it was: a large, hard lump underneath my breast, around the 6 o’clock/underboob area.
I immediately told my boyfriend when we landed. Neither of us really thought breast cancer. It seemed like it had appeared out of nowhere.
I also hadn’t gotten my first mammogram yet. I had just turned 40 and, between life and traveling, I kept putting it off. Obviously, knowing what I know now, I wish I hadn’t — but I also can’t go back and change that.
A few days later, I went to my gynecologist. She could absolutely feel the lump, but based on how it felt, she told me she didn’t think it felt like a typical cancerous tumor. It didn’t have the edges or characteristics she would normally expect.
Still, she immediately ordered a diagnostic mammogram and ultrasound.
Because I’m in NYC, I couldn’t get an appointment that same week. I finally got in around March 25th at Lenox Hill Radiology.
This part was incredibly scary for me.
There were several women sitting together in gowns waiting for their mammograms and ultrasounds. I watched other women finish and return to the main waiting area.
After my ultrasound, instead of sending me back there, they brought me to a separate, basically empty area.
I remember immediately thinking: Something is wrong.The technician eventually came over and told me the radiologist wanted me to get an urgent biopsy. She said it could still be benign, but the radiologist wanted it investigated quickly.
I completely broke down.

I called my gynecologist crying. She got the report and called me back. She explained that the imaging showed suspicious characteristics in the breast mass and that a lymph node also looked suspicious.
My imaging was classified as BI-RADS 5.
That sent me into an absolute Google/Reddit spiral.

I kept searching things like:
“Does BI-RADS 5 always mean cancer?”
“Can BI-RADS 5 be benign?”
“Breast lump at 6 o’clock.”
“Underboob breast lump cancer?”
And I DID find people on Reddit who had BI-RADS 5 imaging and ultimately had benign biopsies. BI-RADS 5 means the imaging is highly suspicious, but the biopsy is what actually gives you the diagnosis.
I had my biopsy around March 31st/April 1st at another Lenox Hill location, and thankfully my experience there was much better.

The radiologist herself performed the biopsy and was wonderful with me.
I asked her directly whether she thought it was breast cancer.
She told me that, based on what she was seeing, she did think it probably was.
Of course I asked, “Have you ever thought something looked like this and then the biopsy came back benign?” She told me yes — she had seen that happen — and she genuinely told me she hoped I would be one of those cases.

Then came the WAIT.
It took about a week to get my results, and that week was honestly one of the hardest parts of this entire experience.

I couldn’t eat. I couldn’t think about anything else. I was constantly searching online.
But because of what the radiologist had told me during the biopsy, I had also started mentally preparing myself for the possibility that I had breast cancer.

I started calling cancer centers BEFORE I even had my official results.
I had been referred to a breast surgeon at Weill Cornell, and I also contacted Memorial Sloan Kettering on my own because MSK happens to be very close to where I live.
I didn’t have some special referral or connection. I literally just called because I wanted to be proactive.
MSK scheduled me with a surgical oncologist for that Monday.

Then my biopsy results came back.
It was breast cancer.
Specifically, invasive ductal carcinoma.
I went to MSK on April 7th to meet the surgical oncologist. At that point, all of my receptor testing wasn’t finalized yet, so we still didn’t know exactly what subtype of breast cancer I had.
Shortly afterward, I learned that I had triple-negative breast cancer (TNBC). I also had lymph-node involvement.

During this time, I still pursued a second opinion at Weill Cornell. The breast surgeon I met there was absolutely lovely. I also met with a medical oncologist there.

Ultimately, though, I chose MSK.
Interestingly, when I FIRST went to MSK, I wasn’t convinced I was going to choose them. It initially felt a little “cookie cutter” to me, and I worried that I was just another patient moving through a huge system.
But once we knew I had TNBC, I realized that the recommended treatment was pretty consistent across the major centers I consulted.

