DCIS- 2nd Opinion?

aratanawan

My mom was diagnosed with early Stage 2 Breast Cancer- DCIS and the Dr. said he would not be offended if we asked for a second opinion.  When we were in his office we said no no- you're a great Dr. etc but now that we've come home it seems that the best thing to do IS get a second opinion to confirm treatment.  He is highly recommend a mastectomy due to location of tumor and how big it is 4.5 cm. 

Question:

- Is a 2nd opinion recommend?

- What is the first step in finding the right Dr to getting a 2nd opinion?  Look under the insurance, search for renown Medical Oncology expert, etc?

- She lives in Los Angeles

Thanks All!  

Lifeafter

Hi aratanawan - Was your mother diagnosed, Stage II and DCIS?

aratanawan

Hi Mrochon- Yes they said she was early Stage II and DCIS- non invasive with tumor size 4.5 cm 

Lifeafter

If it were me I would definitely get a second opinion. My mother-in-laws sister was just diagnosed with a similar diagnosis. She will be having a mastectomy in a couple of weeks. You need all the consult you can get right now.

You will need to call your insurance to see what the process is for second opinions. I have Blue Shield of CA. The process for me was to go back to my referring physician which was my gynecologist. I asked him for his recommendations because I have a very good relationship with him and trust him. I got a second opinion scheduled within a couple of days. I was also allowed to go to any oncologist I wanted, even if they were not under my insurance.

I would recommend putting a thread out for recommended oncologists in your area on this board to see what you get back. That way you have some names to take with you to your referring doctor.

aratanawan

I agree- nothing come be "bad" about getting a second opinion. 

They were planning for her surgery at the end of February so there is still time.  She has Anthem Blue Cross HMO.  Would definitely want to go within insurance as to not incur any unncessary fees (if possible.)  

Some boards have said to try to get a 2nd opinion outside of network your physician is in because they might be prone to have the same prognosis.

Thank you so much for the quick response!  

fitzdc

Another question to ask is what type of cancer is the Stage II as DCIS is Stage 0 -

cycle-path

aratanawan -- I think possibly your mom has DCIS grade 2, rather than DCIS stage 2. 

I saw your other thread looking for an oncologist in the SF Valley -- I'm south of LA so my docs aren't near you, but I'm wondering if you really want an oncologist. At this stage, it seems like a Breast Surgeon may be the way to go. Am I confused about something? Is there a particular reason you're looking for an MO instead of a BS? 

You might try contacting member RobinH -- I think she may be in the Valley. She doesn't have Anthem, but she may be able to give you some names anyway. Have you thought about going to UCLA? Not terribly close, but certainly a good cancer center. If you're willing to go downtown, I'd suggest you try Dr. Dennis Holmes. Here's his web site: http://www.breastcanceriort.org/ 

CookieMonster

I commented on your other thread too. It really sounds from this like you want a breast surgeon, they can tell you about the surgery options, the medical oncologist can talk about the systemic stuff (chemo, hormone therapy, etc...) the breast surgeon can talk lumpectomy vs. mastectomy.

At UCLA I got a second opinion with Helena Chang, and my BS also recommended Prati if I couldn't get in to see Dr. Chang. My BS fully supported me getting a second opinion and even predicted what Dr. Chang would tell me and why. A doctor who doesn't want you to get a second opinion is one not to be trusted. I was NERVOUS about telling her I was getting the 2nd opinion (this was after my first lumpectomy), but when I did she was 100% supportive. Her name, BTW is Nova Foster, but while associated with UCLA, her office is in Santa Monica, a bit further from UCLA.

Feel free to PM with more questions if I can help.

tranquilitywithn

My sister recently was diagnosed with DCIS grade III. Her Doctor said she needs to do a partial masectomy and stated that if she wants to live a long life, he suggests she have a double masectomy. My sister asked for a second opinion and it was approved through her insurance.  The second opinion results were that she didn't need a double or partial masectomy. She now wants treatment with City of Hope, but the Insurance is saying she has to go through her first doctor. We are going to try and appeal the denial. This is all so new for us and I just need some feedback. We are scared because they were rushing to get her into surgery. City of Hope said something about how her file is being rushed through and that it was good. But they didn't know why. We had several appts for the the next few days ahead. Surgery was scheduled for 2/29/12. Then we received a call from City of Hope saying they didn't have authorization after all. They are so awesome, and this is who we want treatment with. Any suggestions or info will be greatly appreciated. We dont want the cancer to spread to other parts of the body. We are in Valencia, CA.

Jelson

DCIS. Eventhough grade 3, your sister has time to pick the best surgical option and negotiate with insurance so she can be treated by a doctor and facility in which she has confidence.  THERE IS NO NEED TO RUSH to a bilateral mastectomy. Many women with DCIS who do choose that option take months to research their reconstruction options, to choose a plastic surgeon and then schedule the procedure.

your sister is lucky to have you.

Julie E

ej01

You will never regret getting a 2nd opinion. 

I think the best place to find a doctor for a 2nd opinion is from a memember of the medical community.  Maybe call you general Physician or OB/GYN doctor and ask who they would recommend.    They should be in a good position to know who are the best specialists in your area.     

gumshoe

I have DCIS grade 3 and just had a partial mastectomy. My surgeon gave me the option, but suggested that because it was only in one general area, she was confident she could get it all. I agreed with her. If it comes back, well then, I still have the mastectomy option. 

Obviously, every case is different and every decision is personal. I think if anyone wants to get a second opinion, then they absolutely should. It's your health and your body. Many surgeons don't see the person underneath it all.

tranquilitywithn

Thank you Julie for your response. Does it matter that its comedo? Not sure what that means.

tranquilitywithn

We were denied from Health Net to go to City of Hope. So now my sister is going to have to wait til May 1st. Thats when she has open enrollment. She is going to change to PPO. Is that safe for her to wait that long?

tranquilitywithn

Nevermind that last question. We got a call an hour ago from the Doctor at City of Hope telling us to not wait. For her to go to her Doctor for surgery right away. Thank you for all your help.

Scared462016

hello. I know your post is old but wondering a couple things. Your last post said they called and told you to have surgery. What surgery did they decide on? How did that all work out? Happy with decision. Also have dcis and after 2 lumpectomis md wants bilateral mastectomy

reniebeanie

Hello,

My 50 yo mom had clear and bloody discharge from her left breast, and went in for a mammogram, then a 3D ultrasound, but nothing was seen until she had an MRI. They saw 3 2cm masses, and performed a biopsy that came back with secretory-like findings. Originally, her doctor said it was stage 1, grade 2 and triple neg. He said she had a very good outlook and wouldn't need chemo or radiation, only a lumpectomy. Then he came back and said she would need chemo, and came back again 2 weeks later saying she wouldn't. She just had a double mastectomy 2 days ago. After the surgery, her surgeon came out and said they got all of the cancer and that her outlook with secretory was good. The pathology report just came back today saying that she had 2 tumors in the left breast. One was 0.6 cm and the other was 6 cm. The report says the pathologist found DCIS, cribriform and micro papillary, and secretory types. It also says she is stage 3, and her doctor says she will need radiation or chemo. What I don't understand is how 5 months ago there was nothing on a mammogram, she only had 2 cm masses, was stage 1, and wasn't going to need chemo. Now she has a 6 cm mass, is stage 3 and probably needs chemo. How could they have missed a 6 cm mass? How did it take her doctors 5 months to figure out what was wrong with her? I feel like they have no idea what they are doing, and I need to find her a doctor that has treated invasive secretory carcinoma before. I'll take her anywhere. I don't care if we have to travel to the other side of the country. Any suggestions?