What happens at first consult with breast surgeon?

Your BS will have all your X-rays, etc and will discuss your surgery options. I was inundated with information as to my particular BC. I had no clue what most of it meant. It’s a lot to absorb. I did read all the printed material they gave me.

Don’t be afraid to ask questions or clarification.

Once the surgery is scheduled the process should move quickly.

You can do this. We’ve all been right where you are. My husband went with me when I had surgery and oncologist’s appointments and for routine mammograms for the first 5 years. I’ll be 7 years out next month.

Good luck!

Diane

My first appointment with the breast surgeon was a consult, and it took place after my biopsy (done by a radiologist) and with the full pathology results. Because I was Her2+ it was my oncological breast surgeon that was the one who told me I would need chemo, and he directed me to the oncologist he felt was best suited to my subset. I trusted his judgment on who to see because he had previously been the head of breast surgery at an NCI center, and I knew he was dialed in to who would be a good fit. He was absolutely right on this - I adore my oncologist. At this appointment we discussed the need for genetic testing since I was adopted and had no access to family history, and also discussed what type of surgery that he would recommend, but reserved his final advice for after the genetic testing results results were received. My husband and adult daughter (she was 21 at the time) were with me at this appointment and the BS fully explained the difference between DCIS and IDC, as I had both, and the basic mechanics of cancer in the breast, including drawing diagrams - he devoted quite a bit of time to answering questions from all three of us and also spoke to my daughter about her risk going forward due to my diagnosis. We discussed types of surgery and types of reconstruction and indicated he was able to connect me to whatever plastic surgeon was best suited depending on what type of surgery I chose, if I desired reconstruction. He explained the basic process for surgery, what things needed to be done prior to surgery in terms of any additional testing, and set up an MRI to check more thoroughly bi-laterally for additional issues. We also discussed timing of the surgery, recovery from the different types, how long I would be in the hospital, anesthesia use, and what to expect. Good luck, wishing you the best! Once you have a plan it does get easier - you will feel more proactive when you are making decisions and moving forward.

I think the biggest decision most of us face is if we want to do lumpectomy or mastectomy. Everyone has their own thought process on this. Remember it’s your decision (assuming lumpectomy is an option for you).

CPB - I'm sorry you have to go through this, too. It is indeed like getting on a fast train with no stops. I, too, saw a Surgical Oncologist (i.e. breast surgeon) first. As everyone says, they should have all of your pathology labs, etc. I found it hard to be lucid enough to ask questions and had a friend with me. Here are some questions I wish I'd know to ask the first time:

1. What is the stage, grade, and type of my cancer?

2. What are my surgical and/or treatment options?

3. Are there differing prognosis' for each treatment option? If so, what?

4. How much time do I have to make a decision?

5. Will you be referring me on to a Radiation Oncologist, and a Medical Oncologist? If so, who?

6. If I am having surgery, how long should I plan to be away from work/resting at home?

7. Are their any social workers assigned to me at this hospital? (social workers will get you through red tape, counseling etc., take advantage)

These should give you the information you need to make a decision on what your path will be. The choices are different for everyone - but we all share the same fear. I think it's normal to feel that way. I have a good friend who has been living with Stage 4 brain cancer for years now - he's on hormone therapy at an NCI in Denver. He tells me: just do what your doctor says. I've followed his advice - but have never stopped asking questions about my treatment. I was an anxious and bitchy patient, I'm sure the radiology department couldn't wait for me to get through radiation, initially - cancer is scary and I wanted to know every detail about what they were aiming their laser beams at, etc. - but bless them, they were as committed as I was, and we all cried at the end. You are about to meet some of the heroes of your life.

These forums helped me tremendously. I hope you find them useful, too. Good luck and let us hear from you.

Here's what happened with mine:

I called the surgeon's office. They had me send over my pathology report from the place it had been done and arrange to send my slides from the path lab so that they could retest them. Both were simple paperwork procedures.

Once she saw my initial path report they scheduled an appt.

I met with her and her nurse for a while.

She discussed her impressions of my tumor, explained hormone receptor status, described the choice between lumpectomy (for which she felt I was candidate) and mastectomy, explained recurrence and survival rates. She discussed removing lymph nodes, how they decide on how many to remove in the moment. She explained potential complications from both surgery and lymph node removal and gave me odds on those occuring.Explained what would happen aftter surgery and who i would likely meet with next. What recovery I could expect from either surgery. She told me that mastectomy is always an option with breast cancer but she felt that a lumpectomy was a decent choice with me. I asked her if I let her choose what would she choose and she said lumpectomy. I decided to trust her.

The approach after that was to rule out things that could suggest mastectomy instead of lumpectomy

I had an MRI, genetic testing, and a biopsy on a second suspicious area on something else that turned out to be cyst. All of these appts were scheduled by and arranged for by my surgeon's office.

While everyone's experience is different. I found that the practice I went to (which is part of a major cancer center at a major hospital), prioritized making things easy for the patient, both emotionally and administratively. This is something that is very important to me and I'm glad I went somewhere like this.

good luck at your first visit!

It sounds like a relief to have a decision made, and a great surgeon! Just a little homework, maybe a special project... one appointment at a time... what more can you do, right? Good luck with everything!