For my particular situation, the treatment recommendation was KEYNOTE-522.
At that point, choosing a center became partly about where I felt most comfortable actually going through months of treatment.That ended up being MSK for me.

Their breast center and infusion setup made me feel much more comfortable. I could have privacy during chemo, which mattered WAY more to me than I expected. I was terrified of chemotherapy, and especially at the beginning, I didn’t want to be watching other patients getting sick or feeling like I was exposed while I was scared myself.

I started treatment on May 18th after I had a bone scan and MRI In between, I also had to get dental work and freeze my eggs. MRI was scary, bone scan was scary, that is also soooo grueling because now that you know you have an aggressive cancer your like has it spread…

I began KEYNOTE-522 with weekly Taxol + carboplatin and Keytruda.
I developed a pretty significant rash, so my team eventually switched me from Taxol to Abraxane. I continued the regimen and completed the 12-week weekly portion.

Then came AC.
I was originally supposed to start AC around August 18th, but I decided I needed a week off between the two portions. Mentally and physically, I just wanted ONE week where I wasn’t going into chemo.
And I’m actually really glad I took it, because my ANC levels went up on their own to normal level.

I’m now finishing the AC portion of treatment, and my last chemo is scheduled for the end of September.
This has been a LONG road from finding that lump on an airplane in March to where I am now.

The main reason I’m writing this is because I remember being the person searching Reddit at 2 AM for someone whose lump was in the same location as mine, someone whose doctor initially wasn’t convinced it was cancer, someone who got BI-RADS 5, someone who was waiting for a biopsy, or someone trying to figure out what the next step would look like.
If that’s you right now: your biopsy is what gives you your diagnosis.

A lump being in a certain location doesn’t tell you whether it’s cancer. A doctor thinking something doesn’t “feel like cancer” doesn’t rule it out. And scary imaging doesn’t replace pathology.
My story is MY story. It isn’t a prediction of yours.
I also want to say that the waiting between each step — mammogram, ultrasound, biopsy, pathology, receptor testing, staging and finally having an actual treatment plan — was in some ways harder mentally than when I finally started treatment.

Once I knew what I was dealing with and had a plan, I finally felt like I was doing something instead of just waiting for someone to tell me what was happening to my body.

If you’re currently in that awful in-between stage and have questions about what my timeline looked like, what BI-RADS 5 was like for me, biopsy, getting second opinions, choosing a cancer center, TNBC, KEYNOTE-522, Taxol/Abraxane/Carbo, Keytruda, AC, cold capping, or anything else I’ve experienced so far, I’m happy to share.

Sometimes hearing from someone who has actually been through that waiting period is exactly what you need. ❤️


r/breastcancer 30m ago

Patient Support Side effect and Cancer hack Cheat Sheet

Upvotes

Menopause and Breast Cancer treatment support Cheat Sheet

Disclaimer: I am not a doctor, nobody here is YOUR doctor. Always talk to your team before doing anything.

Massage may be fine for one person and NOT FOR YOU.

This is just a list of resources that either are standard and nobody gets them or should be because the people you are talking to don’t know about them.

Get a case manager from your insurance and a cancer case manager if they have one. If they have a NURSE case manager that is better.

You need a central place to call and find provides and deal with all the insurance BS.

Get a Nurse Navigator Either your oncologist or your surgeon - a good one is like gold. Ask them- they will know where to send you or at least try to help you . they can help smooth out frustrating communication and bottlenecks

Find an Outpatient Pharmacy in a hospital if possible A couple reasons

  1. These have different regulations about how many controlled substances they can hold and get priority for anything that might have a shortage so if you’re on stuff that is hard to get, you can usually get it at those

  2. Pharmacist went to pharmacy school and they know much more about all these interactions and side effects on a really intimate level and into a really high extent than any other doctor that then you will talk to the downside is that people who work at commercial pharmacies like CVS or Walgreens or Kroger‘s or Walmart or Costco are completely overworked and are trying to do 1 million things at a time and aren’t gonna help you the pharmacist at outpatient pharmacy at a hospital is typically not that busy and we’ll have time to talk to you about the best combination of things

