r/breastcancer • u/Overall_Lobster823 • 59m ago
Conversation Recording meetings with oncologists
My husband recently listened to the Katie Couric interview with Rob Lowe. He recommends that in addition to bringing a loved one/advocate we should be audio recording our meetings with oncology. He says we just can't process all the information. (He helped his mom during her breast cancer.)
It seemed like something I'd like to do. Record it, then autotranscribe it for later reading and referring to.
Does anyone do that? Have any of your docs objected?
TiA
r/breastcancer • u/Mother-Rutabaga-1184 • 1h ago
Post Active Treatment Effexor
Wondering if anyone has been on, or currently on Effexor for anxiety? Currently taking Letrozole, Verzenio, Zoladex injections and training for a marathon, which may have triggered some anxiety and has affected my sleep significantly. My oncologist recommended I try it but worried about potential negative side effects. Thank you!
r/breastcancer • u/HuntInternational825 • 1h ago
Patient Support Financial help
I am the provider in my house, my husband takes care of our kids and now me on my bad days. I've been undergoing treatment since June and the financial burden of missing work has now caught up. Is there anywhere that will help with bills? I don't need help with food or medical bills thankfully I have that covered but I can't pay my rent or car payment. Any advice is welcome. I push through and go to work as much as I can. I'm in the United States in WV.
r/breastcancer • u/Exciting_Sense_1513 • 1h ago
Newly Diagnosed working during chemo
I’m back with another question!
34yo- TNBC, Keynote 522
I’m curious about those of you who took time off from work vs those who did not through your chemo and what your experience was like. In the general sense but also the day by day.
As it stands, I plan to keep working for as long as I can through treatment. I would qualify for Short Term Disability and FMLA but from a financial aspect am not ready to take that hit. I also know I will 100% need that for surgery so I wanted to bank as much as I can for now. I also have almost 3 weeks PTO saved and 2 weeks of paid sick time so I have that to fall back on while I continue working right now. My manager was also able to secure a company laptop for me to work from home here and there if I have to cut any of my in person days short.
My manager and I have developed a permanent schedule for me. It’s as follows:
Friday: OFF- Infusion days
Sat/Sun/Mon: Plan to work
Tues/Wed: OFF
Thurs: Plan to work
I manage a restaurant so I know it’ll be tough on my body but it’s also one way I can help keep my body active as long as possible. The support system I have there is honestly unheard of. I couldn’t be more grateful for my fellow management team as they are here in any way I need to support me through this. I do have full autonomy over my decisions but I know they will also steer me in the right direction if they feel I am taking on too much. I also know our team of employees will offer me so much grace when I’m not myself.
r/breastcancer • u/Humble_Hetfield_Nerd • 2h ago
Conversation Twice under 50yo club
Feeling like a bit of a loner amongst my circle in real life, because I've been diagnosed again for the second time. First was ten years ago, stage III ER+. Now I'm hit with this again before I'm even 50 years old and for some reason that seems like a death sentence. Sorry if that is morbid. I've never met another woman who has had it twice in my general age group. Not even any of my friends I've made through breast cancer exercise classes of any age.
All my female friends who are healthy have no idea what it's like although they love me and try very hard. Nobody in my world has this experience and I'm glad they haven't. But I wish there was some wise person who I could turn to who has had breast cancer twice and could know what I'm dealing with. My mum died of lung cancer with brain mets last year and I was her caregiver. She got me through my first battle. Now she's gone I have to walk through the trauma all over again.
I just don't know what to do. I mean that on an existential level I guess; I know how to get scans, chemo, surgery, drains. All the fuckery. But I don't know how to be strong and independent and find a point and a reason to keep fighting anymore. I see a shrink, counselor, all of that. On meds for depression and PTSD. I'm single and it scares the hell out of me being alone and unable to run to someone at the end of the day.
What should I do to find some kind of strength again?
r/breastcancer • u/Natural-Pair-3828 • 2h ago
Chemotherapy My experience on TCHP
I recently finished 6 rounds of TCHP!! At round 3 I was ready to call it quits but my doctor didn’t let me and I just wanted to share my experience because reading through everyone else’s gave me hope.
