Need right decission

sam012

My aunt was diagnosed with breast cancer few months back. Doctor told it as Invasive/infiltrating Ductal Carcinoma.
A tumor was observed in the breast and the tumor was cut away by an operation. After the operation doctor told it is cancer and need to arrange an operation to cut more cells around the tumor.
But another doctor gave advice not to cut anything. And his advice was to adopt 4 cycles of chemo. Now 3 cycles of chemo has already been adopted. Now the doctor is giving the advice to adopt radio therapy. Is the treatment in the right track? Or it needs other treatments like cutting down some cells around the previously exists tumor again?

idaho

If there were cancer cells left I would most certainly want them taken out...  "clean margins" are very important to have.  The  chemo and radiation  would probably kill the cancer cells that were left...  but probably and getting them out for sure are different things.  Tami

Ezscriiibe

I have IDC and have had a lumpectomy. The surgeon who opted for going back in is probably trying to get "clear margins," and it would be helpful to read the pathology report to ensure whether the margins really were clear or not.

I am getting 4 rounds of chemo then will start radiation therapy after the chemo is complete.

There are really two different doctors involved in this case. Well, three, actually.

One is a breast surgeon, whose responsibility was to remove the tumor with the additional margin of tissue to attempt to ensure "clear margins" (tissue with no cancer cells in it). He is responsible for reading and interpreting the pathology report to ensure that he got the clear margins. Additional surgery would be his call.

One is a medical oncologist. His speciality would be to read and interpret the pathology report and take the medical history (and possibly more CT scans) of the patient and determine a chemo course of treatment, if one is required. He would not be involved in the surgery, but could recommend or advise regarding surgery. It's just that is not his speciality.

The third is a radiation oncologist. His specialty would be to read and interpret the pathology report, take a medical history (and possibly more tests) of the patient and determine a course of radiation treatment, if one is required. He would also not be involved in the surgery, but could also recommend or advise regarding the surgery. But, again, it's not his specialty.

Hope that helps.

Oh, by the way, the reason for chemo and radiation is that no matter how well a surgeon may excise a cancer tumor, there is virtually no way to know for SURE if ALL the microscopic cells have been "captured." That is why the two oncologists use their expertise to determine what sort of treatment, based on a variety of things, including the type of cancer cells, to use.

My tumor was removed with clear margins. I am getting chemo  and radiation. I don't want any sneaky, stubborn, sly little microscopic cell to escape, if at all possible.

Surgery just CANNOT guarantee that.  Even if one removes all breast tissue, there will still be a tiny bit of tissue that can't be removed.

The bottom line is that we have to trust our medical team. I'm guessing your aunt trusts hers. 

It's natural for you to care about her and want her to get the best treatment, but from what I can tell just by what you've shared, the regime seems to be in line with other experts.