Patients Opting for Lumpectomy Might Need 2nd Surgery

maize

Cancer Patients Opting for Lumpectomy or Partial Mastectomy Might Need 2nd Surgery, Says Study

http://abcnews.go.com/Health/Wellness/lumpectomy-partial-mastectomy-require-2nd-surgery/story?id=16765266#.UAAfJfUec80

nwest125

That would be me. I needed a re-excision for clear margins and that's when they found a second type of cancer and I was told that when they found two different types of  cancers in the same breast( IDC and ILC ) they recommend a  MX, I never questioned my BS about that at all, that was the last thing I had wanted to have to do, But when the tears finally stopped I decided on a BMX even tho the other side was cancer free and haven't looked back.

Nancy

proudtospin

I needed 3 lumpies to get clear margins, if it comes back it is definitely mastectomy time but my surgeon and other docs all agreed to this approach

maize

This woman told me that she had a breast tumor 2 inches long and (she said) about 1/4 inch wide and her doctor did a lumpectomy and didn't mention to her to at any time that she should have radiation or Tamoxifen or any other hormone treatment.  She said she's fine now.  She said all she had was surgery to remove the tumor and a few weeks of chemo, no other treatment. She acted shocked when I mentioned radiation and hormone therapy.  She said she's been cancer free for over five years.  She seemed to think it was a bit ridiculous for me to be upset about the DCIS--like I was being melodramatic (???)

I realize she might have had an ER- and PR- tumor, so maybe hormonal treatment wouldn't help her, but I've never heard of someone with a larger tumor having only surgery and about six weeks of chemo and that's it. 

proudtospin

not sure that is what my docs would have suggested but then again, I think dif docs do things dif and without knowing all of her details, hard to speculate why or what

I am comfortable with the decision my docs have helped me to make

3monstmama

I had two surgeries in connection with my lumpectomy--as someone else noted they did a reexcission to get good margins.

I suspect one is more likely to get a second surgery with a more skilled & experienced surgeon as they are more likely to try to get away with taking less out.  At least that was the case with me--the first surgeon I went to said I would need a "partial mastectomy" while the second did such a neat job that you can hardly tell I had surgery (well except for a bit of pointing to the left!  :-)  )

crazyride43

I have IDC but this thread caught my eye because I just had a re-excision.  For anyone worried about this (like I was!) it's really not a big deal if you have a great surgeon.  As 3monstmam pointed out, a really skilled surgeon is trying to take the least amount of tissue to get clean margins, and they would rather go back in and take a tiny bit more (once they have the pathology report and they know exactly where to go) than take a big old chunk the first time.  My surgeon explained that even with all the scans etc, they really are "flying blind" once they open you up.  Rarely does a tumor look like  abig obvious lump that they can clearly see.  I had chemo before surgery, and my lump wasn't even visible on scans anymore...it was more like lace scattered over a 2cm area.  I was pretty impressed that my surgeon even knew where to cut, and she did such a good job and my breast doesn't look any different.  My breast also looks exactly the same after the re-excision, same scar, and is healing really quickly.  I only needed twilight sedation too...so even though it was annoying to have to go back for more surgery, it didn't impact my life to much and I was soooooo happy to know that all the cancer was gone!

maize

The skill of the surgeon in taking out the cancer and getting clear margins without taking out so much that the breast looks odd...They put what I think of as a "fish-hook" with fiberoptic wires hanging out in my breast to be able to locate the cells (wire localization) and injected an isotope and had me massage my breast.  That was really weird...massaging my boob in the hallway (while people were walking by) so the isotope would be absorbed.  To add to that, the tech said: "Oh, you'll be back within 15 years."  When I asked her: "What?" she said: "Oh, nothing."  The radiologist put a titanium clip in the breast during the stereotactic biopsy...and still, I guess it's not easy to locate the cells they want to take out.

anastasia31

Thanks for adding these posts.  This makes me feel better about my lumpectomy and attempting to get clean margins.  It makes sense to me now about a skilled surgeon trying to take as little out as possible.  I'm still waiting on my pathology report after my surgery, but pre-surgery, I certainly didn't get a warm and fuzzy feeling from my surgeon that he was going to get everything on the first try since I have scattered DCIS.  As long as they don't have to do the wire localization again for the re-excision, I will be happy!  Can't believe I have to wait 10 days for the pathology report.

Hils

Hi Maize I initially had a lumpectomy to remove a 6cm x 3cm lump of DCIS unfortunately they did not get good margins. So following a MRI which showed another 7cm x 3 cm lump of DCIS and a 7mm lump of IDC I had a UMX. I would loved to have had a re-excision but unfortunately due to the size of the DCIS etc I would not have had much of a breast left.

On the positive side if they had not got clear margins the first time I would not have had the subsequent MRI and would not have had the UMX and I still would have a breast but one full of DCIS and IDC. So for me there was a silver lining to the UMX

gumshoe

anastasia, you never know, you might get lucky! Some get it on the first try. I had to wait a long time for my path results too, so that never helps.



I also had a re-excision for my DCIS. There's really a lot of guess-work involved especially when it's a large, scattered area like mine was.



And even though I had clear margins after the re-excision, I just had a mastectomy because they had to take so much tissue anyway, and I wanted to avoid rads.

Nickyy13

Hello ladies. I am new to this site. Have had the lumpectomy on right breast, and all my lymph nodes removed. Partial pathology report shows IDC grade 3 stage 2. Necrosis.

I wanted a mastectomy but as the tumor was only 2cm surgeon said overkill. Now that the pathology says what it does, I am going to ask again for bi-lateral mastectomy. Don't wanna be having the same conversation in 5 or 10 years. Waiting for the rest of my path report.

He says I will be having radiation and chemo. The waiting is so hard. Incision has healed nicely but oh my heavens the underarm is so bothersome. Pain killers help but don't like taking them-don't wanna get hooked. I have a great husband, and awesome friends but most of all my FAITH is so very strong!!!! Not afraid of treatment - just the waiting - and the chance of recurrence. Thanks for all your posts. . Still smiling.

gumshoe

Hi Nickyy,



Sorry you have to be here. There is a lot of great support on this site. You might want to check out the IDC thread too.



Your surgeon said that? Wow -- only you can decide what is overkill and what is not!