Surrounding Organs

Hi. My question: isn't it wise to check adjacent organs & surrounding tissue (both pre-op & during the operation) for evidence of metastasis?
I'm a 47 y/o. Breast cancer (DCIS) removed (negative nodes)& radiated done this year. No Tamoxifen. Receiving antibiotics for acute,chronic Lyme disease - an illness that's weakened my immune system. Saw two gyno-oncologists for a persistent complex right adenexal cyst (some internal echoes) that's grown to 4.5 cm.  Cramping between periods, nausea, GERD & constipation. Also, scalp hair loss not related to radiation. Frequent nightime coughing. Post-op CA-125's going up: 33,58 & now 103 U/mL.
My current onco-gyn would do whatever I want: a cyst laparotomy or hysterectomy (if cancer), or continue to monitor - seems to have little concern that this is cancer. Hasn't suggested a colonoscopy (am requesting one). Due to Lyme dz, was advised to not undergo a diagnostic operation (D&C), as 2 operations in a row after the breast surgery might be overtaxing. At a website affiliated with M.D. Anderson Cancer Center, an nurse for ovarian cancer patients states that "preoperative procedures are conducted to determine bowel, bladder, liver, & pulmonary involvement".
In Fran Drescher's book about her hysterectomy, she says that
"SURROUNDING TISSUE and lymph nodes are removed & biopsied" during the hysterectomy. What should be checked out pre-op & post op?
Thanks, TexasPam

[TexasPam]

Correction to final question:
What should be checked out pre-op & during the operation?
Thanks, TexasPam