17. Psychosocial problems following a diagnosis of breast cancer.

Most breast cancer patients are not ill but have to cope with major life changes, in the knowledge that they have a potentially life-threatening illness. Additionally they have to withstand multiple physical and psychological demands of local and systemic treatment. The role of the specialist breast care nurse is to reinforce information, discuss treatment options, and if the patient has further questions to arrange additional appointments with the appropriate member of the breast team. Approximately 20% of newly diagnosed patients will experience long-term psychological problems, and those at greater risk are cases with a previous psychiatric history, lack of support and low expectations of the benefit of treatment, sometimes from a previous adverse experience with a family member. The breast care nurse is in a good position to identify those at risk and to advise on the benefits of surgery and breast reconstruction. Clarification of the benefits and side-effects of other treatments such as chemotherapy and radiotherapy are also part of the breast care nurse's remit. Patients in need can receive support including coping strategies which will improve their psychological well-being during the cancer journey.