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Which doctor will manage your regular check up/ monitoring after your breast surgery

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Hello. I was just diagnosed with IDC. I’m still confused about the roles of different doctors. I know the surgeon does the surgery. The medical oncologist deals with meds (tamoxifen, etc). The radiology oncologist does radiation therapy. However, I’m not sure what doctor is devising the treatment plan (do I need chemo, do I need radiation), doing the coordination and provide you with a monitoring plan after the lumpectomy/mastectomy is done (what type of tests are needed and how often). Could someone shed some light?


Also, I guess it is beneficial to use all these doctors from the same cancer center. Is this assumption correct?


Thank you.

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  • katg
    katg Member Posts: 223
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    sunflower777

    From my experience, the breast surgeon contacted the medical oncologist. The Medical oncologist made an appointment with the Radiation department. The medical oncology department gave me my treatment plan. They scheduled the MRI's, CT Scan, Bone scan, Ultrasound and other tests i had. The Nurse Practitioners coordinated all of it. My MO though, with the team of DRS in the Oncology unit weekly meet to cover patients with unique circumstances to alter a plan if need be. I had some results that required a change of plan. I also had the plastic surgery department which my Medical Oncology department set up.

    For follow-up, after my surgery was done, I was to see the breast surgeon at least for 3 years, every 6 months. My breast surgeon moved to another hospital, so I see her there, but i missed a year so August is my 1st.My medical oncologist moved to the same hospital as my breast surgeon, so I plan to go there for her. I have a new MO, but I want to keep the one who created my plan.

    We advocate for ourselves. I hope you are at a good hospital that is known for treating cancers. I am sure others will pot after me, but I am at a hospital in California that does a good job.

  • exbrnxgrl
    exbrnxgrl Member Posts: 5,072
    edited July 8
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    My medical oncologist developed the treatment plan which included everything from meds to rads. Your surgeon, both general and plastic if recon is involved, will care for you during the post surgical period. Of course the RO planned the exact course of rads as that’s his field, but my mo directed the overall course of tx. All ongoing treatment and monitoring is done by my mo. I belong to an all inclusive medical/ hospital system, so all my providers are already coordinated in every way. There is a lot to learn about breast cancer , it’s not as simple as the pink ribbons portray it, but try to digest it in small bites. All the best to you.

  • maggie15
    maggie15 Member Posts: 1,081
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    Exactly which doctor does what varies somewhat depending on the institution. When they are all in the same location they tend to work as a team. For example, my surgeon ordered my oncoyped dx since it required a pathology sample but I discussed the results with my MO. While there are many different types of bc there are standards of care for each type. For example, if the tumor is ER+ and HER2- whether or not you need chemo depends on your oncotype score and your age. If you are HER2+ or triple negative you will have chemo. If you have a lumpectomy radiation will be on the table. With a mastectomy radiation is only recommended if there are positive nodes. Anyone who is ER+ will have HT recommended. There are many other scenarios depending on your particular diagnosis.

    For follow-up things are different depending on your institution so it’s best to ask when surgery/chemo/rads are done. Many times you will see an NP or PA instead of the doctor. Other times you will be referred to your PCP. For example, my MO deals with anemia during chemo but later it’s the PCP’s remit. If you have reconstruction you will see your plastic surgeon. Many people don’t see their ROs after the three month post rads checkup but I had late term side effects so I still see mine. Those with more complicated cases have a different frequency of appointments.

    It sounds more difficult than it actually is. If you have a problem call the office of whichever doctor you think would deal with it. If they know the responsibility is another doctor’s they will tell you who to call. This is the same if your doctors are in different locations.

    It’s a steep learning curve at first but once you know what your treatment plan will be there are fewer variables. All the best!

  • exbrnxgrl
    exbrnxgrl Member Posts: 5,072
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    Excellent point, maggie! There is no single standard way that this is managed as each institution has their own protocols.

  • tigglewinkle
    tigglewinkle Member Posts: 25
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    @sunflower777 I have had that question for a while so thanks for asking! When I was diagnosed in May, I had to find a breast surgeon and it was a daunting task, despite the fact that I live in a major metro area with excellent providers and hospitals. It was only after I was in the hospital system (having finally found someone) that the care became more seamless, but that doesn't eliminate the challenges or questions. Sometimes, the oncologist/RO/plastic surgeon is not available or taking new patients or maybe you want to see someone else. For me, I saw a breast surgeon who referred me to a plastic surgeon, and then to a RO. Finally, there was a referral to an oncologist. So it does seem to be somewhat out of order, but maybe not if radiation is always in the cards. I find myself just getting on and off the train when they tell me to. Somehow it seems easier! I will say, staying within a hospital setting is easier because of the portals they use, but I am also trying to research other options to find the best one for me.