2nd Opinion - Oncologist or Surgeon

April 21, 2002

I just joined this group, so if my question has been answered before

please refer me to where I should look. I'm also not familar with all

the medical terminology so bear with me.

On 3-20 I had a core biopsy, right breast only, diagnosis: DCIS,

Stage 0, noninvasive. The general surgeon said it would easily be

treatable with a lumpectomy and 6 wks of radiation. I had my

lumpectomy on 4-11 (22 days later). On 4-17 the surgeon blindsided me

by saying the margins were less than 1 mm and she now recommends a

total mastectomy,w/o removing the lymph nodes. Actual diagnosis:

" Intraductal carcinoma coming very close to resection margins, focally

less than 1 mm distance " . She did mention that she had a hard time

seeing because of the bruising caused by the biopsy. She felt even

though the mammogram did not show any more microcalcifications there

might be more cancer and did not feel another lumpectomy would be

helpful. She did not confer with an oncologist re my treatment.

I've received info from the ACI and NCI and both seem to advocate

seeing an oncologist at some point in treament.

I definitely want a second opinion, I still don't understand why

another lumptecomy wouldn't work if its just a matter of margins, take

out a bigger section the next time. So, here's my dilemma. The

surgeon has referred me to a surgeon at the Cleveland Clinic. The

Cleveland Clinic has a good reputation, however although the 2nd

surgeon works in the breast dept, he is not an oncologist. Also, I am

leary that because of their referral system he might just agree with

her to not make waves. I also do not want the lst surgeon to operate

on me again, so even if I see the surgeon she referred me to, I'll

probably have to get another surgeon to do the next operation. I also

worry about just being a " number " at a large clinic, yet they would

have the most up-to-date equipment, research, etc.

My other choice is for a second opinion with a oncologist/surgeon who

specializes in the breasts. He has been referred to me by a couple of

people who were pleased with him.

How important did you find it to meet with an oncologist? Is a

general surgeon just as good? I did look up both of their credentials

on the ABMS.org site. Are there any other sites I should search to

check credentials?

Thanks,

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