Here’s some thoughts -

Immediate Focus for Tuesday:
Tissue Biopsy
The most urgent priority for your visit is requesting a tissue biopsy of the wound bed and edges.
When a radiation wound continues to tunnel, deepen, or fail to heal after standard treatments and hyperbaric oxygen, doctors must formally rule out two possibilities:

Recurrent or persistent breast cancer: Cancer cells in the wound bed can prevent normal healing.

Severe Radiation Necrosis / Vasculitis: High-dose radiation can destroy micro-blood vessels, leaving deep tissue without the oxygen needed to heal.

Questions to Ask Your Oncologist

1. About the Non-Healing Wound
"Can we perform a tissue biopsy of the deep wound bed and edges to rule out local recurrence or infection?"

"Are we dealing with severe radiation necrosis, and should I be evaluated by a specialized reconstructive plastic surgeon or a dedicated wound care team that works with complex radiation injury?"

"Has a deep wound culture been taken recently to test for specific resistant bacteria or fungal growth in the tunneled area?"

2. "What is my current systemic treatment plan, given that my wound has prevented normal recovery?"

3. About Surgical & Advanced Healing Options
"If hyperbaric oxygen and wound vacs are failing, are we at the point where a tissue flap (moving healthy, well-vascularized skin/muscle from another part of the body) is needed to close this wound?"

"Should we pause or adjust any current treatments until this tissue gets healthy blood flow?"

I have to admit these questions were created by Google Gemini. I know some people don’t like AI supported searches and analysis but it has hit on some important things that might be helpful to you!