Breast surgeon questions

Posted by whyme2023 @whyme2023, Mar 16, 2023

I just got my diagnosis yesterday (DCIS, R breast); awaiting a call to schedule the breast surgeon consultation; during the diagnosis call I got a lot of overwhelming info but I think I’m clear on next steps. Since I’m young, 53 and in good health, praying this will be a somewhat routine process - surgery and radiation 🤞(no maternal family history); I know we are all different but being optimistic is the best approach in my opinion. My question is, are there specific questions I should ask the surgeon during the consultation?

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My surgeon could only advise on how he thought treatment would go post-surgery. He is responsible for getting clean margins around the tumor and checking for any lymph node involvement ( having a blue dye injected the day before so that he can follow it from the tumor to the lymph node/s.)
Based on the initial biopsy diagnosis ( invasive lobular carcinoma stage 1) my surgeon and radiologist predicted radiation and hormone therapy. After surgery with clean margins and no lymph node involvement (the sentinel lymph node was removed and biopsied) the oncologist/hematologist recommended chemotherapy, radiation and hormones. The pathology report on my tumor said INVASIVE CARCINOMA OF NO SPECIAL TYPE (ductal) WITH LOBULAR FEATURES and DUCTAL CARCINOMA IN SITU. I asked for an oncotype test to be done on my tumors, to better understand if chemo will really be necessary. The oncologist orders it and the test is done on the tumor that was removed by the surgeon(no new tests). This test takes about 3 weeks, and I am waiting for my results...impatiently! An oncotype score of 26 or higher warrants chemotherapy due to the chance of cancer recurrence.

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You could ask if an Oncotype for DCIS is going to be done. You might be prescribed an aromatase inhibitor if you are post-menopausal. Good luck!

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Breast cancer surgeon questions -
Oncologist questions -
Reminder our surgeons give you the options and provide the risks.

It was my choice to go all
Out and take the full surgery and double mastectomy.
After tumors were reviewed radiation and more chemo.
At this point I am Cancer clear!
Diagnosed HER2 positive stage 3 grade 3, 9/28/2021.
New scans 4-24!!
Good luck on your journey, prayers with all!

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@windyshores

You could ask if an Oncotype for DCIS is going to be done. You might be prescribed an aromatase inhibitor if you are post-menopausal. Good luck!

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Thanks for your reply - I added to the list to ask about the oncotype testing and if an aromatase inhibitor is needed.

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The biggest question is lumpectomy vs mastectomy? Any lymph node effected?
If possible, have a friend / family member on call. Two sets of ears better then one.

Check out these two web site for possible questions.

First is two page list of questions that are good starting point:
https://www.komen.org/wp-content/uploads/QTAD-Breast-Cancer-Surgery-KO0520-FINAL-3-17-HR.pdf
This website has longer list of questions:
https://www.cancer.net/cancer-types/breast-cancer/questions-ask-health-care-team
Laurie

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You also might want to have genetic testing done. That may tilt the scale to having a mastectomy, if you have breast cancer markers. That being said. Not having the markers doesn't mean that you won't develop a cancer. I'm the 3rd out of 4 females in my family to develop breast cancer.

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@roch

The biggest question is lumpectomy vs mastectomy? Any lymph node effected?
If possible, have a friend / family member on call. Two sets of ears better then one.

Check out these two web site for possible questions.

First is two page list of questions that are good starting point:
https://www.komen.org/wp-content/uploads/QTAD-Breast-Cancer-Surgery-KO0520-FINAL-3-17-HR.pdf
This website has longer list of questions:
https://www.cancer.net/cancer-types/breast-cancer/questions-ask-health-care-team
Laurie

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Oh my goodness, what a great set of resources. Thank you so much for sharing these links - it’s greatly appreciated. My consultation is Wednesday and the more I know in prep for that session, the better. Many thanks!!

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UPDATE - I had my consultation yesterday and got a lot of questions answered. I feel very good about the plan and am eager to see the results of the genetic testing and MRI (obviously praying for nothing more serious than the calcification that currently appears).
Here’s the treatment plan:
1 - genetic testing (bloodwork sent yesterday)
2 - PreHab (occupational therapy - learn exercises to avoid complications in R arm after surgery) scheduled for Monday
3 - MRI - scheduled after insurance preauthorization is received for MRI and surgery
4 - Surgery (lumpectomy planned unless something more serious is found in MRI)
5 - Radiation (3-5 weeks depending on what’s found in MRI)
6 - Meds - anti- estrogen
Surgeon doesn’t expect much/if anything to change to this plan unless of course the genetic testing and MRI reveal something she can’t see or is t aware of currently.
Fingers crossed - feel free to offer follow up suggestions if you think there are other things I need to know or ask.

Thanks for all the support. 🙏

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@dyevooshka

My surgeon could only advise on how he thought treatment would go post-surgery. He is responsible for getting clean margins around the tumor and checking for any lymph node involvement ( having a blue dye injected the day before so that he can follow it from the tumor to the lymph node/s.)
Based on the initial biopsy diagnosis ( invasive lobular carcinoma stage 1) my surgeon and radiologist predicted radiation and hormone therapy. After surgery with clean margins and no lymph node involvement (the sentinel lymph node was removed and biopsied) the oncologist/hematologist recommended chemotherapy, radiation and hormones. The pathology report on my tumor said INVASIVE CARCINOMA OF NO SPECIAL TYPE (ductal) WITH LOBULAR FEATURES and DUCTAL CARCINOMA IN SITU. I asked for an oncotype test to be done on my tumors, to better understand if chemo will really be necessary. The oncologist orders it and the test is done on the tumor that was removed by the surgeon(no new tests). This test takes about 3 weeks, and I am waiting for my results...impatiently! An oncotype score of 26 or higher warrants chemotherapy due to the chance of cancer recurrence.

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Me adding that I got my oncotype Dx yesterday and at 64 years old with a score if 17, chemo will have no effect for me, so NO CHEMO! Now we discuss radiation or just hormone blockers and tamoxifen.

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@whyme2023

UPDATE - I had my consultation yesterday and got a lot of questions answered. I feel very good about the plan and am eager to see the results of the genetic testing and MRI (obviously praying for nothing more serious than the calcification that currently appears).
Here’s the treatment plan:
1 - genetic testing (bloodwork sent yesterday)
2 - PreHab (occupational therapy - learn exercises to avoid complications in R arm after surgery) scheduled for Monday
3 - MRI - scheduled after insurance preauthorization is received for MRI and surgery
4 - Surgery (lumpectomy planned unless something more serious is found in MRI)
5 - Radiation (3-5 weeks depending on what’s found in MRI)
6 - Meds - anti- estrogen
Surgeon doesn’t expect much/if anything to change to this plan unless of course the genetic testing and MRI reveal something she can’t see or is t aware of currently.
Fingers crossed - feel free to offer follow up suggestions if you think there are other things I need to know or ask.

Thanks for all the support. 🙏

Jump to this post

Thanks for posting the update. Everything sounds perfect! Soon you’ll be on your way and will have this all behind you. ♥️

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