Why would I be seeing a chemo doctor for DCIS?

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Kimmy_nl
Kimmy_nl Member Posts: 21
edited June 2018 in DCIS (Ductal Carcinoma In Situ)

Hi everyone,

I just saw my surgeon this morning and got back my path report from my second lumpectomy. He said my margins were good this time but less than 0.9 mm on part of it but that was because he went deep and removed the tissue to the chest muscle. I got the call from cancer clinic this afternoon and I’m set to see a chemo doctor on Tuesday and the radiation dr on Friday. I’m stumped why would I have to see a chemo dr? My surgeon told me they did find more DCIS in the pathology but the margins were good. why would I have to see a chemo doctor? I didn’t think chemo was used to treat DCIS

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  • moth
    moth Member Posts: 4,800
    edited May 2018

    Medical Oncologists don't just do chemo.
    It could be that your MO might want to order the Oncotype DCIS test which tries to predict the risk of recurrence.
    More about the Oncotype DCIS http://www.oncotypeiq.com/en-US/breast-cancer/pati...

    Also, usually it's the MO that also recommends and manages hormonal therapy to prevent recurrence.


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  • Lula73
    Lula73 Member Posts: 1,824
    edited May 2018

    are you referring to the medical oncologist (MO) as the chemo dr? If your DCIS is hormone positive, it is MO who will manage the anti-hormone meds and discuss your options with you.


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  • Kimmy_nl
    Kimmy_nl Member Posts: 21
    edited May 2018

    Hi Lula73,

    All the cancer clinic told me was they have me scheduled for an appointment with a chemo dr. They didn’t say MO. But perhaps that’s what they meant? Up to this point the only person I have had any contact with was my surgeon. I haven’t met with anyone else. They also told me that I could schedule an appointment with a cancer patient navigator nurse? I’m in Canada, so things may be a little different in what order you see drs. But it’s certainly would have been nice to have a nurse to talk to before any of my surgeries

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  • Egads007
    Egads007 Member Posts: 1,603
    edited May 2018

    Newfie, I’m in Canada too...I delt with the surgeon from testing through diagnosis, and then saw an Medical Oncologist (chemo doc) once my diagnosis was in place. She prescribed the chemo. I saw her most of the time from that point on and only went back to the surgeon for check ups once the surgery was done. This is your cancer ‘team’. Your MO will be your primary caregiver for cancer. If you have to have radiation, you’ll also see a Rad doc.Did they tell you the status of your cancer? Triple negative? ER+ etc ?

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  • Kimmy_nl
    Kimmy_nl Member Posts: 21
    edited June 2018

    Egads007 I have no idea about the status. I guess I’ll find that out when I go to cancer clinic next week. All the surgeon told me today was that they did find more DCIS in the second lumpectomy as well. But the margins were clear. I didn’t read the path report myself

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  • moth
    moth Member Posts: 4,800
    edited June 2018

    newfie - I'm in BC. I suggest you get a copy of the pathology reports. I have a whole binder of pathology reports and lab results and my notes from meetings with doctors. It's good to have your own copies to refer to.

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  • nonomimi5
    nonomimi5 Member Posts: 434
    edited June 2018

    I had a similar question where my surgeon told me to book a RO 2 weeks after my surgery and book a Chemo dr. 3 weeks after surgery. I didn't know why I was seeing the chemo dr. when I am not doing chemo but figured it was for the hormone therapy. I saw the chemo dr. this week and she spent over an hour going over my pathology and Oncotype report and did a blood test for hormone and vitamin D level to look at hormonal therapy options. So I figured she is my MO as everyone calls it on this website. My surgeon was in and out - barely spoke to her - but she was good and it reminded me of Cristina Yang in Grey's Anatomy, she didn't really know me but she knew my tumor. But the MO was very detail oriented and asked a lot of Qs - I actually got tired talking to her. I am meeting the MO in a month, after my radiation and bone density test. I guess she is my medical "person."

    Mimi

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  • Egads007
    Egads007 Member Posts: 1,603
    edited June 2018

    Moth makes a great suggestion, get and keep copies of everything. When I moved it put me way ahead of the game in getting things set up with a new facility. Never know when they'll come in handy. As you go through the procedure records are great for knowing & understanding your situation, best treatments and advocating when necessary. It all seems overwhelming right now but breath easy, you'll get to a point that it makes sense.

    Nonomimi - yup, your MO will be your key provider. Count yourself lucky, my first MO rushed through everything. I learned so much more from the good folks here. Besides my MO didn't look look like Christina Yang...I need a celebrity status MO! Lol

    Edited to say: Newfie...YAY!! Clear margins!!

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  • Kimmy_nl
    Kimmy_nl Member Posts: 21
    edited June 2018

    Thanks everyone! Great suggestions wrt to keeping a folder or binder with the reports etc. It is a great idea; so that I have all this to give to my daughter, so she will have all the history as well and stay on top of her own breast health. I did see my last 2 path reports and they haven't mentioned anything about the status of the cancer. Just that it is low grade DCIS and the size. But the core biopsy only indicted ADH initially, so perhaps when the first surgery (excisional biopsy) was done there was no need for that type of testing for ADH. The first surgery came back with DCIS, so then perhaps the second lumpectomy was tested for status? I am putting together a list of questions for the dr next week to find these things out now that you guys have brought it all up. I have found this site very helpful and you ladies are a wealth of information :)

    Nonomimi - My surgeon was the opposite of Christina Yang, he was so compassionate and kind. But he was also very medical detail oriented at the same time. He always took the time to answer my questions, but at the same time I felt like the decisions were made for me before I had a chance to analyze any of it. Truthfully, if I end up having a reoccurence or if it shows up my right breast down the road I will opt for the mastectomy. I am very paranoid that they left some behind and that it will progress over time. But hopefully I will have the option to have Rad, I will take anything they can offer to prevent a reoccurence!

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  • nonomimi5
    nonomimi5 Member Posts: 434
    edited June 2018

    Newfie,

    Good luck on your appt next week. The Dr. usually has a copy of your reports to look at during your appt. I always ask for them after the appts b/c they can always print more copies. I was qualified for the Canadian accelerated 16 session radiation therapy. I will go to my 3rd session today. If you need radiation, you may want to see if you can do the accelerated rad. Your Oncotype genome test will indicate your reoccurance % with the treatment options. My surgeon did it for me but if your's didn't, ask the chemo dr. to do it. You need this to know if you need chemo b/c it tells you how aggressive your cancer is. Until you get this report and your cleared, you never know if you need chemo or not. My Oncotype score was 17 and I do not need chemo.

    mimi

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  • Kimmy_nl
    Kimmy_nl Member Posts: 21
    edited June 2018

    mimi,

    Yay you don’t need chemo! That’s great news! I will certainly ask about the accelerated radiation treatment. The surgeon told me he figured 20 sessions, but the radiation dr will have more info.

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