Hearing the words “You have breast cancer” can stop you in your tracks. Suddenly, your world is flooded with uncertainty and fear – and a thousand questions.  What does this mean? What happens next? Why Understanding Matters A breast cancer diagnosis can bring on feelings of doubt, disbelief, hopelessness, anger, fear, worry and grief [1]. On top of this emotional weight, you are faced with a maze of unfamiliar terms: stage, hormone receptor status, HER2, subtype and more.  It can feel overwhelming, but understanding your diagnosis is an important first step.  Each detail of your diagnosis helps your doctor create a treatment plan tailored just for you. The more you understand, the more grounded, involved and in control you may feel [2]. Research shows that patients who understand their illness are able to care for themselves better and are more engaged in their own healthcare and treatment [3]. What Does “Stage” Really Mean? After diagnosis, there may be further tests to find out the stage of the cancer—the size of the cancer and whether it has spread. Generally, the lower the number, the less it has spread. A higher number like Stage IV means the cancer has spread beyond the breast to other organs [4].  You might also hear the word ‘grade’. While stage describes how far the cancer has spread, grade describes how fast it may grow, based on how the cancer cells look under a microscope [6]. Understanding the Different Types of Breast Cancer When people hear the word “cancer”, chemotherapy often comes to mind. But not all breast cancers are treated the same way.  There are different subtypes of breast cancer, determined by the presence or absence of certain receptors, such as oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) [7]. This can affect how the cancer behaves and how it needs to be treated [7].  The three most common subtypes are: Hormone Receptor Positive Breast Cancer This is the most common subtype, with about 70% of breast cancers testing positive for progesterone or oestrogen, or both [8]. Endocrine therapy (specifically anti-hormonal therapy) is usually offered as part of treatment [9]. HER2 Positive Breast Cancer This subtype makes up around 15% to 25% of breast cancers [10]. These cancers have too much HER2 protein, which helps them grow [11]. Targeted therapies that specifically aim to block HER2 protein are used to stop the growth of these cancer cells [11]. Triple Negative Breast Cancer (TNBC) Triple negative breast cancer accounts for around 10% to 15% of breast cancers [12]. This subtype does not have PR or ER receptors and also does not produce much HER2 protein [12]. It tends to be more aggressive, growing and spreading faster [11]. While it can be harder to treat, recent advancements, especially in immunotherapy, are offering new hope  [13,14]. You’re Not Alone: Taking an Active Role in Your Care Understanding these terms can be helpful—but it’s just as important that the information is explained in a way that feels manageable and supportive.  Everyone absorbs information differently. What helps one patient feel in control might feel overwhelming to another. Studies show that both information overload and a lack of clarity can negatively affect treatment decisions and increase anxiety and distress [3].  It’s okay to have to ask for clarification or ask repeat questions. You deserve to feel heard and supported. Not sure what to ask? Here are some questions you could use as a starting point [16]: What type of breast cancer do I have? How big is the cancer? Has it spread to other organs? What is the stage or grade of my cancer? What does this mean? Will I need more tests before deciding on treatment? Will I need to see other doctors or health professionals? What are the hormone receptor status and HER2 status of my cancer? How will my cancer type affect my treatment options, long-term outlook and survival? Should I consider genetic testing?  Can I have a copy of my pathology report?  If I’m worried about costs and insurance coverage, who can help me? You might not remember or understand everything your doctor says right away—and that’s okay.  Each small piece of knowledge adds to your strength and clarity. Just by showing up to appointments and asking questions, you’re already taking brave steps forward and building the confidence to face what comes next. You may not have chosen this chapter, but you can shape the story. And you are never alone on the journey.  Click here to access essential, informative guides to support your breast cancer journey. Article contributed and reviewed by Dr Chan Ching Wan, Senior Consultant and Breast Surgeon at Solis Breast Care & Surgery  References: [1] Psychosocial impact at diagnosis and coping strategies among women with breast cancer-A qualitative study [2] American Cancer Society, After Diagnosis: A Guide for People with Cancer and Their Loved Ones [3] How to know what to know: Information challenges for women in the diagnostic phase of breast cancer [4] American Cancer Society, Breast Cancer Stages  [5] Solis Breast Care & Surgery Centre, Luma Women's Imaging Centre, My Breast Health Guide [6] National Cancer Institute, Tumour Grade [7] Solis Breast Care & Surgery Centre, Luma Women's Imaging Centre, Strength in Strides [8] Advances in Therapy for Hormone Receptor (HR)-Positive, Human Epidermal Growth Factor Receptor 2 (HER2)-Negative Advanced Breast Cancer Patients Who Have Experienced Progression After Treatment with CDK4/6 Inhibitors [9] American Cancer Society, Hormone Therapy for Breast Cancer  [10] Subtypes of Breast Cancer [11] National Breast Cancer Foundation, HER2 positive breast cancer [12] American Cancer Society, Triple-negative breast cancer [13] Hope and Hype around Immunotherapy in Triple-Negative Breast Cancer [14] Advances in immunotherapy for triple-negative breast cancer [15] Irish Cancer Society, Getting the most from your doctor's appointments [16] American Cancer Society, Questions to Ask Your Doctor About Breast Cancer