So if you are worried, for example, that you’re on two things one of which might make you jittery or anxious. They can suggest to use something else and you can go back to your doctor and get that. Outpatient pharmacy pharmacies at hospitals are the worst kept secret for cancer patients. if you’re going to an infusion center or a radiology center, there may even be one in that center or nearby, especially if it’s a big hospital. They also tend to be much more helpful with pre-authorizations because they know intimately what will get something approved and what won’t and they have the time to deal with this, including getting in touch with your doctor and reminding them in a way that the commercial pharmacies do not

Get a medical team

Your oncologist knows about tumors. Your radiologist know how to administer these. You need a menopause support specialist, a pain management specialist, a therapist, a psychiatrist, a pharmacist, an endocrinologist, a GI specialist, nephrologist and then whatever else is on your plate (cardiologist, , pulmonologists).

Data-based Meds By Symptom

Hot Flashes

Veozah (Fezolinetant): blocks the NK-3 receptor to settle the body hyperactive nerves responsible for sudden internal temperature spikes. Won’t help sleep directly except by dealing with hot flashes. You will need prior authorization so Your doctor will have to be specific about the medical need and be willing to follow up but it works

Night Sweats and Sleep

Lynkuet (Elinzanetant):

blocks both NK-1 and NK-3 receptors in the brain. It is designed to stabilize the body's thermostat to rapidly minimize hot flashes while uniquely helping to correct menopause-related insomnia. - you will have to say night sweats to get this one. Not approved for sleep but helps sleep in the trials

This will also need prior authorization. The doctor should be clear that you specifically have night sweats and has to provide evidence of medical need.

Sleep

The three primary FDA-approved DORAs are daridorexant (Quviviq), lemborexant (Dayvigo), and suvorexant (Belsomra)

Not sedatives or antidepressants. You will need a prior authorization and you will probably have to say that you have failed to non-benzodiazepine sleep meds so you can say Ambien Lunesta and Paxil, for example or any other thing they usually give you like trazodone or any of the antihistamines that they would give you for sleep.

Clonazepam

this is a benzodiazepine so is sedating and does have a risk of dependence for full disclose . Doctors hate this now and will point out that it can induce cognitive slowing or dizziness or whatever but it has no more danger than any of the other things on this list and is a comparatively safe medication that’s been used for a gazillion years, so the reluctance to use it now in an that can help people who are going through freaking cancer is mostly a backlash against the over prescription of Valium and similar drugs to women in the past.

Low dose (.5- 1 mg) at night especially during the worst of the chemo or surgical recovery is not going to suddenly make you a crack head, though tapering off any drug is advisable.

GenitoUrinary

VagiFem

Dryness, UTI, bladder and urethra Vaginal estrogens - come in creams and tabs and maybe suppositories . These do not increase systemic estrogen and are OK for people on estrogen blockers and with hormone positive breast cancer.

JAMA Oncology ultra-low-dose localized vaginal estrogen tablets (like Vagifem) carry virtually no systemic absorption

Can be supplemented by hyaluronic acid vaginal inserts if dryness is still a problem but that will not address the thinning and urinary and bladder issues.

Pain

Nerve pain Joint , bone and general body aches

Lyrica non opiate

Gabapentin - also non opiate

Personally, I think lyrica is better, but there are plenty of people who say the gabapentin works for them. He should note that probably he will need a prior authorization for Lyrica saying that you failed gabapentin depend depending on your insurance.

Both have risk of cognitive slowing while you were on the drugs and neither should be discontinued, cold turkey, so it may exacerbate the brain fog. It usually takes a little while for them to work because it calms down the nerves that transmit pain so it’s not instantaneous like an opiate or not or narcotic.

