The Breast Cancer Coordinator at your local cancer center can be a great help to you.  She can assist you in making doctors appointments, providing literature about procedures and what to expect, and letting you know of additional resources available such as transportation, products, etc.   The thought of seeing multiple doctors can be overwhelming and without the help of a Coordinator, it may be even more difficult.  Understanding the role of each specialist will help you understand how each will play a part in your health care and what questions you might ask.

Sometimes a mass is found by an Obstetrician-Gynecologist or by an Internist.  Specializing in the care of women and their reproductive organs, the Obstetrician-Gynecologist is often a woman’s primary care physician.  Usually a breast examination, pelvic examination, and pap smear are performed during the annual exam.  If a woman feels a mass in her breast, she will more than likely contact her gynecologist first.  An Internist may be your primary care physician, who normally specializes in comprehensive medical care and is involved in ongoing health care needs.  A baseline mammogram is ordered usually at age 35 and then annually after age 40.  If an abnormality is found or if the mammogram is questionable, you may referred to a Breast Surgeon.

A Breast Surgeon specializes in operating on breasts and may also perform a biopsy to determine if a tumor is malignant.  Some breast surgeons specialize in breast reconstruction.  If a breast surgeon recommends surgery after a biopsy is performed, he should also recommend the necessary treatment following surgery and refer you to other specialists as needed, such as a Radiation Oncologist, Chemotherapist and Plastic Surgeon if you are considering reconstruction.

It should be noted here that most women do not meet a Pathologist who specializes in diagnosing her condition once the biopsy is done.  Any specimen removed by the surgeon during the biopsy is sent to a laboratory, where the pathologist will examine it and report back to the surgeon with the findings.

If the findings are positive for cancer, you will be referred to a Radiation Oncologist.  Radiation Oncologists specialize in treatment of cancer with irradiation.  He will determine if and when irradiation should be used and what type is best in combination with surgery, whether it be radiation or chemotherapy.  

Knowing the right questions to ask these specialists will help you evaluate, understand, and consider all your options. 

1. Is the cancer invasive or in situ?  Invasive implies it has probably spread to other surrounding tissue.  In situ refers to breast cancer cells that have remained in the place of origin, implying it has not spread to other areas of the body.  The type of cancer defined will determine your course of treatment.

2. What are my options?  And what are the alternatives?

3. If surgery is needed, describe exactly what will happen and where the incision will be and how you think it will look once it is healed.

4. What are the complications of my surgery choice?

5. How long do you think I will be in the hospital?

6. What is the cost for you to perform this surgery on me and will my insurance cover it?

7. If I want to get a second opinion, how do I go about getting copies of my pathology report and my mammograms?

8. If I decide on reconstruction, can you recommend a reconstructive surgeon?   

1. What is the best treatment for me?

2. What are the possible side effects of the proposed treatment?

3. How many sessions of treatment will I need?

4. What is the cost for this treatment and will my insurance pay for it?

5. How long will each treatment last?

6. Will I be able to engage in normal activities?  What will my restrictions be?

7. I am concerned about how my skin will react to the treatment.  Can you show me pictures of women who have had radiation or chemotherapy so that I can get an idea of what it might look like?

1. How many sessions of radiation do you recommend?

2. How long will the treatment sessions last?

3. What will the recommended treatment do to my skin?  Do you have example photos?

4. What will the side effects be in my case?

5. How much will this cost and will my insurance cover it?

1. Are you certified by the American Board of Plastic Surgery? What is your training and experience?

2. What kind of reconstruction would you recommend for me? 

3. How many operations will it take to complete the reconstruction process?

4. How soon after breast surgery do you recommend reconstruction?

5. If you recommend immediate reconstruction, will you be present during the breast surgery?

6. What are the possible complications with this surgery?

7. What is the anticipated pain and recovery time?

8. Do you have photographs of your work that I can see? 

9. How much will this surgery cost and does my insurance cover it?