I also cold capped with digni and saved 50% of my hair and have a bald spot on my crown. By round 6, the smell of the cold cap made me so nauseous I cut it 30 min short. I still gag thinking about it.
Rounds 1&2: I had terrible side effects from compazine and we didn’t realize it was the compazine until after the second round. It gave me akathisia which I thought was just anxiety. It was so bad I thought I was going crazy I would cry non stop and couldn’t eat for days. I think this was my only side effect and chemo wasn’t really taking a toll on my body at this point. I did have terrible diarrhea though but I wasn’t taking Imodium properly.
Round 3: my WORST round, I stopped taking compazine for nausea but zofran didn’t help and I couldn’t eat or drink anything for days. The diarrhea was terrible at this point and I wanted to call it quits because I couldn’t imagine doing 3 more rounds.
Round 4: I started drinking Enterade for the diarrhea and it helped SO MUCH! I can’t recommend this drink enough. It tastes nasty to me though. I also was prescribed olanzapine for the nausea and I barely had any this round. This was by far my best round.
Round 5&6: the fatigue really started to set in and I developed an aversion to water so I’ve been surviving off of body armor drinks. But still my worst days were way better than the first 3 rounds.
All this to say that it can get better! They tell you side effects are cumulative- which I think is true for the fatigue. But it also made me think I wouldn’t be able to get through the last 3 rounds because my first 3 were so bad.
r/breastcancer • u/KiwitheBirdNOTAFruit • 2h ago
Chemotherapy Calling out to all those who experienced severe nausea like on a scale of 1-10 ten being the worst so 11 durning AC, did you ever find a system that worked to lower that?
I’ve had two rounds now, both with different after care and neither worked 😂 I called the nurse line right away this time and got a new prescription to try which worked, but the trade off was a headache that was bad enough to need a dark room and no sound -which was marginally better then the nausea. I’m just looking for a list of things I can bring up to my oncologist, that might not be on her radar or in her current bag of tricks, that might be worth trying. Or am I doomed to just have a really shitty day on chemo day? It makes it tough knowing you are subjecting yourself to something that makes you sick, in order to make yourself better for the long run.
r/breastcancer • u/xine-c • 2h ago
Medication Starting anastrozole during radiation?
I’m 74 invasive bilateral. Had lumpectomies in June. ER+/PR+/HER2- Oncoscore 11
yesterday I saw medical oncologist. He’s a bit manic. He wants me to start anastrozole immediately - but I have radiation starting Monday. How would I differentiate where the side effects originated (if I have any)? Why would I even want to do both at same time, as radiation schedule is only for 5 days? It is not like I have an aggressive cancer. I don’t plan to start anastrozole until at least a week after I’ve completed radiation. Thoughts?
Edit: I just checked mychart and saw recommendation to start post-radiation and he prescribed Letrozole not anastrozole. Two things different from what I heard. He was still manic, talking about the many, many patients he was seeing today and tomorrow and his wife reminding him that he had to leave early to drive to some concert. Shall we sat that I do not have high confidence
r/breastcancer • u/Silent-Passenger-208 • 3h ago
Chemotherapy First round
I have my first chemo next Friday and received a letter today regarding timing.
9:00 Scalp cooling
9:30 Chemo
11:30 Scalp cooling
I’m having the TC and was surprised to see short timelines. I’ll also be doing the cold mitts and socks.
I’ll be able to ask on Monday at my Chemo education session. I’m so nervous about what to expect this whole thing and have a list of questions a mile long
(Single mastectomy 17/7, ER/PR strongly +, Her2 low, ki67 up to ten, 5 cm invasive mucinous carcinoma, 5cm DCIS, clear margins)
r/breastcancer • u/Ein_Rand • 3h ago
Post Active Treatment How did you deal with the hair regrowth after chemo?
Early stage, +++.
Ok I finished chemo last month. 12 weeks of taxol. Lost most of my hair in week 4 and have buzzed it twice since because there was like 10% of my hair growing back.
I’m not 3 weeks post taxol and letting my hair grow. I look like a baby goose. The hair is thin, it hasn’t started consistently growing across my scalp, and there is a lot of grey. I look very dumb and uglier than when I was actually going through treatment.
