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I’ve Just Been Diagnosed with Breast Cancer – What Happens at My Consultation?

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Being diagnosed with breast cancer can be a confronting and emotional experience. Your first consultation with a breast surgeon is a crucial step toward understanding your diagnosis and planning your treatment. The goal is to assess your overall health, review your cancer findings, and develop a personalised treatment plan tailored to your needs.

It’s highly recommended to bring a trusted friend or family member with you. They can provide support, help absorb the information, and ask questions you may not have considered.

Getting to Know You

We begin by getting to know you—not just your diagnosis. Understanding your lifestyle and medical background helps us tailor your care effectively.

  • Your background – We’ll discuss your age, occupation, living arrangements, and support system at home.
  • Medical history – We’ll review any existing health conditions (particularly heart or lung problems), regular medications, allergies, smoking and alcohol use.
  • Family history – A history of breast, ovarian, or bowel cancer in close relatives may suggest an inherited genetic risk, which can influence management.

Understanding Your Breast Cancer

Next, we delve into the details of your diagnosis:

  • How was the cancer found? Was it detected on a screening mammogram, or did you notice a lump or symptom yourself?
  • Duration – How long have you had symptoms? Have you had any previous breast issues?

We’ll then review your breast imaging:

  • What imaging has been performed? (e.g. mammogram, ultrasound, MRI)
  • How many tumour areas (foci) are there? What is their size and location?
  • Are there any suspicious lymph nodes in the axilla (underarm)?

We also examine your biopsy (histopathology) results, which typically include:

  • The type and grade of cancer
  • Hormone receptor status (ER/PR) and HER2 status
  • Ki-67 index – an indicator of how fast the cancer cells are dividing

In certain cases—such as large tumours (>50 mm), involvement of skin or muscle, or lymph node spread—we may recommend staging scans (e.g. CT, bone scan, or PET) to determine if the cancer has spread elsewhere.

Planning Your Treatment

After gathering all the necessary information, we will formulate a personalised treatment plan. Breast cancer treatment often involves a combination of the following:

🩺 Surgery (click for more information)

Most patients will undergo surgery as a key part of treatment.

  • Lumpectomy (breast-conserving surgery) – removes the cancer while preserving most of the breast.
  • Oncoplastic surgery – advanced techniques used to reshape the breast at the time of lumpectomy, ensuring better cosmetic outcomes.
  • Mastectomy – removal of the entire breast. Most patients are suitable for reconstruction, either:
    • Immediate (at the time of mastectomy), or
    • Delayed (after completing chemotherapy or radiotherapy), using either silicone implants or autologous tissue (e.g. from the abdomen or back).
  • Sentinel lymph node biopsy – to determine if the cancer has spread to the lymph nodes.
  • Axillary clearance – removal of all lymph nodes under the arm, usually only performed if cancer has already spread to them.

💊 Chemotherapy and Immunotherapy

These systemic therapies are used to treat cancer throughout the body.

  • Chemotherapy – typically given over 4–6 months and used for more aggressive or higher-risk cancers.
  • Targeted therapy – for example, trastuzumab (Herceptin) is used for HER2-positive breast cancers.
  • Immunotherapy – such as anti-PD1 monoclonal antibodies, may be used in some triple-negative breast cancers.

☢️ Radiotherapy

  • Radiotherapy is usually required after a lumpectomy to reduce the risk of recurrence in the remaining breast tissue.
  • It is not always needed after mastectomy unless there is a large tumour, involvement of skin or muscle, or multiple lymph nodes affected.

🌡️ Endocrine (Hormonal) Therapy

If your cancer is hormone receptor-positive, hormone-blocking tablets are recommended:

  • Tamoxifen or raloxifene – commonly used in younger or premenopausal women
  • Aromatase inhibitors (e.g. letrozole or anastrozole) – typically used in postmenopausal women

These are usually taken for at least 5 years and significantly reduce the risk of recurrence and improve long-term survival.

What’s Next?

In most cases, surgery is the first step, and we will discuss your options for lumpectomy or mastectomy (with or without reconstruction), as well as sentinel node biopsy.

For more complex cases, we may organise additional scans, consider genetic testing, or refer you to medical or radiation oncologists. Your case will be discussed at a multidisciplinary team (MDT) meeting, where specialists collaborate to ensure you receive the best possible care.

We understand this is a lot to take in. If you feel overwhelmed, a second appointment can be arranged to review everything and address your questions.

Support Along the Way

You are not alone.

  • The McGrath Foundation offers free access to breast care nurses who provide ongoing physical, emotional, and practical support from the time of diagnosis through treatment and recovery. No referral is needed.
    👉 Find a nurse here

Final Thoughts

Every breast cancer journey is different, but you are never alone. We are here to guide and support you every step of the way. Asking questions and understanding your diagnosis empowers you to make confident decisions about your care.

Check out: What Can I Expect After A Breast Cancer Diagnosis?