Should I see an oncologist?

[MoreTeaVicar]

Hi,
I had a stereostatic core needle biopsy that came back as atypical ductal hyperplasia.  However, they sent me to the surgeon as they want to do a further surgical biopsy to "remove all the AHD and see if anything was in it".  The surgeon said that if there was a mass it would have been removed and that I would just need some radiation - it was very matter of fact.  He also said that he wasn't concerned about the margins.  When I asked if it was BC would they need to do more surgery, he was confident they would have removed it all.  Well at the time it sounded reasonable, but after thinking about it I am now a little concerned with his 'margins' remark.  A friend who has had BC suggested I see an oncologist before I go under the knife - is she right?  They said they are going to biopsy about 1cm.  I have small breasts (34B at most), and I have a wide 4cm range of calcifications.... should they be removed too?
I am know that this is probably an over reaction, but I do not want to entertain the possibility of BC.  I have just turned 40 and have 2 small kids, the chance of this ADH being something more serious and then metastasizing is something I want to avoid at all costs.
So, I am right in thinking a second opinion is needed before I go any further?
Thanks.

[katarina777]

You need a referral from another doctor to see an oncologist. I do not believe you can refer yourself until you have already seen one and in that case you can arrange your own second opinion.

An oncologist cannot really say or do anything unless he has objective information and this usually involves the results of a biopsy, and most often comes from a surgeon who will either be your surgeon when you need it or a radiologist.

One those preliminary results are available, the doctors and also the radiation oncologist work closely together, and all may order further diagnostic tests, as well as your Primary Physician.

hope this helps!  kat

[japdip]

Standard treatment for ADH (which IS NOT cancer) is surgical excision followed by Radiation and possibly hormone therapy. I see no particular reason to see an Oncologist before the surgery and the final Pathology report on the specimen obtained. ADH only increases a woman's risk of developing breast cancer but as previously stated it is NOT cancer. As far as the microcalcifications; I'm sure there would have been some recommendation for their removal if it were deemed necessary at this time. Microcalcifications can be present and be a benign finding .... this would require a biopsy of the area to determine if they were anything other than benign. Unless they are clustered in a certain pattern or in a group they are usually not of much concern. They do appear scattered about normally within the breast tissue. If you are uncomfortable with the opinion of the Surgeon then see another Breast Surgeon and have him/her go over your films as well as the Pathology reports; otherwise you should follow the recommendation you have been given.     Regards .....