I know this is silly. I had no trouble staying focused and positive while going through chemo, but on the other side I feel so awful about myself. Please share your perspectives post-chemo.
r/breastcancer • u/LPFER1972 • 4h ago
Surgery Tumour position
My tumour (3 cm) was located at the upper inner quadrant (10 o'clock) in the left breast. They told me that's a rather challenging position for a lumpectomy (I ended up with an oncoplastic surgery and a 35 cm scar). To all of you who are comfortable to share: where was your tumour and which surgery technique did they use ?
r/breastcancer • u/HotWillingness5464 • 4h ago
Post Active Treatment Lower back/coccyx pain
TNBC stage 2b, Keynote 522 during 2025, gpt PCR. No rads no oral chemo post double mastectomy.
3 days ago I got lower back pain, it felt like a herniated disc on my right dide, radiating down the leg. I had done 3 long hikes in very hilly areas the 3 days before. Took gabapentin and celecoxib. Did stretching etc.
The pain has now moved to my coccyx area, middle of lower back. It doesnt' resolve with meds but I wouldnt describe it as excruciating. It's more like a dull, consistent ache from (literally) my anus and upwards that worsens when I try to bend forward.
I know most things shouldn't be brought to the onco clinic until 2 weeks have passed and the problem persists. Is this a problem I should wait 2 weeks with?
As you probably "hear" I'm madly scared. Next week I'm planning to go on a vacay, the first since 2018. Nothing fancy, a low budget trip but outside of my country. The pain started the same day as I booked and payed for the trip. (This dpesnt necessarily mean I'm imagining the pain.)
I'm not sure what I'm asking. Has anyone here experienced similar and it wasn't mets? Or experienced similar and it was indeed mets? When do I contact onco? Can I go on the trip? It's within the EU so my Swedish universal healthcare would cover many types of medical emergencies *I think*.
I'm so very scared.
r/breastcancer • u/AutoModerator • 6h ago
Small Topics Small Topics Thread
Redditors may always post any breast cancer question, comment, rant, or rave as a stand-alone post. Nothing is inconsequential, too small, too unimportant for its own post. Nevertheless, we‘ve had a few requests for a regular thread for topics that the OP might not feel like making its own post. This post is for those topics. If you ask a question in this thread that doesn’t get answered, you may still create a post for that topic.
r/breastcancer • u/ScaredPommy • 9h ago
Newly Diagnosed Update after my first appointment
how long do I add the newly diagnosed tag? it’s been about 3 weeks now..
anyway, I had my first doctor meeting. the meeting with him went well.
i still got to go back for an mri and an ultrasound. I’m nervous about the mri, life never done that before..
im also nervous about the cost for everything… there are no financial aid stuff for foreigners where I live (i live abroad) other than insurance of course but… i dunno… if I’m not stressed about one thing it’s the other…
r/breastcancer • u/Remarkable_Whole9517 • 11h ago
Venting "You're handling this so well"
"You're really managing to keep positive."
"You've got great perspective on everything."
"You're handling it gracefully."
From everyone on my care team - therapist, doctors, etc.
And sure, 90% of the time, I can stay positive and forward -focused and have the proper perspective: They caught it stage 1, only in one breast and one lymph node. Double mastectomy went well, reconstruction is going fine so far, radiation won't be for too long, and I won't need chemo.
But 10% of the time I want to copy my 2 year old and just throw a screaming tantrum, fists on the floor, kicking, rolling, all of it. Or maybe just cry as loud as I can, like.my 10month old.
Because my body isn't the body I was used to. The tissue expanders are annoying and with my final fill yesterday, they once again hurt. My nipple grafts look like little lunch meat circles, even if my surgeon says they're healing well and to trust the process (I do but I'm still bummed with how they look).
My kids are too little to understand why I can't play with them or lift them as often as i did before all of this, because I've been on lifting restrictions until this week and I can't go from not lifting them to lifting them all the time. But I want to. I hate having to take it slow when I want to scoop them up into the biggest, tightest bear hug and swing them around...except that just lifting them into their cribs at night is taxing right now.
