I can understand your reasoning, that you think one visit to the surgeon is enough and that you need not see him/her twice. I agree that you could see the MD either before or after the mammogram. I don't think it matters but I understand that you think after is better since you have some concerns that the mammo may show that there is something wrong.
As Japdip says, i don't understand why there is a need at this time, (four years after you had bc) to see a surgeon at all. I would think your PCP, or anyone for that matter would order the regular mammograms and if there is a question or problem about it, them follow up would be scheduled as appropriate with a surgeon.
But I think the point her you are making is 1) why you cannot have the mammo a few weeks early, and 2) why you need to see the surgeon before and after you have this test.
I think your questions are very valid. I don't know what the deal is but I understand where you are coming from. maybe you could just call and tell them you just cannot afford two visits, and that's it. there is really no reason you have to see the doctor, any doctor, twice around this mammogram, either way.
(me thinks, at least, and that is all I have to offer)
If you already have a date set for your annual mamogram I don't see that it would have anything to do with your visit to the Surgeon. I have annual mammos and never see the Surgeon although the order comes from his office. If I were you I would just keep the appnt. with the Surgeon and perhaps she will order the mammo to be done earlier than the 20th. Actually we aren't talking about much time for either event. I'm surprised that after this length of time you are still seeing the Surgeon on a routine basis. Pt.s are usually only followed for 1 year after Surgery. Pt.s are often followed for some time after treatment by their Oncologist. When it comes to cancer a few weeks isn't a great deal of time as the wait between diagnosis and surgery or treatment is much longer. You might ask why you are still being followed by the Surgeon since expense is a factor. Regards ...