Navigating Tough Conversations After a Diagnosis
- Krista Brown’s breast cancer diagnosis felt especially personal after watching her mother battle stage 3 disease, prompting her to undergo BRCA genetic testing and stay vigilant about her own risk.
- Experts note that BRCA mutations are inherited, giving each child of a carrier a 50% chance of inheriting the variant. “Patients with a strong family history of breast cancer or ovarian cancer or patients who have a diagnosis of a couple of breast cancers in their lifetime will be at higher risk,” Dr. Kate Tkaczuk from the University of Maryland Medical Center says.
- She underwent a double mastectomy and reconstruction, crediting her preparation and care team for helping her navigate the shock of diagnosis and the emotional weight of treatment.
- One of her toughest challenges was explaining cancer to her three daughters; she shared the news honestly, in small, age‑appropriate pieces, encouraging questions, and emphasizing that facing it together strengthened their family.
- “Having these conversations may bring up deep emotions you may have stowed away. There is nothing wrong with showing our emotions to children as long as we can remain calm and give them a sense of safety,” licensed clinical psychologist Dr. Marianna Strongin says.
Brown says she underwent genetic testing for BRCA mutations, which normally help regulate cell growth but, when altered, can significantly increase the risk of breast, ovarian, and other cancers.
Read MoreWhen Brown’s own routine checkup led to a breast cancer diagnosis, she was stunned despite all the steps she’d taken to stay vigilant.
“I was actually really surprised at the diagnosis, but grateful I had a plan in place instead of scrambling to make decisions,” she said.
Krista underwent a double mastectomy (removal of both breasts) followed by breast reconstruction.
WATCH: Breaking Down Breast Reconstruction Options
As Dr. Andrea Pusic of Brigham and Women’s Hospital explains, reconstruction can play a powerful role in healing.
“Breast reconstruction is a restoration of a woman’s form and her sense of self… putting cancer in the rearview mirror,” Dr. Pusic said.
However, one part of her journey proved harder than expected for Brown, explaining her diagnosis to her three daughters.
Brown chose honesty, delivered the news gently, and in age‑appropriate bite-sized pieces.
“Hard conversations with kids need to come from a place of clarity,” she shared on Instagram. Taking time to process her own emotions first helped her speak calmly and confidently with her children.
She believes in being truthful while not overwhelming them.
View this post on Instagram
“Genetics and cancer are hard things to explain to young children. Sharing small pieces of age‑appropriate info and then letting them process before adding more over time was so helpful.”
Brown encourages parents in a similar situation to invite questions, validate their feelings and the feelings of their children, and move through the experience together.
“Trust the process. These are tough conversations, but facing these things together has brought us closer in so many ways,” Brown said.
Expert Resources for Cancer Patients
- Tips For How to Handle the ‘Cancer Conversation’ With Friends and Family When You Gather for the Holidays
- Talking to Kids About Cancer: Be Open as Much as You Can
- Talking About Cancer Over Holiday Dinner Can Be Tough — Here are Some Tips to Get You Through It
- Tools For Talking To Loved Ones About Your Prostate Cancer Diagnosis
- How to Be Realistically Optimistic: Coping With Mental Health Long-Term
- Mental Health: A Guided Breathing Exercise to Help Manage Anxiety
- Mental Health: Coping With Feelings of Anger
- Mental Health: Understanding the Three Wellsprings of Vitality
More Tips for Parents Struggling to Talk About Their Cancer
If parents are nervous before this conversation, licensed clinical psychologist Dr. Marianna Strongin said children can pick up on their emotions, so it may help to check in with yourself beforehand.
“If, at this moment, you are feeling scared, it might be helpful to calm and soothe yourself first before speaking to your child,” she said.
“Having these conversations may bring up deep emotions you may have stowed away. There is nothing wrong with showing our emotions to children as long as we can remain calm and give them a sense of safety,” she said.
View this post on Instagram
Helping them feel safe can give them tools and strategies to manage their feelings about the situation.
“I love using my childhood self when explaining anything to children,” Strongin said. “I might say, ‘When I was your age, I remember feeling scared of many things, but one thing that always helped is taking three very deep breaths and telling my body it will be okay.’
“It is these kinds of dialogues that allow our children to feel safe and in control.”
There is no single way to discuss cancer with children, as widower John Duberstein explained to SurvivorNet.
Duberstein lost his wife to breast cancer, but the couple discussed her cancer with their children before she passed away.
“I think it’s really important to be open with the kids as much as you can, as much as you feel like they can handle,” Duberstein explained.
