NCCN Guidelines for Patients
Stages I and II Breast Cancer, Version 1.2014
Genetic counseling | Fertility counseling
if the physical exam, imaging tests, and biopsy results
are normal. Read page 27 for more information. The
two needle biopsies for lymph nodes are:
An FNA (
spiration) uses a very thin
needle and syringe to remove a small group of cells
from a node. Ultrasound may be used to guide the
needle into the node. This biopsy takes a few minutes
Core needle biopsy
The needle used in a core needle biopsy is able to
remove a solid tissue sample. Like FNA, ultrasound
may be used to guide the needle into the node. Local
anesthesia is given to reduce pain.
Assessing for hereditary breast cancer
About 10 out of 100 breast cancers are due to
changes in genes that are passed down from a parent
to a child. This is called hereditary breast cancer.
Using your age, medical history, and family history,
your doctor will assess how likely you are to have
hereditary breast cancer. If the likelihood is high, you
should see a genetic counselor.
A genetic counselor is an expert in changes within
genes that are related to disease. The counselor
can tell you more about how likely you are to have
hereditary breast cancer. He or she may suggest
that you undergo genetic testing to look for changes
in genes that increase your chances for developing
Hereditary breast cancer is most often caused by
mutations in the
genes help to prevent tumor growth by fixing
damaged cells and helping cells grow normally.
Genetic testing can tell if you have a BRCA or another
mutation. Your test results may be used to guide
Some abnormal changes in genes, called VUS
ignificance), are not fully
understood by doctors. Your doctors may know of
research that aims to learn more. If interested, ask
your doctors about taking part in such research.
Talking about having babies
If you still have menstrual periods, your doctors will
have important information to share with you. First,
it is important that you not get pregnant during most
cancer treatments. Cancer treatments may harm your
baby. Your doctors can tell you which birth control
methods are best to use while on treatment.
Second, some breast cancer treatments may affect
your ability to have babies in the future. If you want
the choice of having babies after treatment or are
unsure, tell your doctors. After treatment has ended,
some women decide they want to have another baby.
If you still have menstrual periods, it may help to
talk with a fertility specialist before you begin cancer
treatment. A fertility specialist is an expert in helping
women get pregnant. The fertility specialist can
discuss with you ways to help you have a baby after