If you’ve recently received a TNBC diagnosis, you can expect to experience a range of emotions, like anxiety, worry, depression, impatience, frustration, and disappointment. These kinds of feelings are normal as someone comes to terms with a diagnosis that could change the trajectory of their life. Though a range of emotions may be common, you should ask your oncology care team about supports that can help you feel like you aren’t alone, such as social worker, psychologist, support groups, and peer-to-peer support programs.

During those first days after a diagnosis, you may also expect some additional testing to determine the stage of the cancer through imaging of the breast. This could include:

• MRI (magnetic resonance imaging): a non-invasive test that provides detailed images of the breast
• Mammogram: an X-ray of the breast
• PET scan (Positron Emission Tomography): uses a small amount of radioactive material to detect cancer cells
• CT scan (Computed Tomography): uses X-rays and computer technology to look for cancer spread

After additional testing is complete, you may also have an appointment scheduled with a surgical oncologist to discuss findings from the biopsy, which is a small sample of tissue that is examined under a microscope, and the role of surgery in your care plan.

It’s important to keep in mind that the timeline for all testing and appointments can be variable by health region and will depend on the capacity of the system.

How to feel more empowered

After a diagnosis with breast cancer, you may feel more empowered by writing down a list of questions for your oncology care team about your care plan.

Be sure to ask:

• About the type of breast cancer and stage
• What treatments you can expect
• Who your care team will be and who to contact if you have more questions
• What support services are available through your hospital or clinic
• Anything else you may be concerned or curious about

The more information you have about your cancer the more you will be able to advocate for your care.

• PET scans (Positron Emission Tomography): uses a small amount of radioactive material to detect cancer cells
• CT scans (Computed Tomography): uses X-rays and computer technology to look for cancer spread
• Bone scans: uses a small amount of radioactive material to create images of the bones to see if cancer has spread to the bone
• Echocardiograms: uses ultrasound to create images of the heart
• Portacath insertion: a procedure to insert a catheter and port for administering medications or fluids

• Chemotherapy: uses powerful chemicals to kill cancer cells
• Immunotherapy: stimulates or modifies the immune system to recognize and attack cancer cells
• Targeted therapy: uses drugs to identify and attack certain types of cancer cells

Surgery:

• Lumpectomy: surgical removal of the tumor
• Mastectomy: surgical removal of the breasts

Radiation therapy: uses high-energy rays or particles to kill cancer cells and shrink tumors

How to feel more empowered

Managing treatment side effects

During treatment, you can expect to feel a range of emotions often linked to how you’re tolerating treatments. Treatment side effects are common and can impact a patient’s ability to function at home and live a normal life. There may also be feelings of anxiety relating to the future and the outcome of treatments. However, there are different ways of managing symptoms, such as medication, mindfulness exercises, and diet. Always be sure to ask your care team what options you have to lessen the effects of your treatment.

Staying organized

Good organization is key to coping with treatment schedules and planning around work, childcare, and other activities. To help prepare for balancing responsibilities, ask your care team lots of questions about what to expect and how appointments and treatments will be scheduled. You may wish to consider a shared calendar for family and friends who want to support you by helping with childcare, transportation, and meal preparation.

Self-care

Taking care of yourself is critical during treatment for TNBC. Physical activity has been found to be effective for cancer-associated fatigue and can be as simple as taking a walk or doing a free yoga video on YouTube. It’s also important to eat a healthy, balanced diet, as well as utilizing social supports to help reduce anxiety and depression. Since cancer is a journey, not a sprint, self-care can help to increase your resilience in the face of your breast cancer diagnosis.

A year after diagnosis, what you can expect may look very different depending on the stage of your journey. You may still be on treatment if your disease is progressive, or be at the stage of commencing remission or continued monitoring following the first round of treatment. You may still be experiencing side effects from the treatment, which can vary, but can include hair loss, nerve damage or pain, fatigue, brain fog, postoperative pain, skin rash, and reduced mobility of the arm and shoulder. Your side effects may differ depending on the treatment you received and response. After the first year, you may see a reduction in the number of medical appointments.

Managing your emotions

This is also the time that you may see some return to normalcy in your life, such as going back to work, or taking on more family responsibilities. Although you may start to live your life the way you did before your diagnosis, there’s a chance you may have anxiety about the risk of your cancer returning. Fear of cancer recurrence is a common psychological concern for breast cancer survivors and can be debilitating for some people. Because you might feel you are no longer doing anything to treat your breast cancer, it may feel like the cancer will come back despite you doing everything possible to reduce that risk. To reduce these feelings, try to introduce self-care, healthy habits, and relaxation into your lifestyle.

Sense of self and body acceptance

Through the first year of a diagnosis with TNBC, you can expect some changes to your body and how you feel about your body. Some women may face body image issues after breast surgery if they undergo a mastectomy, the complete removal of the breast. If you wish to have children, you may consider speaking with a fertility expert to talk about options such as egg freezing.

A year after diagnosis, it’s important to detach your identity from your breast cancer and focus on other aspects of life that give it meaning and where you find happiness. Otherwise, you risk allowing breast cancer to consume you, despite having completed your treatment. Women who have experienced TNBC may feel empowered to help others or seek other meaningful ways to live with and beyond breast cancer, because TNBC is your diagnosis, not who you are.

In partnership with Jordan Rivera, a Toronto-based oncology nurse practitioner.