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Understanding a Breast Cancer Diagnosis

A diagnosis of breast cancer can leave you and your family reeling, but it is important to remember that you are not alone. In fact, one out of every eight women in the United States will develop invasive breast cancer in their lifetime, according to the American Cancer Society. Fortunately, there is a high rate of survival for many forms of the disease when caught early and properly treated.

“Most people learn they have breast cancer from their primary care doctor,” says Rachel P. Dultz, MD, FACS, Medical Director of the Penn Medicine Princeton Medical Center Breast Health Center. “When they do, the best thing to do is to see a breast specialist. Around 80 percent of breast cancer treatments start with surgery or a pre-operative procedure, so turning to a specialist right away is very important.”

What Stage is it?


Following diagnosis, your breast specialist will perform testing, such as blood work, a breast MRI, a CT or PET scan, or other procedures, to determine the extent (or stage) of your cancer. This will help determine your prognosis and the best treatment options. 

Stages range from 0, which indicates the cancer is noninvasive or contained within the milk ducts, to IV, which indicates the cancer has spread to other areas of the body. Stage IV is also referred to as metastatic breast cancer.

“Your doctor will go over the staging process with you, since it can involve quite a few factors,” says Dr. Dultz, who is a fellowship trained breast surgical oncologist and board certified surgeon. “Generally speaking, it involves the biology of the cancer, how aggressive it is, its size and whether the lymph nodes are involved.”

Developing a Treatment Plan


Most breast cancer care plans involve two phases. The first phase is usually a surgical procedure such as a lumpectomy to remove the tumor and a small area around it, or a mastectomy to remove one or both breasts, as well as surrounding tissue. For some women, a nipple-sparing mastectomy may also be an option. Before one of these procedures is performed, your surgeon may perform a sentinel node biopsy to determine if the cancer has spread to your lymph nodes. If it has, they may also be removed during your breast surgery.

The second phase of treatment usually involves radiation therapy, chemotherapy, hormone therapy or targeted drug therapy. 

At the Breast Health Center, all aspects of care — from routine screenings to surgery and after-surgery care — can be performed in a centralized location, and a nurse navigator is available to help coordinate your care.

The Center has been awarded three-year full accreditation by the National Accreditation Program for Breast Centers, a program administered by the American College of Surgeons, and has been designated a Breast Imaging Center of Excellence by the American College of Radiology. 

For more information about the Penn Medicine Princeton Medical Center Breast Health Center, or to schedule an appointment, call 609.688.2700, or visit

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