Questions to ask specialist


I was diagnosed with BC two weeks ago, and had a mastectomy with lymph node removal last week.

When the doctor came to see me after surgery he refused to answer any questions saying “good patients don’t ask questions”. I now have an appointment with him tomorrow to get the pathology results and I was hoping you could give me some advice on what to ask, apart from the usual, what grade, stage, type of receptors, treatment etc. I am acting really positive, but it’s worrying when you know absolutely nothing, and I need to make sure I ask the right questions as I believe this will be a one off appointment so I won’t get the change to ask again.

Thank you

Hi dbusby

You can call our helpline on 0808 800 6000 which is operated by qualified breast care nurses and trained helpliners. It is open 9 - 5 Monday to Friday and 9 - 2 Saturday. You can also email our help the nurse service, but there would be a delay in responding due to the number of queries recieved at the moment. I hope you get the answers you need tomorrow and please do remember that Breast Cancer Care are here to support you in whatever way we can.


There are resources on this site, such as
Hope this helps!

what a load of rubbish - good patients don’t ask questions. I would report him and make an official complaint

Knowledge is power


I have to agree with mole, that’s just shocking. Sadly at a time when we can be quite vulnerable, ‘some’ medical people can be far too patronising. It is your body, your illness, your life. I think I would be asking to see someone else.


My goodness what an ar…le. You have a RIGHT to know. I would make a list as long as your arm and make sure that he answers every question in detail. I hope that someone is able to go with you as he sounds daunting.
On several cancer websites it lists questions to ask. I seem to remember that cancer research is one of them. I hope this is of some help to you.
I wish you well for tomorrow.

There is a good booklet on here about understanding your pathology report. you can download it. I took it with me for my results although I had memorised it all anyway. Good luck, Looby

I agree with the others - how dare he refuse to answer your questions. If you don’t know what the situation is then how the hell are you supposed to deal with it.

If he still refuses to answer your questions report him … and remember your breast care nurse can answer your questions too.

The day after I had my lymph nodes removed I asked the surgeon if they had found everything. He explained to me that he didn’t do that bit, the path lab examined everything and he would be able to tell me at my clinic appointment the following week. He couldn’t tell me how many nodes he had removed either, but he did tell me what he saw looked very healthy. I had it in 1 node out of 22.

This site has a comprehensive list of questions:

Are you sure he wasn’t just trying to be funny in order to lighten the atmosphere?

Hi dbusby

As loobytuesday has mentioned BCC do have a booklet called understanding your pathology report. You can find it by following the link below:-

I hope you find it helpful.

Kind regards

BCC Facilitator

Hi dbusby,

I am outraged, to say the least, that a cancer surgeon, or indeed any doctor, can speak to you in that manner. You can ask, or demand, as I did with an arrogant, patronisiing and downright rude Oncologist, to see another surgeon who will explain your path results and any fruther treatment.

Unforunately I had not found this site until well into chemo, but a friend in the US, whose husband has lung and kidney cancer, told me to get a copy of my pathology report. When I went for the results of my 2nd surgery, total axillary removal, I asked my surgeon for a copy of my pathology report. His eyebrows went up, didn’t say a word, just went and got me a copy right away. Unfortunately, he didn’t go through with it with me. When I got home and looked at it, I thought I was reading a foreign langugage, which I suppose it is. That was when I started researching my own bc. I was surprised to see the words “DCIS” on the path report, which of course I didn’t understand, along with most of the report, and googled it. Not only did I have a 2 cm invasive ductal tumour, but “associated nuclear intermediate grade DCIS, comedo and cribriform”. Duh? surgeon didn’t tell me this! The report should also give you stage,grade, ER, PR and Her2 status, plus size of tumour, and number of lymph nodes removed, and whether they are benign or malignant. DCIS and vascular invasion should also be noted. Mine also gave a Nottingham Prognostic index number, although I am not sure if all hospital pathologists do this.

This is probably the most important piece of information you can have, as it will dictate your future treatment (chemo, rads, hormone therapy, if necessary, etc.).

