And if surgery is required, women may be faced with deciding whether to have breast reconstruction.
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One woman shares her experience, to help others 'beat the odds against breast cancer.'
Mary Depoe of Lancaster, Pa., first thought she'd be done with breast cancer after a lumpectomy and chemotherapy.
However, the cancer was more complex than first thought, and, Mary was soon facing a bilateral mastectomy, with reconstruction.
After exploring options with Penn Medicine plastic surgery chief Joseph Serletti, Mary settled on what's called a DIEP flap.
"I liked that it would be one surgical procedure, that it wouldn't be multiple procedures," she explained.
"I went to sleep with breasts, and I woke up with breasts," she added.
Dr. Serletti says reconstruction is more common now that laws require health insurers to cover it.
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And if it's needed, insurers must also cover balancing procedures, such as augmentation or a breast list, for body symmetry.
Reconstruction generally falls into 2 categories - those with implants, and those using a patient's own tissue.
However, there are changes in each category.
"We used to have just round implants. Now we have shaped implants," said Dr. Serletti.
Mary chose the other route, with Dr. Serletti using just a small piece of abdominal muscle, plus fat and skin - not full muscles like in the past.
"I was in the hospital for a couple of days, went home, didn't have tremendous pain, and I was back on the tennis court in 6 weeks.," Mary says with a broad smile.
She says tennis kept her active, and her spirits high through her whole cancer journey.
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"My game's not any better, though," she jokes.
She was also happy to get back to her job working with children so quickly.
A survey out earlier this year showed that many women don't fully understand what reconstruction entails.
Next Wednesday, October 18th, Penn Medicine will host its 6th annual BRA Day, or Breast Reconstruction Awareness Day - to make sure they do.
It's free - just register at BRA Day 2017.
Mary says she was very happy to be able to get all of her Penn Medicine care - from diagnosis, through treatment, surgery and reconstruction, and follow-up care close to home at Lancaster General Health, which is now part of the Penn system.
See Mary's story at: A Breast Cancer Journey.