3rd excision or mastectomy?

judimac

 

     I posted this on the DCIS site, also. Since I have IDC also, I am posting it here, too. 

     I had a lumpectomy and sentinel node dissection for IDC. The margins and lymph node were not clear so I had a reexcision and full node axillary. The margins are still not clear of DCIS and my surgeon is talking mastectomy. I would be willing to try one more excision ( no further node involvement) and then mastectomy if the margins still aren't clear. Apparently the DCIS is in two quadrants, at least. Is there anyone who has experience with this? Does it make sense to try a 3rd time? Can I monitor the DCIS?

  I will be getting an MRI on both breasts. 

Dx 4/29/2009, IDC, 1cm, Stage Ib, Grade 1, 1/1 nodes 

my3girls

I can tell you from my perspective and my situation. I had IDC..not DCIS, and the first lumpectomy and 22 nodes removed, but the margins came back not clear. My surgeon told me she could do another excision, but that would not guarantee that the margins would be clear. She also said that my breast would be somewhat deformed by then (I am a D cup). I asked her what SHE would do, in my shoes..she said the mastectomy. I am very happy that I went that rout. I had reconstruction as well...and do not regret any of my decisions.

Your decision whatever it may be, is what is best for you. Good luck to you!

Lisa

stef58

Judimac, I had a mastecomy on Wednesday po last week and I do not regret any decision that i made. The mastecomy is not bad. In and out within 2 days. Had an expander put in. Make sure that if you are having radtion that maybe to wait for the expander. I am feeling great and it it a great feeling not having to worry that part of me anymore. The pain is very minimal for me. Hugs Dianne

noellech

Hi Judimac, I had mast due to somewhat extensive DCIS , I think 3 cm total. At the time based on mamogram they thought that it could be as large as 5 cm and both my breast and plastic surgeon told me that they thought I would be happier long term with mast and reconstruction. I was told several times that reconstruction of an irradiated breast that had undergone lumpectomy was difficult. Newly reconstructed, my cancer breast is not perfect but looks very good and I have no fears of recurrence. I did have my nipple spared which helped alot in the reconstruction process. Maybe you could consider keeping your nipple if you choose mast. They place the expander at the time of the mast and fill it quite a bit, so it is not nearly as shocking as you might think. Good luck.

cakelady

Judimac...... I had the exact same thing happen to me.  I had IDC and DCIS.  I had the first lumpectomy which included 2 small spots close to each other.  The margins were not all clear.  So I had a re-excision,  still not all margins clear, still showed some DCIS.. I started out as DDD. The surgeon said he took out a large section, but it wasnt that noticeable because of my size.  He said he would do it a third time if I wanted to but it would deform me a bit and there was no guarantee the margins would be clear then either.... and it would delay my starting chemo.  He was concerned because I should have started chemo already.  If I had another  re-excision it would be delayed again so I could heal.. and if the margins were not clear it woud still mean a mastectomy after all that,,, and more delay of chemo... So I chose a mastectomy........and its a good thing I did because they found more IDC in there too.  I chose to have both sides removed , the left side turned out to be okay, but I did it because I thought my chances of getting it in that side were too great and also due to the  reconstruction success later... they would'nt do immediate reconstruction on me., so I will do it later.  Also I didnt want to walk around for a whole year with a DDD on one side and nothing on the other.. I was always tooooo big anyway... what a way to get a reduction.. Huh!!!!   yea and the plastic surgeon I will go to later also said he would not do implants on a radiated breast.....