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Updated: February 2009

What Do I Ask My Doctor?

You've been diagnosed with breast cancer, and surgery is imminent.  But, where do you begin?  Like many women, you want to prepare a list of questions to bring to your consultations with your breast surgeon and plastic surgeon.  In this section you'll find a great starting point.  A printer friendly version is available to bring with you as a reference during your appointments (click here).

The most important part of your consultation with your plastic surgeon starts before you walk into the office.  You've done your research, you've asked friends and family for advice and you may have an idea of what type of reconstruction you desire.  Although that's a good starting point, it is likely that something essential is missing.  In order to ensure that you will have an informative consultation, you should make a list of your reconstructive goals.  This list will serve as a reference during your initial appointment with your plastic surgeon.  The “best” surgeon is one who will discuss these goals honestly, and establish what is realistic, and what is not.  Every member of your team of doctors, from your breast surgeon to your radiation oncologist, needs to be on board with the aesthetic goals for reconstruction that you establish with your plastic surgeon.  If all of your doctors work together, you can create a “dream team” that can hopefully make your reconstructive goals a reality.

Putting together a list of goals may be easier for some than others.  Try to establish three to four main goals (see example below).  Ask yourself what you want to get out of reconstruction.  Achieving symmetry?  Matching your other breast?  Having breasts that are larger or smaller than they were before cancer?  Your aesthetic goals should include anything that you desire.  Even if your goals seem unrealistic; your surgeon can go over what is achievable and what is not. 

Example: Jane Doe is 33 years old, and has invasive cancer in her right breast. GOALS:

  1.  Remove both breasts, left side prophylactic
  2.  Maintain my full C cup, if not one size bigger
  3.  Keep my nipples
  4.  Get the most natural looking and feeling breasts

 

Jane presents these goals to her surgeon.  Along with these goals she has a list of questions:

  1. Which type of reconstruction am I the best candidate for?  What are the risks and benefits of this procedure?
  2. Will this procedure meet my reconstructive goals?
  3. How many surgeries are involved with this procedure?
  4. What are the complications that can arise from this type of procedure?  What are the rates of infection and other morbidities?
  5. What are the lifetime maintenance requirements for this procedure?
  6. How many times have you performed this procedure?  How many failures have you had with this procedure?
  7. Can I see before and after photos?
  8. Do you have a former patient that I can talk to over the phone?
  9. What are the next steps - including insurance approvals and preparing for surgery?

 

In Jane's case, she describes what is most important to her.  Ideally, she would like to have reconstructed breasts that feel natural, and have a substantial size.  Keeping her nipples may not be possible, but if she didn't present that goal to her surgeon, it may have been overlooked.  Wanting a more natural look and feel to her breasts, the surgeon may recommend a flap procedure; however, Jane would need enough of a donor site to support her desire for large breasts.

This is just one example of why it is essential to have a list of goals when you go into your appointments.  You will walk away feeling like you have a connection with a surgeon that takes the time to listen, answer, and thoroughly explain what is and what is not possible.  Knowing that you are on the same page with your doctor will leave you with less anxiety and new found hope as you approach your surgery date.

Written and edited by our medical board