Questions to ask surgeon?

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Olive4
Olive4 Member Posts: 84
edited July 2016 in DCIS (Ductal Carcinoma In Situ)

Hi,

I have been diagnosed with high grade DCIS with some necrosis and there is some suspicion of a microinvasion but that has yet to be confirmed.

I have my first consultation tomorrow with the surgeon and am trying to get a list of things together that I need to ask.

I have read lots on here about DCIS and it has been so helpful as I have learned so much. The support here is amazing.

No testing was undertaken on my core biopsy for hormone receptors and I haven't had a MRI so was going to ask about those things as well as my treatment options of course. I am thinking though that without a MRI they won't be able to tell me too much about my options etc. Am I correct in thinking that? I just want to get on with the surgery and the treatment that follows so I can move on in some positive direction. I feel pretty powerless and have a feeling of being stuck in a place where I don't want to be if that makes sense! The process seems so slow to me.

If anyone has any advice on what else I should be asking or experience of high grade DCIS I would love to hear from you.

My journey is just beginning. I am hoping it is a smooth ride as we all do I'm sure!

Thanks to all in advance.


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  • Annette47
    Annette47 Member Posts: 957
    edited June 2016

    I never had a MRI ... apparently my breasts were not difficult to read on mammogram and there was no suspicion of other problem areas. You may want to ask about your breast density and whether it warrants a MRI.

    At this point, I would want to discuss whether there is any need for genetic testing (which if you were positive could change the recommended surgery). That usually depends on your age, family history and other factors such as if you are an Ashkenazi Jew or other high risk group.

    You also need to discuss what surgery they are recommending and why. Usually a lumpectomy is preferred but depending on the size of the lesion a mastectomy might be needed. Also ask what follow-up treatments would be necessary with each type of surgery. Radiation is pretty standard after lumpectomy, but is usually not needed after mastectomy (although in some rare cases it might be depending on the margins).

    Most of what you really need to know will be determined by the biopsy of the tissue removed during surgery (ie. confirm micro-invasion, hormone receptors, etc.) and those are the things that will drive your treatment plan going forward but you can certainly ask “if ... then ..." types of questions.

    For what it's worth, the only difference having a micro-invasion made for me was the need for a sentinel node biopsy, which would be done as standard practice with a mastectomy, but might be held off on with a lumpectomy until after the presence/absence of invasive cancer is confirmed (mine was found on the needle biopsy so we knew for sure going in). If they suspect a micro-invasion though, they may just want to go ahead and do the SNB with the lumpectomy from the get-go. This is certainly something you could discuss with them.

    Other treatments such as Tamoxifen would depend on the results of the hormone receptor testing.

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  • Olive4
    Olive4 Member Posts: 84
    edited June 2016

    Thanks Annette47,

    That gives me more questions to ask.

    My breasts are dense so it concerns me that there could be things lurking that weren't seen on the mammogram.

    I am hoping that if they feel a MRI is necessary which I think they will that I don't have to wait weeks. The MRI could then lead to more biopsies and on we go! I know I need to take each step as it comes but I'm not good at being patient! Sigh!

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  • PNWBCHgirl
    PNWBCHgirl Member Posts: 115
    edited July 2016

    olive4 have you fund out anymore from your dr and have you had he MRI

    I was diagnosed with high grade DCIS in 2014. Had MRI's one for a second biopsy. .hope you get good quality Dr's and care who will help you make Good decision's

    I ended up after a lumpectomy not getting clear margins so had MX with staged reconstruction.

    No chemo no radiation


    Praying and wishing you the best through this journey

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  • Olive4
    Olive4 Member Posts: 84
    edited July 2016

    Hi PNWBCHgirl,

    I am having a lumpectomy tomorrow and then radiation if all goes to plan. I was unable to get a MRI and couldn't get a 2nd opinion as it was too long to wait.

    Thank you for your best wishes and I hope all is well with you now.

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