What to expect with first appt with surgeon and oncologist

DelightfulJade

Hello again! My biopsy showed IDC provisional grade 2 in R, and at least low grade DCIS in L. ER/PR +, HER2 -. Lymph nodes looked normal per ultrasound. I haven't had any other testing (MRI, CT,etc). I have an appointment with a breastsurgeon and a medical oncologist coming up. What can I expect at this appointment? Do they have enough information from the biopsy alone to direct a treatment plan? From my research, I was under the impression they would need an excisional biopsy as well as a sentinel node biopsy before they could decide on a treatment. I don't know if an oncotype test was done but I didn't see results posted.

I am blessed to have some very caring friends and family who have offered to accompany me to these appointments for support and to provide a second set of ears. However, I'm thinking there won't be much new information given to me just yet. I don't want to take anyone's time if it won't be needed.

I wish I had asked the nurse navigator when she called. Am I overthinking or minimizing?! What usually happens during these initial appointments?

Thank you and I wish you all the best.

EDIT: I had my appointment. The surgeon went over everything, drew diagrams and discussed lumpectomy vs mastectomy options. She ordered an MRI to get a better look at the DCIS/ ?IDC area on the L. I saw the oncologist on the same day which was more of a consult at this point. I was glad to meet them both and felt so much better after the visit

jhl

My appointment with the surgeon had a lot of detail. She brought my images up on the screen so I could see them and correlated where they were on my breast. She went over the pathology from the biopsy in detail and gave me context with how it related to my health. She then went over my options - mastectomy, lumpectomy or do nothing at all. She went in detail what each choice entailed and gave me her best guess of what would occur after surgery. She made it very clear she was not an oncologist and those discussions were important to have with that person. I did not meet my oncologist until after my surgery was over. I did have unrelated complications that had to be sorted out. That pushed my case to the tumor board even though my pathology was straightforward. I had plenty of time for questions, discussions & what ifs.

My appointment with my oncologist was similar but different. At that appointment, she went over the surgical pathology which was an improvement from the biopsy pathology. My surgical tissue was sent for Oncotype and it was resulted by the time I met with the oncologist. At that point, I did not have many decisions to make because I did not need chemotherapy. She went over receiving radiation and an AI. I am very familiar with AI's so I didn't need much discussion about that. I knew I would opt for radiation and I did not need much discussion about that either.

All in all, I was never rushed and felt I could ask any question or express any concerns.

Good luck,

Jane

BtwnStars

I would advise taking someone with you if you can for a second set of ears. They are most likely going to go over a lot of information and their recommendations, so you will have some decisions. They will most likely discuss if you need further testing like MRI, genetics, or more biopsies.

My initial appt with my breast surgeon was well over an hour. She presented me with a binder full of resources that we went thru, as well as a page in which she drew pictures and made notes about all of my options. I brought initial questions with me as well to go over. I would be prepared to ask anything and everything you need to know including if you will need further tests before surgery.

Oncotype is generally something that happens after the full pathology of tumor is sent out. Lymph nodes can't be fully vetted until a biopsy, which is usually done with any other surgery to remove cells/tumor. Depending on the size of your cancers that may contribute to determining your type of surgery.

I would prepare yourself with questions and also be prepared to talk about scheduling whatever further tests you may need.

NotAsCalmAsILook

don’t forget you can always call the navigator back and ask about what you should expect.

I met with Surgeon before MO. She had me do more tests and then I met with MO. They worked one office over and MO literally ran to SO to discuss chemo pre vs post surgery and ran back to let me know what they thought would work.

Like btwnstars my SO drew lots of pictures.

typhoon

jhl - my first appointment with the breast surgeon took over an hour. During the appointment, she explained the type of bc I had, showed me the radiology images, diagrammed out the locations of my tumors, diagrammed a flow chart of my different treatment options (which included all the variables, such as results of lymph node biopsies, issues with clean margins, oncotype testing results, etc.), explained the additional testing she was ordering, gave a couple of referrals for plastic surgeons and oncologists, walked me through the most likely sequence of events, and gave me a ton of literature. She then followed up later that day via the patient portal with a written summary of our appointment and the decisions we had made, recommendations, etc. I seriously could not have asked for more. I walked out of that appointment feeling 1000x better than when I had walked in. I hope you have the same results with your appointment!