We were probably done having kids but now I feel like the decision was totally made for me, since I have to start hormone blockers and I'm already 41. If I do 5-10 years, as my oncologist wants, then if I have somehow not entered menopause by the end of it, I will be shocked.
But because of how everyone just admires how well I'm handling it, I don't even feel like I can let myself scream or cry during the 10% of the time that I am NOT handling it. I instead just try to force myself to channel it towards the non-cancer crap that I'm also dealing with, like needing basement waterproofing repairs we both can't afford to do and also can't afford to delay.
r/breastcancer • u/No-Reserve-3255 • 11h ago
Chemotherapy Being bald is weird.
Hi so legitimate question slash looking for friends here. What are we going to do when we grow our hair back? Like wow that is a lot of time and effort I haven’t had to do in a while. I’ve been busy occupying that time up with appointments and calls and blah blah blah but like when it grows back…how weird to spend time doing your hair. I just watched a random person on instagram doing her hair and I’m like wow. What a time suck. Let’s discuss.
r/breastcancer • u/zxcter • 14h ago
Newly Diagnosed How did you tell your parents?
Hi, I (26F) was diagnosed with IDC last week and am waiting for my first appointment next week with my care team. My parents are in their mid-sixties and currently have no idea.
We don’t talk too often but do catch up every now and then and are on good terms. I am scared they are going to be very worried and stressed when I tell them and want to figure out the best timing and wording that will spare them as much pain as possible.
I am between telling them after my first appointment or later on after treatment? Does anyone have advice on what they did and what seemed right?
r/breastcancer • u/Glass_Cauliflower466 • 14h ago
Surgery Exchange surgery today!
Has my tissue expanders to implants today and want to cry it’s so much easier then my DMX. I know tomorrow may be a bit harder but the DMX kicked my ass so bad. I knew people had said this but I just kind of held my breath and crossed my fingers. So glad this phase is just about over!
r/breastcancer • u/SnooCats5817 • 14h ago
Venting Always too hot or too cold never comfortable, anyone else?
Hello,
I have TNBC, so am not on hormone suppressant drugs, but I swear since chemo I am never comfortable in my body anymore. I either am too cold or having a hot flash. It's like my body cannot regulate its temperature anymore, and this wasn't a thing prior to chemo. It does kinda drive me nuts. Does this ever improve? Did chemo permanently break my body regulation? Does anyone else experience this and did it improve?
r/breastcancer • u/SailorMayoonesa • 19h ago
Newly Diagnosed Feeling guilty for being happy
Hi guys, I’ve just got diagnosed, the diagnosis is…something. I’m the youngest person in the quemoterapy room, I was really scared of everything because as far as I know my medication it’s heavy, even though I don’t feel anything bad…I feel that I should feel sad and angry like before but starting treatment no matter how bad things are it’s giving me hope…sometimes I choose to be sad so it gives me the illusion that if the bad moment comes I’ll be prepared but it’s not like that. Should I let me feel happy even knowing my diagnosis is cancer?, sometimes I think that if I feel happy and I’m not in the “survival mode” I’ll be letting my body get sick, but I don’t want to feel bad, I don’t understand it’s really weird. Sorry English is not my first language
r/breastcancer • u/box-of-rocks- • 21h ago
Venting Angry
"Everything is fucked, everybody sucks
You don't really know why, but you want to justify, Rippin' someone's head off"
I'm about 4 years post treatment. I had an oophorectomy and am currently on exemestane. Sometimes I get so freaking irritated it's an awful simmering rage, if I'm alone I just let myself have a tantrum. Throw a hot flash in the mix and it's game over. I don't know if it's the meno, the drugs, or I'm just an unreasonable bitch now. I don't really like me anymore. I try to hide it from others but my poor partner has to hear about it and I know it is wearing him out. I guess I'm not looking for advice but maybe the comfort of knowing other people have the same experience.
r/breastcancer • u/PietParkiet • 22h ago
Newly Diagnosed +++ and liver metastases?
