Strategy for her sanity: "I chose to be naive, to a degree."
| Credit: (KAREN TOMMER)

Strategy for her sanity: "I chose to be naive, to a degree."(KAREN TOMMER)Cut yourself some slack if the terminology of breast cancer staging doesn't make sense at first, especially alongside the enormous stress of being diagnosed with breast cancer in the first place. There's plenty of time to find out—unless, like Karen Tommer, you're content to know just the basics.

Tommer, 34, of Newton, Kan., was confused and scared in April 2005 when doctors found a large tumor in her right breast (invasive ductal carcinoma) and ductal carcinoma in situ in her left one; she was diagnosed as "at least" a stage IIIB.

"I knew this stage was not good," she says, "and I told people I was just a half-step away from being the worst, stage IV. Which was a scary thought, especially with two young children I want to watch grow.

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"My oncologist didn't really explain the stage except that I knew we had to do chemo first to shrink the tumor," says Tommer. "OK, maybe he did [explain it], but when you're in this kind of situation, you really only hear bits and pieces."

Some women insist on knowing every last detail about the stage of their breast cancer: Is it in situ or invasive, bigger or smaller than two centimeters, lymph node involvement or not, metastasis or not? Others do not. "I imagine some people might be upset that there wasn't a full-blown explanation by my doc," says Tommer, "but part of my strategy to stay sane was to learn about my cancer, but not so much that I would live in fear every day. So I chose to be naive, to a degree, and still do."

In the end, Tommer did some research—her oncologist's office lent her a book that did a good job of covering the basics, she says—and ended up having eight rounds of "aggressive chemo," followed by a double mastectomy, 35 radiation treatments, and a complete hysterectomy not long after. "Overall, I knew my diagnosis was advanced and we needed to take aggressive steps to win," says Tommer. That was the part that she absolutely had to understand.