Just diagnosed on 5/13/16. I live in Evanston and have questions

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peaches1
peaches1 Member Posts: 137
edited May 2016 in Just Diagnosed

Hi- This is my first post here. I live in the Northern suburbs of Chicago in Evanston. I was diagnosed with infiltrating ductal carcinoma on 5/13. I am currently being treated by Dr. Hyser at St. Francis in Evanston. Has anybody here seen Dr. Hyser? I originally went for a mammogram on 3/21 at St. Francis, and when they found out that I had a lump, they said I would need a referral for a diagnostic mammogram. They called up my PCP, and she told them that I would have to come in to see her. I told them that I was seeing Dr. Hyser a general surgeon at St. Francis for another matter in three days, and I would ask him for a referral. I showed the lump in my R breast to him, and he immediately ordered a diagnostic mammogram and an ultrasound. They could not fit me in for 12 days. I was notified two days after the mammogram that they found something. When I saw Dr. Hyser on 4/14 again, he scheduled me for a breast biopsy in two weeks. He does all of his own breast. biopsies. He can to postpone it, and I finally had the biopsy on 5/11. I just saw him again on 5/16, and got a copy of the biopsy. I have infiltrating ductal carcinoma grade 2, which is positive for ER, PR, and negative for HER2. My concern right now though is that Dr. Hyser wants to do a lumpectomy on me on 5/27. He has a really good bedside manner, and he does most of the breast cancer surgeries at St. Francis, and he appears to be qualified, but he is not sending me to an oncologist before he does the surgery. He told me that I will need radiation after the surgery, or chemo if he finds a positive node. I get the impression that he decides your treatment plan himself, instead of sending you to an oncologist, which makes me nervous. I don't know if I want a jack of all trades doctor.

One of my sisters is an endocrinologist in New Orleans, and she agrees with me that I should also be treated by an oncologist. She is going to call him up tomorrow, and ask him if he refers you out for radiation and chemo, or orders it himself. I just called up Kellogg Cancer center today, and I was able to make an appointment with Dr. Merkel an oncologist there for a second opinion there on 5/26. I might postpone my surgery, or have it done by wither Dr. Winchester, or Dr. Yao at Evanston Hospital instead. One of the advantages of going to Kellogg is that I would have a patient advocate there, whereas at St. Francis I would be on my own. My Sister has a good friend in New Orleans who is a hematologist at the cancer center at Tulane, and her friend is going to ask if anybody knows anything about Dr. Winchester or Dr. Yao. I am sorry this is so long. I might have Dr. Hyser do the surgery, and go and see an oncologist at Kellogg, or I might just switch entirely to Kellogg. I would appreciate hearing from anybody that has experience with St. Francis and Dr. Hyser. Thanks

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  • LisaAlissa
    LisaAlissa Member Posts: 1,092
    edited May 2016

    Hi peaches1!

    It sounds like you're getting good advice and great support from your sister. (Yea! for sisters!!!)

    Increasingly chemo is being recommended before surgery for various types of BC. I think seeing a MO before surgery is a great idea. It's the MO who usually "leads your team" after your surgery is complete. And you want to see what that person thinks before you forstall an option that would otherwise have been recommended for you.

    After all, once surgery is complete, it's too late to have neo-adjuvent chemo.

    Best wishes,

    LisaAlsisa

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  • peaches1
    peaches1 Member Posts: 137
    edited May 2016

    Thanks for all the advice. My Mother had BC, and my youngest Sister was diagnosed with BC three years ago. It was in the beginning stages when she was diagnosed by a routine mammogram at the age of 51, and she had a lumpectomy and radiation and is in remission now. She has also given me a lot of advice the last few days, and she said that I needed to be followed by an oncologist too. The doctor called me up last Friday with the biopsy results, and asked me if I could come into his office that afternoon and have the test for the breast cancer gene. He also ordered an ekg and a chest xray. I then saw him on Monday and he scheduled me for surgery on 5/27, assuming that the genetic test came back in time. He also told me that my ekg was abnormal, and I would have to go to my PCP to get a repeat one. I told him that I had an ekg, echo, stress test and cardiac cath two years ago, and there were no blockages. During my visit with him Monday, he never mentioned anything about seeing an oncologist, and just told me that I would have radiation unless he found a positive lymph node, in which case I would have to have chemo. I think I am at least going to postpone the surgery until I get a second opinion at Kellogg. This has been going on too long though, and I kind of want the surgery over with.

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  • doxie
    doxie Member Posts: 1,455
    edited May 2016

    If you've not yet done so, post this on the Illinois Ladies Facing BC thread. Many who visit there can help you with north side doctors of all specializations of which there are many. I live further south so can't help there.