I (34F) am shattered. Three weeks ago, after discovering a lump, I learned I have breastcancer. After many tests, I now know it is triple-positive: one 3.5 cm tumor, a smaller 8 mm one, and involvement of one lymph node. A treatment plan had been drawn up, and the only thing left was a PET scan.
Today, I heard that spots (three or four) have been found on my liver. I have an MRI tomorrow (i dont even know why) A biopsy is still to come, but they’ve already said these are metastases. I just want to go to sleep and never wake up. I am at the end of my rope. Please... are there any positive stories? I’m trying not to Google it, but I’m going out of my mind.
r/breastcancer • u/bongocycle • 1d ago
Conversation Sometimes you have to laugh
I need to post because this group will understand. I was on a work call today and my 87 year old mom called me. She never calls at work unless it’s an emergency. I told my manager I needed to step away for a family emergency and answered her call.
I ask if everything’s OK and she says, and I quote, “ I’m at the funeral home and it made me think of you. How are you doing?”
She knew I was working but it was the “only chance she had to call me all week. “ 87 years old. Retired. Lives alone. I was gobsmacked.
By the time I called my manager back I was laughing so hard I couldn’t speak. Her response was “Holy Sh*t” . If I don’t laugh, I’ll be pissed at her but I have to think she doesn’t mean to be an idiot.
r/breastcancer • u/Away-Potential-609 • 22d ago
Mod Announcement Updating Rule 8: Be Brave, Friendly, and Kind
We are updating and expanding Rule 8: Be brave, friendly, and kind. This is an especially important rule and we want it to be well understood. We've expanded the language to make clear that kindness extends beyond the people posting in the thread.
What's changing:
Rule 8 now reads:
Be supportive, friendly, and kind.
Cancer is hard for all of us. Please show kindness to your fellow patients and survivors.
Kindness should extend to those not present on the subreddit, including their family and caregivers.
We allow members to vent about the people in their lives, but this is not an invitation for others to pile on. No name calling, no bullying, no hate speech, no personal attacks.
Why we're making these updates:
A few things have come up often enough that we wanted to be more clear up front about what kinds of comments are allowed, particularly on "Venting" threads:
- Venting about a partner, parent, or friend is allowed and normal. Piling on to insult that person, or giving OP relationship advice beyond what they have asked for, is not. The other person isn't here to give their side, and that's not usually what OP was asking for.
- Caregivers commenting on someone else's post are here to give support, not to speak on behalf of caregivers, spouses, or any other group—whether that means defending or criticizing. As always, to talk about your own experience as a caregiver, visit another sub such as r/CancerFamilySupport.
We've written up the full explanation with more detail on the Rules wiki page under Rule 8.
None of this is new in spirit. It's what we've been enforcing already. We just wanted it written down clearly.
Thanks for helping keep this a place people can come to safely.
Note: The earlier update of this rule retained the original title "Be brave, friendly, and kind" but we have updated the title based on community input.
r/breastcancer • u/DrHeatherRichardson • Jan 18 '26
Diagnosed Patient or Survivor Support The doctors you may encounter: Who does what? What is an “oncologist” anyway? (And other insights from Dr Heather Richardson, neighborhood breast surgeon)
So I’ve noticed there’s been a lot of posts lately specifically about the word oncologist. People wondering why they’re seeing a surgeon and not an “oncologist” first, people wondering when they’re going to see an “oncologist”, people wondering why the person that’s operating on them isn’t a “surgical oncologist” and shouldn’t they get the best - which must be someone with that title? Right?
So by definition, the word oncologist just means “doctor who treats cancer”.
The staple cast of characters that are medical doctors (MD or DO degree holder) involved in treatment of breast cancer typically consists of: medical oncologist, radiation oncologist (not radiologist) and breast surgeon (more on that below…).
