Dr. Pooja Advani is a breast medical oncologist at the Mayo Clinic who helps patients navigate the confusion and fear that often come with a new diagnosis. In our recent Q&A, she explains what to expect in the following days after a diagnosis, how to make sense of a pathology report, and why second opinions and self-advocacy can be powerful tools in your care.
The following questions and responses have been lightly edited for grammatical purposes.
1) Is there a common myth or misconception about breast cancer that you’d like to address?
I think the biggest thing I tell my patients is that this is not the result of anything you did. That’s often the very first thought patients have. They’ll say, “I lived a healthy lifestyle. I did everything right. I got my mammograms on time. Why did this happen to me?”
While we may never know the exact cause for any one person, what we do know is that there is hope in treating breast cancer. It’s the most common cancer women will be diagnosed with, aside from non-melanoma skin cancers, and we have many effective treatments today. Our goal is always to match the right patient with the right treatment while respecting their quality of life.
Yes, this is an incredibly hard, life-changing diagnosis, and we acknowledge that. But the very first thing I want patients to hear is: there is nothing you did to cause this cancer. It’s so important for us, as part of their care team, to reinforce that.
The second thing I tell patients is that every cancer is different. No two stage I breast cancers are alike. It’s great to gather information from the internet, from concerned family members, from books or blogs. Patients today are so engaged, and that’s wonderful. Bring all of that valuable information to your care team and ask, “Is this applicable to me? I’ve heard about this test, am I a candidate?” I really encourage patients to advocate for themselves, bring their questions, and let us help make sense of what’s relevant to their care.
2) What exactly is a pathology report, and how can patients review it?
A pathology report was originally designed to be read by medical providers, so the language is full of medical jargon. That can make it daunting for patients.
Today, many patients can see their pathology report almost as soon as it’s finalized. Several hospital systems even offer tools that simplify the report into more patient-friendly language. Similar tools now exist for radiology reports as well. So if you have access to your hospital’s patient portal, I definitely encourage using it. These newer features can really help break down complicated medical terms.
Another great resource is your nurse navigator or clinic nurse. Education is a big part of their role, and they can walk through the report with you, explaining what “grade” means, what the different subtypes are, hormone receptors, biomarkers, and so on.
Ultimately, it’s the care team’s responsibility to review the report with you and have that conversation.
3) What are your thoughts on second opinions?
I always tell patients: feel free to get a second opinion. The more minds that come together to think about your care, the better. Most medical professionals aren’t offended when you ask. We understand completely.
In fact, getting a second opinion often brings real advantages. At many institutions, it includes a second review of the pathology. A pathologist will look at the slides again, not because we doubt the initial review, but because it’s part of the service. It gives patients peace of mind to hear, “Yes, this other institution agrees with the pathology, the imaging, or the treatment plan.”
The other major benefit is access to clinical trials, which I strongly encourage patients to consider. Clinical trials are how we move the field forward. We now have new knowledge and options that help current and future patients.
Second opinions can help identify trials that might be uniquely available at that institution. I always tell patients not to hesitate. Get the information, bring it back to your provider, and say, “Here’s what they suggested. What are your thoughts?” Together, you can come up with the plan that’s best for you.
Watch the full webinar replay here.
