Not all communities have easy access to the latest therapies or surgical techniques, but asking your surgeon the right questions can encourage further research on his/her part (if need be) and help ensure the best treatment plan for you.

Be sure to do your homework about your surgeon, but in addition, ask the questions below to help guide discussion during your shared decision-making consultations:

  1. Is breast surgery the main focus of your practice, and/or did you do a breast fellowship?
  2. Will you present my case at a multidisciplinary breast conference? Do you participate in a NAPBC-accredited Breast Center?
  3. If I have a lumpectomy, how much smaller will my breast be after the lumpectomy and radiation? How different will my breast look?
  4. If I have a lumpectomy, what are the chances I'll have to go back for more surgery because of a "positive margin"?
  5. If I have a lumpectomy, do you perform oncoplastic surgery to minimize the risk of a cosmetic deformity and ensure I get the best cosmetic result? Can I have a symmetry procedure on the other breast (eg lift or reduction) at the same time so my breasts match more closely? Will you do all the surgery or will a plastic surgeon be involved?
  6. What is your experience with oncoplastic surgery?
  7. If I have a mastectomy and want reconstruction, can I have a “skin-sparing” or “nipple-sparing” mastectomy? If not, why not?
  8. What is your experience with nipple-sparing mastectomy?
  9. What are your thoughts on prophylactic mastectomy of the healthy breast for me?
  10. If I choose to go flat (bilateral mastectomies without reconstruction), can you leave me truly "flat", with an even contour without "dog ears" (extra tissue over the side of the chest")?
  11. (If you have breast implants) I understand implants usually do not do well with radiation. How do my breast implants impact our decision-making?
  12. How much feeling will I lose?
  13. What are the benefits of chemotherapy before surgery (neoadjuvant chemotherapy)? Should we be considering this for me?
  14. If I already have cancer in my lymph nodes, should I have neoadjuvant chemotherapy? If not, why not?
  15. Will you perform a sentinel lymph node biopsy? Will I need an “axillary dissection” if you find cancer in my sentinel node(s)?
  16. Will you follow the “Z-11 trial” approach to my nodes if I have early stage cancer?
  17. (If you're over 70 yrs old) Can I avoid axillary lymph node surgery altogether since I'm over 70?
  18. What is my risk of lymphedema? How can we minimize my risk?
  19. Should I be considering genetic counseling and testing, and should that be done before my surgery? How will your recommendation change if I test positive for a gene mutation?
  20. Would I need radiation only after a lumpectomy, or after a mastectomy too?
  21. Will I need to continue routine screening after surgery? If so, what type?
  22. Can you show me patient photos to give me an idea of how I will look after surgery? 
  23. Will you refer me for consultation with a plastic surgeon before my surgery to discuss my reconstructive options / options for best symmetry?
  24. What follow-up will I have with you after surgery?
  25. I understand I have a little time to process all this but how long do I have to make my decision?

Click here for a printable version of these questions.

Content provided by Dr. Patricia Clark | Ironwood Cancer and Research Center.