“When Nina started to look less like a cancer patient, the kids started to make unspoken assumptions about where Nina stood,” Duberstein said.
He went on to say that, as parents, they had to counter false narratives that developed in their children’s heads about their mother’s prognosis. They had to remind them that her cancer was not going away gently.
“It was hard for them to hear even though they’d already been prepared,” he further explained.
Understanding Early-Stage Breast Cancer and What Comes Next
Early-stage breast cancer means the tumor is small and hasn’t spread to nearby lymph nodes. According to Dr. Comen, the first step is usually surgery to remove the cancer. This may involve a lumpectomy, where only the tumor and surrounding tissue are removed, often followed by radiation therapy to reduce the risk of recurrence.
However, treatment isn’t one-size-fits-all. Factors like age, tumor size, family history, and personal preference may influence whether radiation is needed or if a patient chooses a more aggressive approach, such as a mastectomy—removal of the entire breast. After surgery, a pathologist examines the tissue under a microscope to help determine the next steps in treatment.
WATCH: Understanding Early Stage Breast Cancer
Diagnostic testing plays a critical role in shaping your care plan. If a mammogram or clinical breast exam reveals something abnormal, your care team may recommend:
- Diagnostic mammogram and breast ultrasound to get a closer look at the breast and nearby lymph nodes
- MRI scans for additional imaging detail
- Biopsy of suspicious areas, including lymph nodes, to confirm cancer
- Tumor marker testing to identify hormone receptors and proteins that influence treatment options
- Additional imaging to check for any signs of metastatic disease
Once all this information is gathered, your cancer is staged—based on tumor size, lymph node involvement, and whether it has spread. Staging helps guide treatment decisions, while hormone receptor and protein marker tests reveal how the cancer behaves and which therapies may be most effective.
Your healthcare team will consider all of these factors—alongside your personal health, values, and goals—to create a treatment plan tailored to you.
When to Screen for Breast Cancer
The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.
The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.
WATCH: Mammograms are still the best tool for detecting breast cancer.
Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.
Regular Self-Exams Are Helpful In Between Mammograms
A self-breast exam is an easy way to monitor your breasts for abnormalities. It involves feeling the breast for swelling, bulging, or changes in the shape of the breast or nipple.
WATCH: How to perform a self-exam.
Checking for signs of redness, rashes, or discharge is also part of this exam. If anything is found that is concerning, you should contact your doctor. It’s important to note that self-exams should be done with regular mammograms.
Help Coping With a Breast Cancer Diagnosis
If you are facing a breast cancer diagnosis, your emotions are likely to run high, which is completely normal. Psychiatrist Dr. Lori Plutchik says emotions are often fluid when coping with a diagnosis.
“The patient or person going through the stressful event should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support, whether that’s a therapist, friends, and family, or both, to understand the fluidity of stress-related emotions,” Dr. Plutchik said.
WATCH: How to cope with complex and changing emotions.
If a stressful event affects how you think and feel, it may be time to seek mental health treatment. This could mean traditional talk therapy, medication, changing lifestyle habits (like exercise and diet), seeking a support group, or many other approaches.
SurvivorNet experts suggest that women who need a little extra help coping with a breast cancer diagnosis.
- Let your family and close friends know, and let them help. So many cancer survivors tell us they want and need support, but are often too preoccupied to make specific requests. Urge those close to you to jump in with whatever practical help they can offer.
- Keep a journal. It can be extremely cathartic to let those feelings loose on paper. Grab a pen and a nice journal and chronicle your thoughts throughout the day.
- Join a cancer support group. Groups in nearly every community offer opportunities to connect with others going through a similar journey. You’ll learn constructive insight from others who can tell you what to expect and how to stay strong on tough days.
- Consider seeing a therapist. Ask your doctor to refer you to a therapist so you can discuss your fears and concerns in a safe space. Often, vocalizing your thoughts and feelings rather than internalizing them can provide relief.
Questions To Ask Your Doctor
If you have a breast cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet suggests the following questions to kickstart your conversation with your doctor.
- Do I have dense breasts?
- Do I need to undergo additional or more sensitive screening?
- How is my risk level being assessed?
- Will insurance cover additional screening if needed?
To better prepare for upcoming appointments and conversations with your care team, SurvivorNet recommends exploring its proprietary AI-tool “My Health Questions.” The powerful resource is embedded across the SurvivorNet website. It delivers structured responses grounded in clinical guidelines and medically reviewed research to help people better understand their treatment options and feel more confident navigating care.
Learn more about SurvivorNet's rigorous medical review process.
