The powerful prognostic factors that influence the treatment of breast cancer are the size of the tumor, whether it is invasive or not, if it's metastatic at the time of diagnosis, if it's hormonally sensitive and if there is a family history of breast cancer.  Regardless of the treatment options, the patient's choice is ultimately a personal one.

Fact:  Breast cancer should more accurately be called breast cancers.  The disease is not a singular one, but several, and each type is unique.  You can think of them in two main categories - invasive breast cancer and in situ breast cancer .  The invasive cancers can be further broken down into another two categories - those that spread very early in their development and those that spread more slowly as they grow.

Fact: Each woman with breast cancer will be diagnosed at a distinct stage of the disease.

Fact: Tumor tissue can be estrogen-receptor or progesterone-receptor positive or negative.  A positive result means the cancer uses hormones to stimulate growth and it can be treated by blocking the circulation of that hormone in the body.

Fact: A family history of breast cancer can affect the timing of treatment, treatment response and outcome.  A very high-risk woman may start treatment before cancer shows up with a chemoprevention drug or even with prophylactic (preventive) mastectomy. And, while studies have shown that the combination of lumpectomy and radiation is equivalent to mastectomy for most women, it is uncertain if women with strong family histories are good candidates for this breast-conserving therapy.

Fact: Cancer treatments all have disadvantages as well as advantages.

Fact:  Every woman will react to treatment differently, both physically and emotionally. 

Fact (and theory): In many cases, there is no way to predict with absolute certainty whether a cancer has spread. (In the past, breast cancer was thought to grow in an orderly progression from a tiny tumor in the breast tissue to a larger one, sequentially traveling out to the nearby lymph nodes , then distant ones, and finally to other parts of the body. Now, however, it is thought that cancer cells are capable of traveling from the breast through the blood and lymphatic system very early in the course of the disease.)

There is no one treatment plan that is right for every woman.  It all boils down to probabilities and weighing risks versus benefits.  Breast cancer treatment has to be tailored to each individual woman based on a treatment's probability of success as well as on her preferences.  Each woman will have a unique treatment goal that can vary from treating a cancer as aggressively as possible to choosing not to receive treatment at all.   

Fortunately, new treatment methods and options are continually presenting better odds with fewer side effects.  And, doctors and researchers are developing more tools that can help women with their decision-making process. Until we reach an ideal world, though, be prepared to hear "We don't know ."  Doctors will tell you there are just too many variables so you do the best you can by calculating odds and doing what our panelists recommend -- deciding what degree of uncertainty you can live with and then moving forward.