Appt w/ Oncologist - what to ask/ expect?
I have ADH diagnosed by both stereo and surgical biopsies.
My appt w/ the oncologist is on Thursday, June 18th. I have no idea what to expect or what to ask.
Can anyone give me some idea?
I don't know where he stands wrt Tamox, close follow up etc. I know nothing other than my surgeon recommended him.
Comments
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My best advice to you, is take a good note taker with you! Your onc. will give you the information you need, and it's very difficult to remember everything, much less understand it.
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Hi there Katie T,
Good luck with your appointment on the 18th. Take a tape recorder with you - this way you can replay everything that was said - I have done that in the past - the information you will receive will be very overwhelming. Good Luck!
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Your onc may be screening you for BRCA (if you haven't already been screened.) If you do have risk factors, they may refer you to a genetics counselor, usually found at major institutions, who are the experts in this area.
You may want to refresh your memory about your family history of certain cancers. In some families, this can be more complex than you would think. (My grandmother, who had breast cancer, had only sons, so of course they didn't want to remember anything about those 'female problems', particularly in the 1950s.) The most important features they would want to see is who in your family has had breast cancer, and at what age (trying to find if it was premenopausal or post menopausal), or ovarian cancer. In some families, they purposefully/incorrectly hear the cancer origin, so for ovarian cancer they may call it stomach cancer.
"A woman’s lifetime risk of developing breast and/or ovarian cancer is greatly increased if she inherits a harmful mutation in BRCA1 or BRCA2. Such a woman has an increased risk of developing breast and/or ovarian cancer at an early age (before menopause) and often has multiple, close family members who have been diagnosed with these diseases. Harmful BRCA1 mutations may also increase a woman’s risk of developing cervical, uterine, pancreatic, and colon cancer (1, 2). Harmful BRCA2 mutations may additionally increase the risk of pancreatic cancer, stomach cancer, gallbladder and bile duct cancer, and melanoma (3).
Men with harmful BRCA1 mutations also have an increased risk of breast cancer and, possibly, of pancreatic cancer, testicular cancer, and early-onset prostate cancer. However, male breast cancer, pancreatic cancer, and prostate cancer appear to be more strongly associated with BRCA2 gene mutations (2–4).
The likelihood that a breast and/or ovarian cancer is associated with a harmful mutation in BRCA1 or BRCA2 is highest in families with a history of multiple cases of breast cancer, cases of both breast and ovarian cancer, one or more family members with two primary cancers (original tumors that develop at different sites in the body), or an Ashkenazi (Eastern European) Jewish background (see Question 6). However, not every woman in such families carries a harmful BRCA1 or BRCA2 mutation, and not every cancer in such families is linked to a harmful mutation in one of these genes. Furthermore, not every woman who has a harmful BRCA1 or BRCA2 mutation will develop breast and/or ovarian cancer" http://www.cancer.gov/cancertopics/factsheet/risk/brca -
I have not been screened for BRCA. How is that done?
My mom and I can not think of any family member who had either breast or ovarian cancer.
My husband will probably go w/ me to the appt on Thurs.
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BRCA is tested with a simple blood test. If you do not have any family member who has had breast or ovarian cancer, then you are probably at low risk for having BRCA.
Only about 10-15 % of breast cancers are thought to be due to BRCA or hereditary causes.
If you had a significant family history, then they probably would have referred you to a Major Institution. There they have genetics counselors. Most places require genetic counseling before testing. That is because if someone tests positive for BRCA, they are at significantly higher risk for breast cancer and ovarian cancer, and their blood family members may be at risk too. It impacts more than just the one patient. Some people do not wish to know.
Some insurance plans do not cover BRCA testing, and it can cost on the order of $2K-5K.
You don't have to worry about that aspect, then. Good for you!
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Other than the biopsies, have you had surgery yet? Has your surgeon talked to you about the type of surgery he/she is considering? What size is your tumor? Is it confined or has it spread? Please provide us with a little more information so that we can better help you.
Ask for copies of all your test results and final surgery reports. I have found it very helpful to read through this information and to have copies to take to the various doctors I am seeing.
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The general recommendation for ADH often is breast exams every 6 months with yearly mammo, but some doctors are now recommending the addition of tamoxifen if there are other significant risk factors, such as family history of bc. If tamox is recommended, the oncologist should discuss with you all the risks and benefits for you in taking it for your particular situation. We all have different risk factors, so it's got to be handled on an individual basis. The good news is that nothing more serious than ADH was found (LCIS/DCIS/or invasive bc) and that's very positive news.
Anne
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My biopsy showed ADH but it turned out I had DCIS throughout the entire breast and I had a mastectomy. At first the BS planned a lumpectomy but then a 2nd review of my mammogram found a 2nd questionable area. The 2nd biopsy also said ADH. Surgeon said my choice was either 2 golf ball sized lumpectomies that would leave me pretty mangled or a mastectomy. Luckily, I went with the mastectomy as DCIS was found.
My surgeon said to think of ADH as a stage before cancer. Biopsies only take a few slivers of tissue and could completely miss the cancer that is sitting nearby which is what happened in my case.
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i reccomend this very reliable source and info about oncologist jacksonville oncologist have a nice day ^_^
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