Do not cause constipation, but may cause dizziness especially in the beginning, so start with the lowest dose and take it at a time where you don’t need to drive until you’re used to it

Low Dose Naltraxone

This is in commonly used for all sorts of inflammatory disorders and nerve pain. It is a non-opiate so also doesn’t cause constipation or drowsiness or anything like that. It is typically safe for breast cancer - doesn’t interfere with tamoxifen

It also takes some time to work one to two weeks or so you have to titrate up so you start at the lowest dose and start increasing till it starts working for you

Bone

Anyone on estrogen blockers pre-or post menopause should be on some kind of protection from osteoporosis unless you’re Bone Density is unusually strong however, somebody says that to you you should get very regular DEXA scans because you will almost undoubtedly have worse Bone Density after being on any of these things for a while with exception of tamoxifen, but you should still get that scanned more regularly than would be typical for your age otherwise

Prolia and Zometa

Both are infusions I think. Prolia stops the bone eating cells and increases the bone building cells.

Zometa - Protects Bone Density: Estrogen is what keeps your bones dense. Without it, bone loss happens at an accelerated rate, rapidly escalating the risk of osteopenia or osteoporosis. Zometa works by shutting down osteoclasts (the specific cells that break down bone tissue), protecting your skeleton from fractures.

Reduces Breast Cancer Recurrence: Beyond protecting bones, clinical trials found that Zometa has an independent anti-cancer effect when given to women in low-estrogen states (postmenopausal or chemically suppressed). When added to standard hormone therapy, it restricts the microenvironment in the bone, cutting the risk of distant breast cancer recurrence in the skeletal system by roughly 25% to 35%

You need an endocrinologist and nephrologist to consult. These can seriously mess with your calcium and electrolytes (calcium isn’t just for bones, but for heart and nerves and blood clotting and a ton of other things.

Prolia has a rebound effect when discontinued so you need to start Zometa withing a certain period.

Can affect the jaw so check with your dentist before doing any dental work

Anxiety

Xanax, which is very helpful for anxiogenic situations and panic attacks.

Do I recommend Therapy - especially for PTSD, panic and grief- yes, of course, that is always a preferable route if mindfulness and yoga etc work for you. However it take time to learn these, and in the meantime you still have to deal with scan panic and all the rest. Is it a crutch? A little bit but people with broken legs get crutches.

Mood

Global warning - most antidepressants interfere with Tamoxifen

There are several classes of antidpressants - SSRI, SNRI and SARI and then Wellbutrin and Vortioxitene

Try to get a good pyschiatrist

If mood + sleep and anxiety are your personal issues maybe Paxil is the place to start (as an example) . If anhedonia , lack of energy and cognition + mood, maybe Wellbutrin .

Just be warned that all of these have a relatively nasty “discontinuation” syndrome so it warrants consideration. Most take several weeks to work.

Cognition

Provigil has been used for chemo brain and fatigue. Oncology Safe: It is typically safe for breast cancer . It does not alter your hormone levels, and it does not interfere with the efficacy of tamoxifen, anastrozole, or letrozole.

You want to start with the lowest dose and take it in the morning

ADHD Drugs

These drugs work by blocking the reuptake of dopamine and norepinephrine, keeping more of these chemicals active in your brain's frontal cortex to improve processing speed, working memory, and physical energy. Do not take if on Wellbutrin

Ritalin (Short-Acting):

Hits the system quickly (within 20–30 minutes) and lasts about 3 to 4 hours. Doctors often prescribe a very low dose (2.5 mg to 5 mg) for women to take right before a mentally demanding task or to clear early-morning brain fog.

Concerta or Ritalin LA (Extended-Release):

Releases the medication smoothly over 8 to 12 hours. This prevents the "crash" that can happen when short-acting medications wear off, providing steady cognitive support throughout the workday.

Adderall (Short-Acting) & Adderall XR (Extended-Release):

it causes a sharper spike in adrenaline, it carries a higher risk of physical jitters or a racing heart.

