Breast Cancer (cont.)

Second opinion

Before starting treatment, you might want a second opinion from another doctor about your diagnosis and treatment plan. Some women worry that their doctor will be offended if they ask for a second opinion. Usually the opposite is true. Most doctors welcome a second opinion. And many health insurance companies will pay for a second opinion if you or your doctor requests it. Some companies require a second opinion.

If you get a second opinion, the doctor may agree with your first doctor's diagnosis and treatment plan. Or the second doctor may suggest another approach. Either way, you'll have more information and perhaps a greater sense of control. You may also feel more confident about the decisions you make, knowing that you've looked carefully at your options.

It may take some time and effort to gather your medical records and see another doctor. Usually it's not a problem if it takes you several weeks to get a second opinion. In most cases, the delay in starting treatment will not make treatment less effective. To make sure, you should discuss this possible delay with your doctor. Some women with breast cancer need treatment right away.

There are many ways to find a doctor for a second opinion. You can ask your doctor, a local or state medical society, a nearby hospital, or a medical school for names of specialists.

The NCI Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) or at LiveHelp (http://www.cancer.gov/help) can tell you about nearby treatment centers.

Breast reconstruction

Some women who plan to have a mastectomy decide to have breast reconstruction. Other women prefer to wear a breast form (prosthesis) inside their bra. Others decide to do nothing after surgery. All of these options have pros and cons. What is right for one woman may not be right for another. What is important is that nearly every woman treated for breast cancer has choices.

Breast reconstruction may be done at the same time as the mastectomy, or later on. If radiation therapy is part of the treatment plan, some doctors suggest waiting until after radiation therapy is complete.

If you are thinking about breast reconstruction, you should talk to a plastic surgeon before the mastectomy, even if you plan to have your reconstruction later on.

There are many ways for a surgeon to reconstruct the breast. Some women choose to have breast implants, which are filled with saline or silicone gel. You can read about breast implants on the Food and Drug Administration Web site at http://www.fda.gov.

You also may have breast reconstruction with tissue that the plastic surgeon removes from another part of your body. Skin, muscle, and fat can come from your lower abdomen, back, or buttocks. The surgeon uses this tissue to create a breast shape.

The type of reconstruction that is best for you depends on your age, body type, and the type of cancer surgery that you had. The plastic surgeon can explain the risks and benefits of each type of reconstruction.

You may want to ask your doctor these questions about breast reconstruction:
  • Which type of surgery would give me the best results? How will I look afterward?
  • When can my reconstruction begin?
  • How many surgeries will I need?
  • What are the risks at the time of surgery? Later?
  • Will I have scars? Where? What will they look like?
  • If tissue from another part of my body is used, will there be any permanent changes where the tissue was removed?
  • What activities should I avoid? When can I return to my normal activities?
  • Will I need follow-up care?
  • How much will reconstruction cost? Will my health insurance pay for it?