Expert: Claes-Gustaf Nordquist, M.D. - 4/20/2008

Question
My sister was diagnosed with DCIS Monday this week.  Her OB/Gyn sent her to a general surgeon who is performing lumpectomy next Wednesday.  The gen surgeon said the results from lumpectomy wouldn't be back for one week (this in in small hospital, not in any cancer center)  I had a double lumpectomy 15 years ago in a large medial center by a specialist surgeon, they had the results while I was still "under". (benign)... Also I had endometrial cancer, Grade I-B 2 years ago.  Surgery performed by a gynological oncologist surgeon and he too had the "final" results when I woke up.  Am I being overly "caring" or concerned about the time for the results coming back?  Just have concerns over her not seeing specialist -- she has great insurance,also carries additional cancer insurance.  Breast Cancer in family - mother (43), mother's only sister, their mother (our grandmother), and my great grandmother.  Also, what about lymphs node biopsies?  Is that standard procedure with this kind of lumpectomy -- I read yes, but not sure if I understand completely -- her surgeon said she doesn't need that, nor will she be needing radiation -- Won't that depend on the lumpectomy findings.  No results on biopsy regarding HER-2, or the progesterone/estrogen factors.  He said that comes from the lumpectomy info.  Thanks so much.  

Answer
What you had during surgery was "frozen section pathology". That can ONLY be done if you have a pathology department in the hospital. If not - which seems to be the case here - a week is about normal. If indeed this is ONLY a cancer in situ (or breast cancer stage 0) - and we will know that when the pathology report is available - no lymph node biopsies would be necessary - a sentinel biopsy would probably have been easier done during initial surgery though. However if more advanced than that such biopsies - or at least so called sentinel node biopsies - will be necessary. But I would INSIST on radiation therapy of the operated breast. Tumor genetics and hormone receptors should be known when the pathology report is available too. Endometrial cancer and breast cancer share many risk factors. If indeed a cancer in situ chemo therapy is not needed.