[Steps following the histologically assured diagnosis of breast cancer]

Steps following the histologically assured diagnosis of breast cancer Abstract. Herein we describe the steps following the histologically assured diagnosis of breast cancer. This includes the difficult process of delivering the bad news to the patient (ideally done by a breast surgeon) in which the NURSE model can be of valuable support. Furthermore, we describe the decision making of how to decide for the treatment best suited for the patient. One step in this process is the classification of the breast cancer based on the classification of the 12th St. Gallen conference in 2011. This differentiates between intrinsic subtypes and helps finding patients which would or would not benefit from chemotherapy. As breast cancer is the most frequent indication for a fertility counseling when having an oncological affection, such a counseling should be considered. A genetic counseling can be another important information for the patient. In some cases, a preoperative staging examination can add valuable information supporting the decision-making process and should be done. When all findings and reports are collected, the therapy concept should be fixed in a preoperative tumor conference including the decision whether the indication is given for a neoadjuvant chemotherapy or for an upfront surgery. When treated by a multidisciplinary team, the involvement of a breast cancer nurse as well as a psycho-oncologist is of high importance. This allows for an adequate attention to the emotion-based needs, fact-based needs and physical needs of the patient. By this a better handling of the situation by the patient and an improved quality of life for the patient can be induced and at the same time psychological consequences can be more easily recognized and consequently treated more efficiently.