Friday appt w BS/ what to expect?

nervousnelly456

Hi everyone,

what should I expect at my first appt with the BS? DO they do any bloodwork or additional testing? this week of waiting since my results have been so hard.

From the Biopsy, I have been diagnosed with DCIS. The information from the BS's office said it's early, very small (5mm calcifications), has zero chance on spreading. But I didn't know if that was a general response or if additional tests need to be done to confirm this all.

thanks

Sorry this is all new to me and I don't have any information other than reading my own research here and other websites.

SiameseX2

Hi Nervous,

Both places I worked with had me meet with a multi-disciplinary team (BS, radiation oncologist, and perhaps regular oncologist) in one appointment. Perhaps your situation is different and you won't need radiation.

The breast surgeon will usually describe the treatment possibilities, how the procedures work, risks/possible complications, also answer any questions you might have. They'll recommend tests that might help determine the surgery that is needed - like maybe a genetics test or breast MRI. Towards the end, they'll usually examine you (I joke the need to get a "feel" for the situation ...)

Good luck!

MTwoman

nervousnelly,

The BS is typically the first of your team that you meet. You may (or may not) meet with an RO or MO prior to surgery. DCIS is a bit different in that regard, as DCIS isn't treated with chemotherapy so adjuvant therapy (using chemo prior to surgery) is a non-issue. If you are having a lx, chances are good that you will also have rads recommended (by an RO). If you are ER+, chances are good that you will also have an endocrine therapy recommended (by an MO).

My BS ordered bloodwork, but it was timed immediately prior to surgery (had to have it repeated prior to all subsequent surgeries). There really isn't bloodwork that is used in conjunction with DCIS diagnosis.

"I didn't know if that was a general response or if additional tests need to be done to confirm this all." Part of the bs's job is to remove any bc (sometimes with very small tumors, they've been removed during excisional biopsy) and make sure there are clean margins. Once the remaining tissue has been removed and sent to pathology, you'll get your final diagnosis. In something like 25% of DCIS, there are either micro-invasions or IDC hiding in the DCIS. In those cases your diagnosis would actually change (as would your treatment plan as you treat the most aggressive cells present). So, yes, there are additional tests, but they are done with the rest of the excised tissue.

gb2115

My surgeon went over pathology, survival statistics for my stage at the time, and statistics and pros/cons for the different types of surgery. She did a breast exam, and set me up for MRI and genetic testing. She was very comforting and encouraging--made me feel super confident! I didn't get hooked up with oncology until after my surgical pathology came back.

**Edited---I didn't realize this was the DCIS forum---oops! Still a valid surgeon's visit though! :-)**

Rrobin0200

I was dx'd with dcis in march of this year. An hour after my mammo, I had an us and a biopsy. The next day, I met with the bs. The following day, I received the biopsy results and had already scheduled an appointment with the PS. I was already certain that I wanted a double mx with complete reconstruction. Within two weeks of my diagnosis, I had my surgery and reconstruction. Yes, it's a whirlwind. But you can do this. Best of luck to you.

nervousnelly456

Thanks everyone! Robin, what made you decide to go the MX route? how long was the recovery?

Rrobin0200

My preference of a BMX was strong... I wanted the most radical approach to this beast. But remember, it's a personal choice... what's right for me may not be right for you, and vice versa. Besides the cording that I have on my "good" side, I don't regret my decision. At all. Recovery wasn't bad at all. By the 2nd week, I was back to being myself. However, I followed my dr instructions, rested well, drank lots of water, and allowed myself to heal. Oh, the drains weren't fun either. But they're doable and generally required.

Kkubsky

I remember that panic/anxious feeling when I first started this DCIS journey over a year ago. I was terrified! But what a difference a year makes. I HAD grade 3 with comedo necrosis extending into the lobes, ER/PR negative. My BS was wonderful. She went over the pathology of the biopsy, discussed treatment options, and just took a lot of time to reassure me and calm me down. My initial reaction was to "cut em off" but after a lot of discussion, research and thinking, I opted for a lumpectomy and radiation. At this point, I am very happy with my decision and have not experienced any complications. I went for a check up yesterday with my RO and even he was quite amazed with how well I am doing. Basically my bad boob has gone back to "normal" with little if any change due to surgery and radiation. The internet and Google were not my friends! I finally had to stop going on line as I was making myself crazy. I have to trust my team of drs and do what I can to keep healthy. Hoping all goes well with your BS appt!

nervousnelly456

thanks everyone. Only met with the surgeon today and reassured this will be taken care of. I do have to get an MRI to make sure my other breast does not have any issues. The mammo didnt pick anything up, but since they are dense, we had to rule everything out with an MRI. I assume this is standard. Then I get genetic testing. Once both are clear, surgery will be scheduled for June. I also have to take an estrogen pill for 5 years? I guess I am ER +.

fun fun fun

GAMomma

Hi Nervous, welcome,but so sorry you needed this. I was diagnosed last 2016 and had a double mast. Jan 17. I wanted to share my reasons. The BS was unsure of invasive or non. Reason being my one mass was very very close to my chest wall. Plus I had 3 masses all were over 6 cm,grade 3,uniformed and something else. A lumpectomy was not a choice do to the amount t of DCIS. Then there was my left. No problems. But I was going to have to take Tamoxifen for 5 yrs of I kept that breast. It was a no brained for me. I have 5 kids,I breast Fed all of them. 13 yrs ago I had massive weight loss of 150 pounds. My breasts were some sad looking puppies. Did I really want to keep one to be even more deformed? Plus take meds? So meds.. I do not have a stable marriage or life. My kids are 21-8. Not exactly an easy task to live happy with a medication that has some adverse reactions ? I had more reactions and allergies to meds then most people. I had gastric bypass so it changed my absorption. This helped me make a choice of one or both breasts. So I opted for both. About 3 weeks later my pathology revealed my left breast had issues. I don't have my paperwork right in front of me and I forget exact the wording. I had beginning DCIS cells. Chances are I would have needed it removed in a few months/years. So good choice but it is personal. I hope you can come to a clear decision . Use this site and your bible 💞

Luckynumber47

I wanted to offer you the same reassurance my BS gave me. She walked through the door at our first meeting and said: "You will be fine! This is cancer with a little c, a bump in the road, a minor inconvience. It would be worse to get a diagnosis of high blood pressure or diabetes". And she ended our appointment with the same words: "You will be fine"

Take those words to heart. It's overwhelming to try to figure out what's going on and how to cope, but trust me, things get better in a hurry.