Questions to Ask Breast Surgeon Before Lumpectomy
Questions to take to a surgical appointment before a lumpectomy. They cover what the biopsy showed, why this operation rather than another, margins and lymph nodes, what treatment may follow, and the practical details of recovery.
The questions
Open any question for the note
What did the biopsy show, and what type and stage are we treating?
Why ask it
Ask for the words on the pathology report and what each one means: the type, the grade, the size, and the hormone receptor and HER2 results if they are back. Request a copy to keep.
Why is a lumpectomy the right operation for me rather than a mastectomy?
Why ask it
Ask what makes you suitable and what the tradeoffs are. Survival is generally comparable when lumpectomy is combined with radiation, so the reasoning usually turns on tumor size, position, and what you want.
How much tissue do you expect to remove, and how is the breast likely to look afterwards?
Why ask it
Ask about size, shape, and any difference between the two sides. If appearance matters to you, ask now whether reshaping at the same operation is an option.
How will you locate the tumor during surgery?
Why ask it
Ask whether a wire, a seed, a magnetic marker, or ultrasound will be used, and whether that means a separate appointment before the operation. It affects your schedule on the day.
Will you be checking the lymph nodes, and how?
Why ask it
Ask whether a sentinel node biopsy is planned, how many nodes are usually taken, and what would lead to removing more. This part of the operation carries its own recovery.
What are clear margins, and how often do you need to operate again to get them?
Why ask it
A second operation for margins is not unusual, and knowing the possibility in advance makes it easier to hear. Ask for this surgeon's own re-excision rate.
When will the full pathology results be ready, and how will I be told?
Why ask it
Ask for the expected date, who calls, and whether results are ever given by letter or portal message. The wait is one of the harder parts, and knowing the plan helps.
Who else will be involved in my care, and when do I meet them?
Why ask it
Ask about the medical oncologist, the radiation oncologist, and whether your case goes to a multidisciplinary meeting. Ask for the name and number of the nurse who will be your point of contact.
Will I need radiation afterwards, and when would it start?
Why ask it
Radiation usually follows a lumpectomy, and knowing the likely schedule and length lets you plan work and travel. Ask what would change that recommendation.
Is there a reason to have chemotherapy or hormone treatment before surgery instead of after?
Why ask it
For some tumors, treatment first can shrink the area to be removed or give information about how the cancer responds. Ask whether it applies in your case and what the sequence would be.
Are there genomic or genetic tests that should be done, and would the results change the plan?
Why ask it
Tumor tests can inform decisions about chemotherapy, and inherited gene testing can affect the choice of operation. Ask about timing, since results can take weeks.
How long is the operation, and will I go home the same day?
Why ask it
Most lumpectomies are day surgery, though a node procedure can extend it. Confirm arrival time, fasting instructions, and who needs to collect you.
What kind of anesthesia will I have?
Why ask it
Ask whether it is general or sedation with local anesthetic, and mention any previous problems with anesthesia or nausea. You can ask to speak to the anesthetist beforehand.
Where will the incision be, and can it be placed less visibly?
Why ask it
Placement is partly dictated by where the tumor sits, but there is often some choice. It is a reasonable thing to ask about and easier to discuss before the day than after.
What will the first week at home be like, and what help should I arrange?
Why ask it
Ask about dressings, showering, bras, pain relief, and what you should not lift. Arrange help with children, shopping, and driving before the operation rather than after it.
What restrictions will there be on my arm, and will I see a physiotherapist?
Why ask it
If nodes are removed, gentle arm exercises usually start early to protect movement. Ask who shows you the exercises and when they should begin.
What is the risk of lymphedema, and what reduces it?
Why ask it
Swelling in the arm is a long-term concern after node surgery. Ask what signs to watch for, whom to report them to, and whether early referral to a lymphedema service is available.
Which symptoms after surgery mean I should call, and what number do I use at night or at the weekend?
Why ask it
Ask for fever thresholds, signs of infection, and bleeding or swelling that needs urgent review. Get the out-of-hours number in writing and keep it by the phone.
What does follow-up look like: which appointments and scans, how often, and for how long?
Why ask it
Ask who is responsible for your surveillance mammograms and examinations, and when the first one is due. It is easy to leave surgery without knowing who is now in charge.
If I wanted a second opinion, how would I arrange it without delaying treatment?
Why ask it
Second opinions are routine and most surgeons expect them. Ask what records to request and roughly how much time you have, so the decision is made with information rather than pressure.
Preparing for the appointment
Practical guidance for the conversation itself
Getting through the consultation
- Take someone with you to write things down. Most people retain very little of a first surgical appointment, and a second listener is the simplest fix.
- Ask whether you may record the conversation. Many clinics allow it, and it lets you go back over the details at home.
- Write your questions in order of importance and hand the list over at the start, so the ones that matter most are covered if time runs short.
- Ask for copies of your pathology and imaging reports, and keep them together in one folder with your appointment letters.
- It is normal to ask the same question twice, or to ring afterwards. Ask who you should call with questions between appointments.
Understanding the plan
Surgery is usually one part
Treatment after a lumpectomy commonly includes radiation, and may include hormone treatment or chemotherapy depending on the pathology. Ask for the likely overall sequence, while accepting that some of it cannot be settled until the full results are back.
Some answers have to wait
The final pathology from the operation can change the plan, including the need for further surgery. Knowing in advance that this is a possibility makes the news easier to take in if it comes.
Second opinions are standard
Asking for one is not a criticism of your surgeon, and for most early breast cancers a short delay of a week or two to obtain one does not affect the outcome. Ask your team what timeframe is safe in your case.
Ask about clinical trials
Ask whether any trial is open to you at this hospital or nearby. It may or may not be appropriate, but it is easier to ask before treatment starts than after.
Practical arrangements
- 1Confirm the date, arrival time, fasting instructions, and which of your usual medications to stop or continue, particularly blood thinners.
- 2Arrange a lift home and someone with you for the first day. You will not be able to drive yourself after anesthesia.
- 3Sort out work, sick pay, and any insurance paperwork before the operation, and ask the clinic who signs the forms.
- 4Buy a soft front-fastening bra or whatever the team recommends, and set up somewhere comfortable to rest propped up.
- 5Put the ward number, the nurse's number, and the out-of-hours number in your phone before the day.
Support
- Ask your team what support is available through the hospital: a breast care nurse, counseling, physiotherapy, or a patient group.
- Decide who you want to tell and what you want them to do. Being specific about the help you need is easier than fielding offers.
- Waiting for results is often reported as harder than the surgery. Ask when you can expect the call, so you are not watching the phone for a fortnight.
- If you have children, ask the nurse specialist about age-appropriate ways to explain the surgery and the recovery.