Breast Surgeon Question

Hi BJ,  it really depends on your insurance plan(s) and facility that you would like to go to, as to whether they require a physician referral. Some breast cancer centers require a prior diagnosis of bc or a high risk condition.  Others don't.  It would be good if you could obtain some preliminary imaging (mammo, sono, etc.) and you could get that referral from either the internist or the gynecologist.  I'd recommend doing that imaging at a top notch breast cancer center.  If you are in Atlanta, I imagine that Emory has an NCI-designated cancer center.  At the same time, you should begin with some primary care doctor (OBGYN--or even a dermatologist) to rule out more basic diagnoses such as mastitis.  I'd get that primary care visit done quickly. If the condition seems to progress very rapidly, that's a possible sign of IBC.  In that situation, you could probably beseech the breast cancer for an early appointment. IBC is usually diagnosed by skin punch biopsy. I am not an expert in IBC, so some of those who have that diagnosis will probably pipe in here. IBC is still considered a rare condition, to my knowledge, so there are other much more common breast conditions which mimic IBC.  I hope that is what you have. Best of luck.

If you haven't had a recent mammo, make an appointment with your generalist, let him/her know that you have an immediate concern, and then you can be referred out to get the mammo immediately.

I asked for the mammo to be scheduled immediately, they told me they would tell the 'scheduler' or I could call myself.  When I called myself (from the parking lot), the mammo clinic said they couldn't see me at the nearby clinic if I had a 'symptom' so got me a next-day appointment at the larger and more comprehensive breast-cancer center in my region. I went from seeing our generalist on Aug 14th, to mammo on the 15th, to biopsies (due to the concerns seen in the mammo and then an unscheduled ultrasound the same day) on the 16th, confirmed diagnosis of IBC on 20th, chemo port installed on the 28th, and started chemo on Sept 5th.

I was assertive because I wanted cancer ruled out so I could quit worrying.  I was 80% sure the mammo would alleviate my concerns and life would return immediately to normal.  Instead... here we are.  All that being said, every day you allow them or yourself to wait or delay is a day it gives the cancer opportunity to spread.  Be firm, fair, and friendly... but be your own best advocate.