That’s when my problems with the Onc started - I by then knew DCIS meant “Ductal Carcinoma In Situ” and at my first appt with him, chosen by my bc surgeon as the “brightest Onc who deals with bc and you have complex other health issues”, I asked him about it. He said it was pre-cancer, I begged to differ as clever clogs me did Latin at school some 50 yrs ago. Carcinoma is cancer, is it not? It’s just that it has not spread outside the ducts. Well, he got up from his chair, mad that I had challenged him and said: “Do you want to continue this conversation:” I should have said: “Not with an uncaring prat like you”, but then I suppose naively, asked him if he had treated a patient with concurrent bc and Crohn’s to which he answered: “No, but I have treated one with psoriasis”. Not quite apples and apples. As he had already told me in no uncertain terms that I had to stop my current chemo, methotrexate, for Crohn’s otherwise I would die of septicaemia (just what I needed to hear in that vulnerable position) I asked how he would treat a flare of Crohn’s when I was on FEC chemo, he blithely replied: “We’ll cross that bridge when we come to it”. Er, well no, we won’t, I thought - has he ever had to wear incontinence pads, doubled up with abdominal pain, live on the loo for hours, be hospitalised with severe rectal haemorrhaging? Methinks not. I burst into tears and fled the room.

I felt I could not go through 4 months of FEC chemo, no methotrexate to hold my Crohn’s in remission, a doctor who felt he was being challenged if I so much as opened my mouth, and was in despair. I knew I had to had the FEC as the cancer had spread to my axillary nodes, but couldn’t bear the thought of having to see this uncaring doctor each time I went to the Oncology Suite. I contacted my oh so different gastro, who blinds me with science every time I see him but he ssaid he could not intervene in my treatment as cancer is life threatening, Crohn’s usually not. He too had never treated a patient with concurrent diseases.

I postponed the FEC chemo until I got my head around what was happening and emailed every major hospital in the US I could think of, and the dedicated IBD hospital St. Marks in Harrow for advice. They all responded but had no experience with my conditions, except for one gastro Professor at St. Marks, who wrote a normal letter, copying my gastro, Oncologist and GP, with a plan and said I must discuss his letter with both the Onc and gastro before going ahead with FEC. So, I decided to have the FEC and when I went for my first treatment, I asked the receptionist if I could see another Oncologist, anyone but the one assigned to me. No questions, no fuss, told to go and sit down. Within 15 mins I was taken to see a lovely young female GP who worked part-time in the Oncology Suite one morning a week - my luck changed!. She didn’t ask why I wanted to change - these doctors do stick together - just said: “Let’s sort you out”. We decided on a small dose of dexamethasone and elemental nutrition - no food for 4 months, just 3 cartons a day of Fortijuice, and although it was difficult, with faecal incontinence, I obviously survived.

I am sorry for this long story, but I was appalled at my initial treatment by the Oncologist but had no idea what to do in the beginning, and through his attitude,nearly did not have the FEC chemo I needed.

I believe every hospital must have a PALS service (Patient and Liaison) and if you are unhappy with any of your doctors (surgeons, physicians) they are a brilliant place to go to get help. We had a need to get help from them when my husband had been waiting 8 months for an “urgent referral” by his vascular surgeon to a neurologist. The PALS lady sorted it within an hour.

I have had Crohn’s disease for 38 yrs and have a long history of in and out patients treatment at various hospitals in England, Spain and once, in the US so I am not really daunted, but for someone who has perhaps never been in hospital except to have children, and especially being diagnosed with a life threatening disease, I can only imagine how frightening it must be.

This post is probably too late for your appt today but at least you can now ask your bc nurse for a copy of your pathology report, if you don’t already know about it, and get the information you need before you make any decisions about further treatment.

I do hope your news is good today and the surgeon got clean margins (another question to ask) and the lymph nodes are benign.

Do come back and let us know how you got on, and how we can help you further.

Take care,

Just want to send best wishes to you dbusby for your appointment with Onc today, hope you get the answers you should.


Hey Guys

Thank you so much for your support, Liz, I find it so sad that you have had to struggle like this, and those who pointed me to the pathology report again thankyou. I shall read it now, appointment not for another 4 hours.

I will let you know how I got on later


I’ve read a few things on these threads that have distressed me, but hardly any more that reading that a consultant could actually have said to you “good patients don’t ask questions”. This is so disgraceful that words almost fail me (and that doesn’t happen very often). I hope you can go armed not only with a long list of questions (written down so you don’t forget them, and can note all the answers), but also your hospital’s mission statement (or whatever they call them) which I am quite sure states that all your questions will be answered honestly and openly, and that the staff will work in partnership with you. Please, get PALS involved in this. I know that you are vulnerable at the moment and may not feel like taking this on. But really this man should be taken to task for his comment. You have no interest at all in being good, or passive, you are a human being with a potentially life threatening disease and he has the privilege of treating you - and has to respect you, listen to you, and answer your questions. A good doctor would never have let the words he uttered leave his lips. I am appalled. Good luck for today, and please let us know how it goes. Sarah xx

I too am shocked to the core that a Consultant could say “good patients don’t ask questions” Mine is always asking if I have any questions and doesn’t mind when I ask anything how ever trivial it may seem to him.
I have been under a Orthopaedic consultant for 2 years and he is sometimes less than truthful but always answers me (some times with rubbish though!)
He told me porkies about my recovery time and it took 6 months for him to admit the first operation had failed.
Personally I now know how much difference it makes to have a consultant you trust and respect so I would ask to be transfered to another Dr if they had said that to me.
Its your body ,your disease,ask all the questions you want.Go Girl!

