Next Stop...Meet with radiology oncologist

Hi Musakmom, the radiation oncologist would not be the one interpreting the MRI.  That would come from the diagnostic radiologist (where you had the MRI).  The radiation oncologist addresses issues pertaining to radiation treatment.  He/she might discuss relative recurrence risk with the lumpectomy vs. mastectomy, where the lumpectomy is treated with radiation.  On rare occasions, radiation is also given after mastectomy for DCIS, if the area of concern is near the chest wall, and if there are narrow margins after surgery.  It sounds like you already had a lumpectomy without clean margins, so you would need another, which sounds pretty disfiguring in your case, vs. mastectomy. Even, I, who chose to have three lumpectomies (over having mastectomy) would have to think twice about having nipple removal. At the same time, they generally do remove the nipple in mastectomy, except for nipple-sparing mastectomies.  If they felt you needed to have the nipple removed for lumpectomy, I'm sure it would be the same for mastectomy--food for thought.  You can wear a partial prosthesis if you have significant cosmetic changes from lumpectomies, and you would preserve feeling in the breast, but you'd still have to live with the cosmetic changes.  The reconstructed breast would look better.  Anyway, the radiation oncologist would most likely not deal with surgery or reconstruction issues either, mainly what his/her area of expertise is, which is radiation treatment. That isn't to say that radiation oncologists are not qualified to discuss the other areas.  Some do and some don't. Reconstruction is usually addressed with a plastic surgeon.  It is also possible to have something called oncoplasty, where there is a plastic surgeon present during a lumpectomy, to deal with the cosmetic issues. You would need to meet with a plastic surgeon before the mastectomy, to discuss options.

I hope the MRI results are negative, and no further exploration is needed in that regard.

Best of luck.

I would think the radiation oncologist appt. would be about the radiation.  Still, with my limited knowledge, I would think that that would be after all surgery was done.  Of course, ask your MO or surgeon why the nipple needs to be removed.  After all surgery, then you talk to the radiation oncologist and ask them about the radiation issues.  I've never heard of planning radiation before all surgery is finished.  My RO was the best doc I had, so even if you see that person prematurely, ask everything you can.  They are an RO, but, first, they are an oncologist.  I got a lot of great info (general) from my RO.  Still; they don't get there until all surgery is finished.  It's going to be OK.  xx

Hi Musakmom, it sounds like the radiation oncology department is very thorough.  I agree with Percy, that it is a bit odd that you are meeting with them prior to completion of surgery.  At the same time, the radiation oncologist could be a great resource for answering questions.  Mine was extraordinary. You are right, that they will probably tell you the results of the MRI prior to seeing the surgeon.  They can't really plan the radiation treatment; however, until after you have the final surgery.  The main reason, that I can see, to meet with a radiation oncologist before your surgery, is to help you be educated about radiation treatment, so that you can more easily decide on lumpectomy vs. mastectomy.  A number of women have made the decision based on fears about radiation treatment, probably without meeting with a radiation oncologist.  Also, with their elaborate health questionnaire, maybe they are evaluating whether they think you are a good candidate for radiation.

About the translucent nipple, it's funny that you mention that, and so vividly.  Mine is that way.  They did take out a portion of the areola up to the nipple.  The breast also became paler after the radiation.  I see that your treated breast is the right breast, so that is good for radiation treatment.  When they radiate the left breast, they have to protect the heart.  On the right side, that is less of a concern. If you are meeting with a radiation oncologist in advance of your decision, I strongly recommend that you also meet with a plastic surgeon, to discuss reconstructive surgery (either with lumpectomy or mastectomy).  I know that this is something that might not happen, but one of the things that really, really helped me in my decision, was that I was able to feel a reconstructed breast.  One of the patients of the plastic surgeon agreed at the time of my consult (she was there for follow-up), to allow me to feel the breast.  I was also given that opportunity at another time. I also visited the shop in my hospital where they have the mastectomy bras and prostheses. With mastectomy and reconstruction, if one chooses, one can have a special nipple tattoo done on the breast.  There is a man named "Vinnie", whom patients travel to from all over the globe to have the nipple tattoo. There are threads about him and his work on bco.org.  I believe that the New York Times did a piece on him last year, as well. The tattoo would be done after all of the reconstruction is completed.

Finally, you were concerned that they might ask about your treatment decision at the radiation oncology visit.  They probably will, but you don't really need to have one yet.  In fact, you shouldn't even make the decision with the surgeon until after a visit to a plastic surgeon.  That's even more important than a visit with radiation oncology.

Best of luck with your decision.