A Breast Cancer Patient’s Journey

Support for Cancer Patients in Maryland

Breast health begins with screening mammography. The American Cancer Society recommends yearly mammograms starting at age 40. Annual mammogram screenings can significantly reduce the number of deaths from breast cancer among women ages 40 to 70.

Meritus Center for Breast Health works collaboratively with Women's Imaging Services at Diagnostic Imaging Services. Annual screening mammograms begin with a referral from your primary care physician. As an established patient, women will receive annual screening reminders from Women's Imaging Services.

A screening mammogram involves an image or X-ray of the breast. A radiologist reviews the images for any abnormalities. If symptom-free, women can expect a reminder for an annual screening one year later.

Diagnostic Mammogram

If a woman's screening mammogram indicates the need for additional imaging, she will be given an appointment for a diagnostic mammogram and possibly an ultrasound. In the most cases, the additional images indicate no area of concern. Less than 20 percent of the time, additional images require the need for further testing or a possible biopsy.

On average, ten percent of women are called back for a diagnostic mammogram. Upon completion of the additional imaging, women are immediately notified of their results.

Diagnostic mammograms or ultrasounds can also be ordered by physicians if they detect something clinically concerning or if a woman is having symptoms of breast cancer.

Breast Biopsy

If images from a diagnostic mammogram look suspicious, a radiologist will request a breast biopsy to remove some abnormal tissue using stereotactic, ultrasound or MRI-guided procedures. For the 20 percent of women for which a biopsy is recommended, only one in 4.7 are positive for cancer. Within several days, a woman will receive a call from her primary care physician or radiologist with pathology's findings. If the result is benign (not cancer), she will return to her regular schedule of screening.

A Cancer Diagnosis

If a woman's biopsy result is positive, she will receive a referral to a clinical nurse navigator. A nurse navigator assists patients with cancer treatment decisions during the unfamiliar and often unnerving process. The specially-trained registered nurse will coordinate care between the patient, physicians and surgeons.

During an appointment with a surgeon, a woman can expect a detailed review of her health history, imaging results and a complete physical.

Breast Cancer Conference

If a woman chooses a surgeon from the Meritus Center for Breast Health, the nurse navigator continues her presence and involvement in the breast cancer conference. A multidisciplinary approach to breast cancer care, the breast cancer conference gathers medical professionals in the area of surgery, oncology, radiation therapy, radiology and pathology to recommend a treatment plan specific to the patient's needs and condition.


Surgery is often needed to remove a breast tumor. Depending on the surgeon's recommendation, a woman will undergo either a mastectomy or lumpectomy. Known as breast-conserving surgery, a lumpectomy removes only the breast lump and some of the normal tissue around the tumor.

When required, the surgeon will perform a mastectomy, where the entire breast is removed. During surgery, the surgeon checks the lymph nodes under the arm for cancer and determines whether a sentinel lymph node biopsy or axillary (armpit) lymph node dissection is required.


Based on the physician's recommendation, a woman may receive radiation therapy, chemotherapy or hormonal therapy after breast cancer surgery. Radiation therapy is used to help lower the chance that the cancer will return. The John R. Marsh Cancer Center uses targeted, state-of-the-art radiation techniques specific to patients' needs.

In some cases, a cancer-killing drug called chemotherapy is used. Chemotherapy is typically given intravenously in cycles, with a period of treatment followed by a recovery period. Hormone therapy is also used to reduce the risk of the cancer coming back after surgery.

Continued Support

The nurse navigator's support continues post-surgery. She will assist with referrals for physical therapy, behavioral counseling, financial aid, clinical trials and establish follow-up appointments with physicians. The nurse navigator is also present to provide emotional support and makes sure patients stay on track with their treatment plans.

Upon completion of breast cancer treatment, a health care provider will give the patient a record of her cancer history and make recommendations for follow-up care, known as a "survivorship care plan." The plan indicates providers responsible for cancer-related and non-cancer-related care, paving the way toward the patient's optimal health.

A Patient's Journey