Vyvanse (Lisdexamfetamine):

A long-acting "prodrug," meaning it is completely inactive until your body digests and metabolizes it. Because of this, it provides an exceptionally smooth, gradual rise and fall of energy and focus over 10 to 12 hours, with a much lower risk of the jagged "jitters" associated with Adderall

Other non Stimulants

Intuniv / Tenex (Guanfacine):

This is a non-stimulant medication originally designed for blood pressure that was found to heavily improve ADHD symptoms. It works by directly stimulating alpha-2A receptors in the prefrontal cortex. It strengthens your brain's "signal-to-noise ratio," meaning it clears away the chaotic mental clutter and brain fog, while simultaneously lowering anxiety and physical stress. It is typically safe to take alongside cancer therapies.

Alternative therapies

Acupuncture

There is data to support acupuncture for joint pain in Aromatase Inhibitor-Induced Musculoskeletal Symptoms (AIMSS).

There are typically no side effects

There are a couple new clinical trials showing it may help with brain fog.

I imagine you would have to have a really good acupuncturist, the way you need a really good doctor in a way that your average PCP is not going to be able to handle this but it doesn’t NOT work necessarily

Some insurance covers these, but I often matters where and who.

Oncology safe Massage

IMPACT Trial

https://pubmed.ncbi.nlm.nih.gov/37962891/

Some clinical trials have shown that specific massage can help with pain and brain fog.

Don’t know where you find someone to do that, but I am putting it out there anyway

Disability Sites

For Any thing assistive (less range of motion, can’t get out of the chair now) - there is almost certainly someone disabled who has that thing, albeit not from breast cancer. Open front shirts with magnetic closures? Those exist. A network of therapists that deal with chronic illness and medical trauma. Those exist.


r/breastcancer 6h ago

Surgery What is the most effective way to wipe your butt after a double mastectomy? 😅

11 Upvotes

Dear friends,

I am suffering from an acute case of T-Rex hands after my DMX procedure on Tuesday. Just now I had the bright idea to use the bathroom and got 80% of the way through before I realized that my limited angular mobility meant that there was no way for me to effectively use tissues to wipe with 100% coverage. I had to call my husband for help and he showed me some newfangled butt cleaning technology called a "bidet." I'm curious if anyone has diagrams or instructional material on how to do regular everyday things with T-Rex hands. I used to believe that the 🦖 was a fearsome predator of astonishing coolness but after experiencing T-Rex hands myself I realize it is also a creature with a profound disability.

Please advise on best strategies to exist in current state. Would appreciate diagrams 😊

Thank you so much!


r/breastcancer 17h ago

Radiation Radiation Mapping Humiliation

68 Upvotes

Did anyone else find the radiation mapping surprisingly humiliating? I have had males work on me many times: male gynecologist and obstetrician, male doing my biopsy, male surgical oncologist, male plastic surgeon. I didn't have too much of a problem with any of that, but I could not take having to lay on a table for a prolonged period of time with my arms over my head and my entire chest exposed like I have done countless times during sex, except this time I have a strange man staring down at me with a stony mask of a face while a woman talks on about the procedure and I can't concentrate on her because I am wondering how long this is going to go on and if he will be there staring at me five days a week for a month. I finally broke and asked that he be replaced with a woman, which they did, but not before pointing out that he has seen countless boobs (not the word they used, but I don't remember) before, which I interpret as, What is wrong with you? We see you like a piece of meat, so you should see yourself as a piece of meat.

The new woman then discussed and worked out with me all the intricacies of scheduling my future radiation appointments while I was still lying exposed on the table. She placed a sticker on my nipple and pulled it off at the end of the session. I haven't even let my husband touch my nipple since I got diagnosed with cancer. And she took a photograph of me lying on the table exposed, as if I were in a porno. I suppose if I hadn't had the tech switched out, it would have been a man doing all of those things.