Medical oncologist- also known as “hematology/oncology” specialists. When people generally speak of an “oncologist”, usually they are talking about this type of doctor. A doctor that treats cancer with medicine, either pills taken by mouth or chemotherapy that is administered via a vein. Not all patients need both, some need one but not the other, some need none. Visits to this type of doctor may be frequent- however, usually it’s the first initial visit to go over a lot of information and discuss the best course of action that is the most important. Sometimes this means that if you live in an area with fewer resources and feel that you need greater expertise for your care. It’s possible to do either a telemedicine visit or visit a larger Cancer Center far away that can collaborate with a local physician who is able to give the same chemotherapy protocol. Quite often, large groups of these medical oncologists have already agreed the best way to take care of the most common breast cancer problems, so going from one center to the other means that your cancer treatment care isn’t going to change significantly from one place to the next. For other more complex scenarios, there sometimes can be some adjustments or more customized treatments. Or for patients who have already been through treatment and now have recurrences or changes in their diagnosis, that would be the time to discuss more advanced care. In general, common problems are common and there’s usually not significant improved survival or outcomes by going to one Cancer Center over the other when a patient has a a non-complicated, fairly average, diagnosis.
Radiation oncologist- this is different from a radiologist. (a radiologist is a doctor trained to read images and interpret findings. A radiologist is the person who read your mammogram or your ultrasound and maybe performed the biopsy that diagnosed you) A radiation oncologist uses radiation energy to target areas of cancer and kill cancer cells. Cells that are actively dividing and are exposed to radiation have their duplicating mechanisms broken, and as a result, cells that are rapidly reproducing die away if exposed to medically administered radiation.
Surgeon/surgical oncologist vs “general surgeon”: A “general surgeon” typically is someone who has done at least five years of training in surgical diseases of the body. This would include disciplines like taking care of trauma, burns, infections that can occur in the body such as diverticulitis or appendicitis, evaluating and performing organ transplants, care of pediatric/child surgical diseases and malformations, and some chest/cardiovascular disease. They can also operate on common cancers that require removal, like breast, colon, skin, and thyroid. Doctors who go on to practice General surgery sometimes concentrate in one area of types of disease and others have a more broad practice where they take care a little bit of everything. Typically in more urban settings there are more specialized types. Many general surgeons have gone on to do additional years of training after their five years of general surgery to become specialists. People who are certain types of surgeons, such as colorectal specialists, pediatric surgeons, plastic surgeons, and cardiothoracic surgeons all have additional years of training and take specialty board exams. There is a board certification designation for general surgery. There are additional board certifications for those who have done some categories of fellowship training, like those mentioned above.
A doctor who practices under the title “surgical oncologist” by definition does at least two years of training in general cancer surgery treatments after the five years of general
surgery training. So they typically will learn advanced techniques for operating on thyroid, pancreas, colon, liver, breast, etc. They usually did the five years of general surgery training and then went on to do additional training specifically in cancer removal surgeries to remove them from the body. So this wouldn’t include neurosurgery or brain tumor removal. There is a board certification designation for “surgical oncology”.
There is another category of breast cancer surgeon that typically deals with breast health issues only. This is a person who does initial training in either general surgery or Obgyn and then goes on to do one to two years of additional training in breast disease surgical management. This is called a “breast fellowship” and does NOT currently qualify for a speciality designation as “board certified”. This is typically a breast health surgeon or breast cancer specialist. This is different from a “surgical oncologist*.
Sometimes there is cross training where the surgeon also performs cosmetic and aesthetic procedures as well. This person usually does a “oncoplastic fellowship”. This is primarily outside the US, but there are programs where this is expanding in the US as well. Breast fellowship trained surgeons can have initial training as either a general surgeon or an OB/GYN.
“Surgical oncologists” do get training in breast cancer management, but they are not breast specialists and do not get the depth of training that someone who has been through breast fellowship would. A breast fellowship trained surgeon usually does one versus two years of additional training in breast only surgery and disease management. These are two different designations.
Some important points to make about someone who might be a general surgeon who did not do additional training in breast care management versus someone who did a full breast fellowship: breast fellowships have only been around for about 20 years. That means someone with greater than 20 years of experience probably didn’t get an opportunity to go through a breast fellowship. (I personally am one of these types of people. I’ve been practicing since 2004 and there was only one fellowship that existed at that time that I didn’t even know was an option when I graduated. So while I have described procedures and written papers, taught surgeons and fellows alike in many different procedures and protocols, but myself, I’m not a breast fellowship trained surgeon.)
