turn around time to pathology/margin report after lumpectomy

Thanks ej01, my 'ICS treatment' statement is short for OVERAGGRESSIVE (without reasonable consideration of side effects) as in lumpectomy + rads or mastectomy - then a  SERM or AI for a DCIS < 1cm, Grade 2 ( low on the grade 2 range) located pretty close to my heart.   That treatment is correct for more serious advanced cases but not a tiny DCIS near my heart (I am thin and small breasted too which makes organ damage more likely with radiation). 

For reasons I don't know both BS wanted me to see the same MO who turned out to only treat ICS patients and saw them for the first time after their surgery as a norm.  I haven't had my surgery - neither she nor I could figure out why I had been referred to her.  It was an expensive waste of time and energy.  I am currently not planning on seeing either of those BS again so I may never find out what they were thinking. 

I appreciate your input re followup care. I have decided that if I try to line up too many ducks in a row though I am never going to 'get them all'.  If I was a CA resident, treated in CA then moved to another state I would be able to transfer care.  I will followup where I get my surgery initially - then will work out 'the details' as time goes on.  I know I may end up pulling my hair out on this down the line but I only have so many balls I can juggle at once and if I don't 'pull the trigger' soon on lining up my lumpectomy provider I may just end up saying the hell with it for months - which would be not as good as finding a good treatment center soon and working out the followup logistics 'later'. 

I have found the breast cancer doctors are not as global a community as some medical areas I have been exposed to where recommendations for the next level of care are much easier to come by.  In Nashville I asked 2 BS, 1 MO and 1 RO for a recommendation for an IORT provider and got dead air all 4 times.   There are no IORT options in Nashville, it seemed reasonable that patients may want to know where to go for it if it looked like a good option in their case.   (I know some places that offer it - this is just an example of how it is hard to get referred to care that isn't down the street from the doctors I have spoken to - including my gp and gyn - for the latter 2 it was not expected that they know expert care but asked JIC)

I get copies of all my studies, pathology, mammography, procedure notes, etc.  It is a deal breaker for me that I get copies as soon as they hit my file or I don't use that service provider (doctor).  I get digital studies when possible - I have all my MRI and mammogram studies in digital format (biopsy radiographs as well) etc.    When I consult with a new doctor I assemble and index the information and provide it up front.  No waiting on all the different groups to send in their stuff, no wondering if everything was sent.  I have not been able to get most pathologists to send me their reports directly but I have been successful in getting the offices of the physicians using the pathology service to send me the results as soon as they arrive.  I never wait for my appointment to go over results for me to get the results - it is in my chart to fax me results as soon as they are in (most places won't email but will fax).  I need to read results ahead of time to know what questions to ask - in some cases I need the time to emotionally process what I am dealing with rather than get it and deal with it right on the spot. Before I schedule a procedure I verify that they will send me the results as soon as they get them, when I show up for the procedure before submitting to it I go through that song and dance again and I find out when the results should be sent, who to call to check with if they aren't in when I expected - I get the name of who is giving me the information - who to call - their number etc.  If I don't get the information when expected I start calling.  We all have a right to this information and if the providers aren't willing to give it to me I pick other providers.  Another reason I am planning to shift out of some Nashville providers at this time - some have made this process much harder than need be and run me around for results. As if there isn't enough stress built into dealing with DCIS already....

At this point I have had 3 pathology reports of my biopsy and 2 of my MRI and 2 of the diagnostic mammogram.  The reports did not disagree but there was significantly more detail in some.    I have more respect for the opinions of those who were willing to put their name next to details rather than the really minimal information on some reports.  Some of the folks interpreting my studies were really ‘phoning it in'.  They didn't say anything wrong - they also didn't say much.

The article I referenced was just 'proof' that it makes sense to know the orientation of the lumpectomy specimen with respect to how it sat in the breast before removal - so that if a margin was not big enough in spot X on the specimen - the surgeons would know where spot X came from in the breast when going back in to get a clear margin.  This seems kind of obvious but it appears that unless there 'is a study' that says something that is really quite obvious then doctors can't use the common sense information.  Why anyone would not store the geographic information for a lumpectomy specimen should be the question - but at this time I do not believe it is common practice to do so.

Weds to Friday seems reasonable for pathology reports - actually fast - do you know if the pathology lab was within the hospital you used or if it was sent out - and if it was sent out was it a long way or within the same city?

Thanks for the info and suggestions!

[Update 2-12-05-22   It took 1 week to get the pathology report from the 'local' pathologist for my lumpectomy.  They did the geographic mapping of the specimen so that any non clear margins could be mapped to where they had orginiated from within my breast (so only non clear areas would need any possible future reexcision).  It is a labor intensive process so a week seemed quite reasonable.]