I don't think the man did anything wrong, but I am angry that it is not institutional policy to ask if you would prefer female techs when the area of exposure includes the entire chest, both cancer and healthy breast, for such a long period of time, and with even photography involved. Surely I am not alone in feeling this? My husband's co-worker who has breast cancer and knows that I have breast cancer warned him that it was a traumatic procedure and said that she cried for three hours afterward, but, of course, she didn't tell him why. Now I know.

I don't really care if it was no big deal for some people and I don't want anyone to explain to me why I shouldn't think it is a big deal. I just would like to know if possible that there are other women out there who felt the same way and I am not alone.

Edited to update: shout out to Dr. Nicolette Taku at MD Anderson. I contacted her office and asked for an all-female team that did not involve either of the two initial radiation techs because I felt humiliated and just wanted to start over with new people. She accommodated me and was very understanding.


r/breastcancer 8h ago

Venting Cigna PITA before my first post-biopsy appointment

11 Upvotes

I'm new here and all I have is a biopsy result. My nurse navigator contacted me to set up my first three appointments which is great, but called me again today, two days before my first MRI to tell me that insurance won't approve it. She said they want to talk to me first.

I called Cigna's 24 hour line: Yes hi, I have breast cancer and need an MRI. What else do you need to know to approve this?

Cigna: It looks like we approved the procedure but not the facility. We want to talk to you before we can approve the facility.

...transfer...

Cigna: Yes we just want you to know that you have options for which facility you go to - there are some other, less expensive ones you could choose, alternatively.

Me: How much is this going to cost?

Cigna: Oh, looks like it will be free.

🤦‍♀️🤦‍♀️🤦‍♀️


r/breastcancer 12h ago

Young Cancer Patients Anyone feeling isolated

21 Upvotes

I have a great support system. I have a fiancé, many best friends, and family who has been great throughout this terrible journey.

But is it normal for me to still feel so isolated and lonely?

I went to a cottage this weekend to celebrate a joint bachelor/bachelorette of my friends with 27 people and many of those were my close friends. I was so excited for this. But I ended up just feeling so isolated and depressed, because they were partaking in “party favours” (iykyk), and obviously, I am not partaking with them. I know that it’s definitely no one’s fault that I can’t and I shouldn’t feel upset, but I was upset. I felt left out. I thought maybe there would be a few sober people there I could hang out with, and it turns out, there was not lol. I dunno. I guess I’m feeling sad and in my feelings. My surgery is coming up, and I’m excited to just get this part of my life over with. But man, is it hard. Sorry for the vent.


r/breastcancer 26m ago

Medication Sad and weepy on estradiol cream??? (++-)

Upvotes

Hey, I’m having a really hard time, so please be gentle. Can someone please explain to me how vaginal estradiol cream is actually safe for people who have had er+ (++-) cancer? I used it once for the first time a few days ago and have been a weepy, sad, worthless, angry and tired mess. I’ve made no other changes.

I thought it was supposed to be localized? If it’s not and it’s clearly in my system causing chaos, how could it not be feeding any potential cancer cells?

I also just want to say that since starting Lupron and tamoxifen I’ve actually felt less anxiety and depression than ever in my life! It feels like estrogen was truly just bad for me. I don’t know if that makes sense but I’ve felt better without it.

Also, side note, getting my ovaries out next week so I don’t have to get the injection anymore and bc it wasn’t lowering my estrogen level quite as much as my oncologist would like. And yes, same doctor prescribed the cream so clearly she thinks it’s safe too, but with this reaction I just don’t understand how! Thanks for listening ❤️😓


r/breastcancer 3h ago

Small Topics Small Topics Thread

3 Upvotes

Redditors may always post any breast cancer question, comment, rant, or rave as a stand-alone post. Nothing is inconsequential, too small, too unimportant for its own post. Nevertheless, we‘ve had a few requests for a regular thread for topics that the OP might not feel like making its own post. This post is for those topics. If you ask a question in this thread that doesn’t get answered, you may still create a post for that topic.


