Frustrated :(

I hope that others come on to this thread and give their input but I never heard that anyone had to wait that long for reconstruction.

that doesn't make sense. My surgeon said if I opted for mastectomy, the reconstruction process would not take very long and both she and the plastic surgeon would do my surgery, she would remove breast tissue and plastic surgeon would begin the reconstruction at the same time. I would definitely get a second opinion.

Many women have immediate reconstruction at the time of their mastectomies if yoou go that route. In my case, my sureon performed the mastectomies and then my plastic surgeon stepped in to place tissue expanders. It was all in one 6 hour surgery. Over 2 or 3 months, the expanders were slowly filled with saline. Two months after that, the expanders were swapped for implants. There are many types of reconstruction to consider. Maybe there isn't a plastic surgeon available for when he wants to do the surgery?

Hi Lagriff:

I am sorry you are frustrated and rushed. You sense you need more information, and I agree. I am concerned that this surgeon is not being responsive to that need.

As others said, you do have time to better understand your surgical and reconstruction options in advance of making any decision! One of the best ways to do this is to seek a second opinion from an independent institution (more on that below). You may find you would rather be treated by the second opinion institution.

The question of whether you are a suitable candidate for a "skin-sparing" mastectomy or "nipple-sparing" mastectomy is a critical piece of information that a breast surgeon would definitely advise you about before you agreed to a mastectomy plus reconstruction option.

Both breast surgeons I met with were eager to arrange a consultation with a plastic surgeon before surgery and this is typical. What you are experiencing seems unusual. You should not be discouraged from seeking information about your options.

Also, it does not seem like you can make a fully informed decision about lumpectomy versus mastectomy plus reconstruction, without first receiving advice from a plastic surgeon about the options for reconstruction that are available to you, as well as their expert opinion on the question of immediate or delayed reconstruction. If you are not a suitable candidate for certain procedures that you would prefer, you might decide differently. You should have a chance to consult with a plastic surgeon before your breast surgery.

Many patients seek a second opinion about one or more of their (1) imaging, (2) pathology, (3) surgical and reconstruction options, (4) neoadjuvant therapy (treatment prior to surgery), and/or (5) post-surgical treatment options. I would recommend that you seek a complete review of all imaging (mammograms, ultrasound, and MRI (if any)), all associated written reports, a fresh review of the actual pathology slides (which are sent overnight to the other institution), and related written pathology reports, plus an independent recommendation regarding your surgical and reconstruction options.

Others above have suggested consulting a medical oncologist before surgery. Sometimes drug treatments (e.g., chemo) are recommended prior to surgery ("neoadjuvant" therapies). A breast surgeon could refer you to a medical oncologist. Other questions are how possible radiation or chemo may affect reconstruction.

If you'd like to learn more about the second opinion process, BC.org has a good section about second opinions. Some insurance plans may actually require a second opinion. Also check that the proposed second opinion institution and doctors are in-network.

http://www.breastcancer.org/treatment/second_opini...

Try to look for a surgical oncologist specializing in breast surgery and the treatment of patients with (or at risk of) breast cancer. Another reason to work with such a specialist is that with invasive disease, a sentinel node biopsy ("SLN" biopsy) is usually recommended. The National Comprehensive Cancer Network ("NCCN") breast cancer treatment guidelines (Version 3_2015) state:

"An experienced SLN team is mandatory for the use of SLN mapping and excision."

I think that generally a breast surgeon who specializes in the treatment of breast cancer as the vast majority of their practice would be the best choice and most likely to have a lot of experience with sentinel node biopsies.

At a hospital with a breast center, it is much easier to access the variety of professionals who may be consulted or involved in your care, including breast surgeons, radiologists, radiation oncologists, medical oncologists and plastic surgeons. Others here have recommended looking for center of excellence, such an NCI-designated Cancer Center:

http://www.cancer.gov/research/nci-role/cancer-cen...

They can explain their second opinion process to you and how to proceed.

In my case, I sought a second opinion about my imaging, pathology, and surgical recommendations at Massachusetts General Hospital. The pathology (DCIS) was confirmed, but the radiologist disagreed with the interpretation of the imaging. This ultimately led to the diagnosis of bilateral breast cancer (previously thought to be unilateral), and a change in surgical recommendation from unilateral to bilateral mastectomy.

This is a supportive place, so please do not hesitate to ask more questions until you get the answers and information you need to do what is best for you!

BarredOwl

Is your pathology report online? I got most of my info from online patient sites.