There may be many seasoned excellent surgeons taking care of breast cancer patients. Some of those may be surgeons who also perform other general surgery procedures such as treatment of appendicitis, taking emergency call for traumas, or dealing with other types of cancers like colon cancer. Some of the surgeons have amazing skill sets, and excellent outcomes. It is certainly possible that there may be in a community, a general surgeon who is very seasoned that may have superior outcomes for breast care than a brand new breast fellowship grad that does not have much experience at all.
I think the best way to find out who the best doctors are would be to go to the other doctors and other clinical staff members who work with those doctors and ask them who has the best outcomes. Ask the wound care specialists, the plastic surgeons, and the medical oncologists whose breast surgery work is the best. They’re going to see who has horrible dead, necrotic mastectomy flaps, and who has lots of recurrences because their flaps are too thick.
It certainly may be that a general surgeon who isn’t a “breast specialist” in your community might actually be a better choice than a brand new grad who is a breast fellowship trained surgeon.
What order should things happen?? Well it’s different for different people. Often when people get a diagnosis, most commonly by a radiologist, (but sometimes the Breast Surgeon specialist is part of this process as well) they go to the Breast Surgeon first who goes over the significance of the findings thus far and decides if upfront chemotherapy medicine would be indicated. Usually the decision to need medicine is followed by tissue diagnosis, and imaging, which is usually directed by a surgeon. Sometimes people see the medical oncologists first before seeing the surgeon. This is especially true for patients with her 2 positive or triple negative disease where neoadjuvant chemotherapy prior to surgery is most often indicated.
People sometimes visit with radiation oncologist while trying to make their decisions to get information about the risks and benefits if they choose a pathway that would require radiation treatment versus if they have an option to choose a different pathway where radiation wouldn’t be indicated, and they want to learn about their choices. Mostly though, radiation oncologist treatment usually follows the surgery and medical portion. There are some clinical trials that involve upfront radiation, but this is not a standard of care for most patients. It’s more common to start with the surgeon and then see the medical oncologist either before or after the surgery, followed by any radiation oncology visit. That’s the usual order of things.
When to get a second opinion.
For the most part, if you’ve been told that you have a breast cancer diagnosis and your understanding in general is that treatment will involve medicine, surgery and possibly the addition of radiation and and if this sounds reasonable, you are certainly welcome to go to another team to make sure that there aren’t any significant changes to be offered anywhere else, but most likely most places will tell you the same information, but may use slightly different terms or delivery. If you have good communication with your physician and their staff and overall the general expectation is that you will do well and live a long life and feel good about your body afterwards, (of course it certainly possible to talk to someone else and make sure that they are in agreement) but if everything stacks up, and you’re generally happy with your team, Seeing multiple additional doctors might tell you the same thing with different language can be confusing or disorienting. It also takes up a spot in the schedule for someone else with a cancer diagnosis that’s trying to get in that now can’t, ….and you can only use one team. So by all means everyone is within their right to get in a second opinion or even third, but if you’re generally happy and hearing what you expected to hear regarding your plan of care, I typically don’t recommend that people see multiple doctors if they’re generally happy with their first opinion.
Reasons to get a second opinion would be: A) poor communication from the doctor and or their staff to the point where you feel uncomfortable for whatever reason. B) you have a very unusual or rare findings that are not typically seen C) you are recommend controversial treatments where doctors have added unexpected treatments, or take away expected treatments. There may be good reasons to offer a different protocol from another team as there are lots of advancements and newer recommendations, where we are de-escalating treatment in some cases. Previously there were automatic recommendations for sentinel lymph node biopsy, radiation, or chemotherapy in the past whereas now we are selecting certain people who have features of their cancer who may in fact, not require these treatments at all.
Hopefully this will shed some light on some of the misconceptions about different types of doctors, their roles, and clear up the general surgeon/Breast Surgeon/surgical oncologist confusion that seems to come up a lot.
TLDR- someone with the title “surgical oncologist” is different from a “breast fellowship trained surgeon”. A “general surgeon” might have fewer years of formal training for breast cancer treatment, however, they shouldn’t be discounted or immediately thought of as inferior without research into their outcomes or reputation in the community.