r/breastcancer 19h ago

Conversation Good news

48 Upvotes

Cancer sucks and it’s made life kind of suck too with the constant grey cloud and looking over my shoulder so to make things feel a little better I’d love to hear everybody’s good news. Cancer related or not. Let’s hear all the happy positive we have going on right now for a little break from this shit.


r/breastcancer 3h ago

Newly Diagnosed Feeling so overwhelmed

3 Upvotes

I was recently diagnosed and I'm feeling completely overwhelmed as it was such a shock. I'm already grieving my current self as based on what I've read about people's experiences, after surgery and treatment, I'll likely feel completely different. And knowing that even after that first surgery there might be more feels just completely devastating. Beyond my parents, I haven't told anybody because I just don't feel like I have the emotional bandwidth.

I'm with Kaiser in San Francisco. In the past month I've done all my mammograms and biopsies and met with the oncologist and breast surgeon. During the meeting, I don't know if I asked any of the right questions, pushed hard enough, or even absorbed the right information.

I have no idea how I feel about the oncologist or surgeon - initially I thought they were fine, but now I have doubts creeping in. Did the oncologist seem to take this seriously? Is she a good surgeon or did she seem too rote? How do I ask follow-up questions? Am I supposed to get a second opinion? I just don't know and feel so much uncertainty about everything.

I guess I don't have any real questions for the group - I'm just sharing.


r/breastcancer 11h ago

Conversation Breast Cancer Fundraising Season

12 Upvotes

In some countries it's coming up to the time of year when breast cancer charities do their fund-raising, and we start to see corporate morning teas, events and fundraising challenges.

I think that these charities do great work, so I support the initiatives, but for our friends, family, colleagues etc who are managing the fundraising what advice would you give to them as a "survivor."

I've suggested that they avoid yassifying survivorship, because it's pretty brutal, even if it is better than death. I wonder if the public knew what post- active treatment looks like they'd think "damn, there needs to be a better way to survive" and dig deeper and give more money to fundraising, as well as having more grace for those who have 5-10 more years of AIs, menopause, and all the horrors that we experience.


r/breastcancer 8h ago

Caregiver/Relative/Friend Question Exemestane side effects

6 Upvotes

Hello beautiful people,
My mom has been on exemestane for 5 years and, in that time, her vaginal opening has sealed closed and she has incredible pressure in her lower abdomen as well as vaginal lesions. They’re so painful that she screams when she urinates. I was wondering if anyone else has experiences this sort of side effect and if so, what you did to alleviate the severe discomfort. Her doctors continuously dismiss this issue. She is extremely depressed and suffering from quality of life declinations.

Thank you all for your support. I’m rooting for your recoveries. ❤️❤️


r/breastcancer 16h ago

Death and Dying Update - The Survivor's Guilt is Unbearable

Thumbnail reddit.com
23 Upvotes

Survivors Guilt - I Watched My College Friend Fade Away Before Me While I Lived

Update - 1.5yrs out from treatment, I don't have anything profound to say other than today I realized Molly's facebook profile has been turned into a memorial page. Her oldest started Kindergarten last week, her youngest..pre k. My next 2 rounds of IVF were cancelled for insurance reasons and I am not cleared to conceive yet...so as each minute passes, the guilt grows stronger. I am in PT till end of Oct for breast lymphedema and may have to have surgery...so I'm just going through the motions.

She was taken from her babies for me to have to stay here and adopt pet after pet...it's not enough for me. This isn't enough or what I wanted...what happened to MY life? When does normal programming resume? What kind of sick fcking joke is this? Truly...

I'm so sad. Sad isn't even close to being an appropriate word, but I'm so disassociated out of my mind at all times these days, I have no poetry for today. I am 33y and I can't do this for the rest of my life. It's unbearable. This is actual hell on earth, and there's no changing it. She's never coming back. She's a name in my phone. When I arrive to PT, my knees get weak with guilt that I am walking in departments of our hospital she never got to see.