    It's not uncommon in some practices for the surgeon to take the lead until after surgery. I didn't see an oncologist until a month after surgery. If your tumor is small and ER + and HER2 - with no apparent node involvement, chemo is not common before surgery. What I think important is to have a full understanding of the genetic test results before going into surgery. You should be counseled by a specialist if the results are positive.

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  • dtad
    dtad Member Posts: 2,323
    edited May 2016

    Hi peaches. I also agree that you do not need to see an oncologist before surgery unless your tumor is large and therefor they might want to do chemo before surgery to shrink it. It doesn't seem like thats the case with you. Also Im not from your area but feel its very important to be treated at a major university teaching hospital. I also think its important to have a breast surgeon rather than a general surgeon. Good luck to you and keep us posted...

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  • Hockyparnt
    Hockyparnt Member Posts: 17
    edited May 2016

    by all means get a second opinion. I am currently searching for my second opinion now. I have the same basic diagnoses as you do and I was told I would see the oncologist after surgery. Hope you get the peace and satisfaction you need

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  • Iwrite
    Iwrite Member Posts: 870
    edited May 2016

    Good afternoon,

    I've been going to Kellogg since the beginning. The North Shore was formerly "Northwestern Memorial" which is university affiliated. The surgeon I saw there, Dr. Yao, heads up all the breast cancer surgery at NorthShore and she came recommended by more than one other doctor in Evanston. She is amazing. They got me in for a consultation within two weeks of my initial biopsy at home and coordinated with plastic surgeons in the NorthShore system. I met with the plastic surgeon as well and felt very comfortable with him. They have the genetic testing group right there and I was able to get that done very quickly...they also help work through all the insurance maze!

    When Dr. Yao did the pre surgery scans and saw something else, she made an immediate recommendation for an oncologist at Kellogg. If she hadn't seen anything odd I think we would have moved forward with surgery within a month and done that prior to meeting with an oncologist. My Onc. is Dr. Ward, but the others in that practice were ALL recommended. NorthShore is one of the top breast cancer treatment centers in Illinois. (My daughters and I spent a lot of time trying to figure out where to go for treatment.)

    They have offices in Evanston, Highland Park and Skokie so it's convenient if you are north of the City. I called U of Chicago and it was going to take a month to get my first appt. At NorthShore I had a plan and was in treatment three weeks after the initial diagnosis on October 8th. This really helped ease the fear that comes with this. My doctors downstate would have done surgery and never done added tests to confirm the situation...we have no local breast cancer specialists and I think that makes a huge difference. NorthShore is incredibly responsive to patient questions, too!

    Feel free to message me if you would like to know more.

    Kathryn

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  • peaches1
    peaches1 Member Posts: 137
    edited May 2016

    Thanks for everyone's suggestions> Well I went to see my PCP today, and she told me that the surgeon had called her up, and he had me lined up to see an oncologist in Skokie who I was not familiar with. This oncologist went to med school at Northwestern and did his residency and fellowship at Beth Isreal. Apparently Presence Health has a new cancer treatment center on Skokie Blvd. across the street from Old Orchard. I wished he would have told me this when I saw him Monday. He says in his profile that he is hands on, and works with you from the beginning to the end, and I just assumed that he was going to supervise the radiation. My PCP told me that she would never send me to a surgeon that would do something like that. I also found out today that he has a patient advocate. I have decided that I am going to have Dr. Hyser at St. Francis do the surgery on 5/27, instead of going to Kellogg. My Sister the endocrinologist has a good friend who is a hematologist at the cancer center at Tulane in New Orleans, and her friend Cindy said that based on what I have told her so far, that my lumpectomy is going to be straightforward, and a good general surgeon should have no problems doing the surgery. She said I should be more concerned about the medical oncologist I pick, and she suggested that maybe I should see an oncologist at Kellogg.

    My PCP said that she did not know a lot about the oncologists at Kellogg's. When I mentioned that I was supposed to have an appointment with Dr. Merkel next Thursday, and she said that several of her patients had gone to him, and he was wonderful. My Sister talked to my surgeon today, and he told her that he had an oncologist lined up, but if I wanted to go to see Dr. Merkel, he was fine with that. My Sister said that she is flying in from New Orleans on Wednesday, and she is going to go with me to the visit with the oncologist, on Thursday, and drive me home after I have surgery next Friday. At least I won't have to ask one of my friends to give me a ride home after I have surgery. That is a big relief. I feel much better now. Thanks everyone.

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