Hello dbusby

I agree with all of the above comments. I would just add that the day I was diagnosed my consultant surgeon gave me a photocopy of my path lab report which really helped as I was far too shocked to take it all in that day. I was able to study the report at home. After WLE and ANC he also gave me a copy of the second path lab report. My oncologist is also excellent and happy to discuss details with me.
Good luck. Let us know how you get on.
Anthi x

Your support has been fantastic. I have just seen the same consultant; he was much better this time as I had a huge list of questions which he answered. (Wonder if he has been reading this forum!!) The tumour is showing Grade 1 ductal carcinoma but there are other areas where the tumour is showing a Grade 2 pattern of filtration. The pathologist wrote “In my opinion, this pattern will dictate the outcome” (Any ideas on what this means?) The tumour only measured 13mm, with a clearance of 16mm (is that good?) He didn’t have the results to see if the cancer had hormone receptors or to see if it was HER-2 positive or negative. The lymphal and adjacent ducts show no evidence of malignancy. Lymph nodes 0/7…wohooo

The consultant doesn’t believe I will need any further treatment but has referred me to an onconologist who I will see on Monday.

Upon diagnosis I was given a breast care nurse, but she didn’t visit me in hospital, hasn’t contacted me since I have been home, she was at my appointment today, but didn’t offer any support or say anything. I am not as worried now that I have most of the results, it was the last two weeks where I needed the support.

Thanks for listening.


The bcn should be there when you need them, but not be “in your face”. I called mine for help when I was in hospital and she came round straight away and sorted everything out, but I haven’t seen her apart from that except at clinic. However, she was there when I needed her! Give em a call.

Hi Deb,

your path report sounds as good as it gets, with a very small invasive tumour, clear lymph nodes and no vascular invasion - go break out a bottle of champagne…if you were in Cornwall I would invite you over to celebrate!

Seriously, it is good news, compared to what some of our members get. I am sorry I have never heard of “grade 2 pattern of filtration” - we have some really bright cookies on this site (JaneRA, Mole (who always has the most pithy and witty remarks, ChristineMH, Dippykate etc., who come to mind - only because they have been on here almost as long as I have, and they have taught me all I know, as the doctors tell you zilch! They don’t pussyfoot around with glib assurances, as I don’t, but they do some incredible research, and I always believe what they write.

Please don’t even tell us which hospital you are being treated at, as no-one will want to go there. Upon my recall: after compression mammo, ultrasound and core biopsy, we were immediately taken into a private office, given cups of tea in bone china cups (what? on the NHS? never even had a cup in a plastic cup before) and the Director of the Breast Care Centre, who did my u/s and core biopsy, introduced us to my assigned bc nurse. She was absolutely brilliant…came to see me every day when in hospital (5 days first time, 7 days next time) and as I got complications with a haematoma, then seroma, was always available at the end of the phone and got me into the ward either the same day or next day for treatment. I could not have got through this without her. Unfortunately she retired on New Year’s Eve and I haven’t been assigned another as they are understaffed at present. No problem though, I had my 5 yrly review Feb 2008 and am NED - the best 3 words in the English language - No Evidence of Disease. I really don’t know what you can do to get another bc nurse, as I didn’t have that problem. Perhaps someone can come along who had to change bc nurses and advise how they did it.

Now you have found “us” there is always support for you here…nothing is too trivial for someone to have an answer to, even if we can only offer emotional support, and there is plenty of that around here.

Desperately hope you get a good Oncologist who takes his/her time to explain matters to you and is a good communicator. I have had some brilliant doctors who have published ground breaking research in Inflammatory Bowel Disease, but hopeless at communicating, or indeed listening.

By the way…I made another big faux pas with the first Oncologist, when deciding whether to have chemo and I said: “What would you advise if it was your wife?” Unbelievably, he responded: “Well, you’re not!”. I was too shocked to say anything. Much like Seabird I am rarely tongue tied, but should have said: “Thank goodness I am not!”. Ah well, I sorted it all out in the end, just because I had to…as you will.

Take care Deb,
Liz in sunny Cornwall.