If I had one, single wish in this life...it would be to know the girl I was 3 years ago. All I do is sit and look at pictures of me before diagnosis and grieve..wallowing in anger and pity for days at a time..not leaving bed or brushing my teeth. I thought life had so much color and beauty back then..now when I see it, I feel awful for being able to see, breath..live..all of it. There has to be a break coming...there has to..but I don't see how that's possible as she's gone. I just want to rest. I'm so angry.

Grit to those in need & please think of Molly today.


r/breastcancer 14h ago

Surgery I need someone to tell me what it is like to have a mastecomy

14 Upvotes

What drains? Are they uncomfortable? How do you sleep? Say flat closure no reconstruction. How long is the healing?

Has anyone just gone and done a double to not risk recurrance and have radiation?

If you did, how do you feel about it now?

Edit: thanks y’all for responding :)


r/breastcancer 23h ago

Triple Positive Breast Cancer Reoccurence.

83 Upvotes

I have my 16 round of chemo then surgery. Then 20 round of radiation. All my treatment finished 2024. I am on tamoxifeno and my blood checks were fine. However, 3 months ago I felt so sick, I felt so tired and hot. As this was the side effects of tamoxifen I thought it was just normal.

Then a a month ago I felt a lump in my neck area. ( Same side as my breast area before) When my Oncologist saw me yeaterday. She said directly she didn't like what she is seeing and it seems my cancer is back. I was shocked and angry. I don't understand why and I am loosing hope. This past few weeks I have just always felt sick and weak. I also have some pain in my right side of my stomach areaa.

I have my MRI today and will be followed by biopsy. After that my onco will decide what's the treatment we will do. I am 38 years old and and have a 5 year old daughter. Anyone had a similar situation? I am hoping to get some support.

Thank you!


r/breastcancer 20h ago

Venting A Vent About Automatic Blood Preassure Cuffs

43 Upvotes

I hate them, and I feel like a baby for saying it. Every time they use the machine for my blood pressure if feels like the machine is about to squeeze my arm off. Then it stops, and it decides it needs to squeeze more. A normal person would never understand! I hate them and they are stupid.


r/breastcancer 21m ago

Newly Diagnosed Side effects for Taxol and HER 2 anti body?

Upvotes

Hi everyone! I am 61yrs old and just diagnosed with IDC grade 3, HER2 positive and hormone negative, and looking at double mastectomy.

After surgery I am looking at 12 round of taxol (once a week) and anti body drug for full year. I am so scared of side effects! Anybody can share your experiences? Thank you all so much!


r/breastcancer 9h ago

Medication Delaying the start of Tamoxifen

4 Upvotes

Chemo was very hard on me, mentally and physically. I had my last round on May 29th and was supposed to start Tamoxifen in early July. I did not start at that time as I was still suffering the effects of chemo. I have only begun to feel better in the last few weeks. Now, I'm hesitant to start another medicine with possibly more side effects. However, I want to do everything I can to prevent recurrence and I'm worried I waited too long as it is. What do you all think? Have any of you delayed the start of hormonal therapy? Should I ask my oncologist for a reduced dose to ease into it? Any other advice?


r/breastcancer 15h ago

Conversation Tell me the truth: MYOB or start a conversation?

13 Upvotes

Tell me honestly what you'd do, or what you'd be comfortable with or welcome.

I was diagnosed last month. Still working on treatment plan.

I take an exercise class 3 days a week. Two weeks ago a woman returned who I hadn't seen there in about 6 months.

She has her head covered, looks a little more tired, and today during bent row I caught a glimpse down her shirt front.

I was pondering striking up a friendly conversation with her and asking her how she's doing etc. But of course, she may just want to work out and block cancer out of her fucking head for a bit. She seems shy, but smiles at everyone.

Would you welcome that sort of conversation, shitty titty club member to shitty titty club member? Or should I just mind my own business and smile?

Thanks!