Do I have a second surgery two weeks after first one.

lindsaytootall

I opted for the lumpectomy and sentinel lympy biopsy.  Had the surgery on the 8th..... lymph came back negative but the clear margin was only 1.6mm.  The surgeon wants to do a second surgery on monday the 22 to get a wider margin.  Do I have the second surgery or do I opt out and just have the radiation?

dlb823

Lindsay, as you may have figured out, there isn't a consensus amongst surgeons re. what is an adequate margin, and re-excisions are very common.  Here's some information from the American Society of Breast Surgeons that might be helpful:   https://www.breastsurgeons.org/statements/PDF_Statements/Lumpectomy_Margins.pdf

If you feel your situation is borderline and are unsure about wanting or needing a 2nd surgery, I would absolutely ask your surgeon to go over with you his reasons for recommending it in your situation.  Was your bc invasive or in situ?  Do you know the Grade?  Do you know if an Oncotype-DX test is being done?  

You need to understand and trust your surgeon's recommendation, but I would personally want the wider margins if you're dealing with invasive bc.      (((Hugs)))   Deanna

bevin

My surgeon said about half of people dont get clear margins and need a second surgery. Some have additional tissue taken during the surgery if pathology can quickly check margins intra operatively, as they did for me or some women need to come back to have more removed.

The clear margins are necessary to ensure the invasive tissue is removed.  Its of course your decision, but since you asked, I'd certainly want to have the additional margin safety and to ensure your invasive cancer is fully removed..

Good luck, keep us posted.

fifthyear

Lindsay, I had a lumpectomy, and had to have a second surgery to get clear margin. At this second one, my surgeon removed the entire scar from the first surgery. I am glad I did, since sometime cancer cells remain around the scar tissues. It was 2wks between surgegies.

jenjenl

You want clear margins. 

GmaFoley

I had second surgery 10 days after my first. No problem and was easier and less painful than the first.

crazyride43

lindsay, I also had a second surgery two weeks after the first for clear margins.  I understand it's really hard for surgeons to find the "edges".  They want to get all the cancer but not take too much extra tissue.  I had about the same margin as you on one side, and my surgeon went back in through the same incision.  It healed really quickly, and I was very happy to know that there was NO CANCER in the wider margin.  It made me feel really confident that it was all gone.

freidaJean

I'm sitting in the same boat, wondering where to paddle.  Lumpectomy on 4/30/13, all lymph nodes clean but on one edge: margin is less than 1 mm.  Surgeon wants me back for more surgery 5/29/13.  I've asked to meet with oncologist/radiologist before making my decision - curious if you have done that already?  Also have genetic testing scheduled for 5/6/13.  Hoping those avenues will give me the arsenal of information to make a "good" decision?  Surgeon said cosmetic results may not be great after 2nd cut, my question is if all margins are negative (albeit close on one) can radiation not take care of it.

Sorry, I probably have as many questions right now as you.

dlb823

freidaJean, I think which direction the margin was facing might influence my decision.  If it's the margin that faces the chest wall, that would be a lot more concerning to me than one that faces up.  So see if your path report specifies which margin is the problem.  

Your stats -- DCIS vs. IDC or ILC, grade, hormone positve vs. negative, and your Her2 status -- will also add helpful information to the picture.  I suspect your surgeon will want to get a better margin no matter what, to comply with the standard of care.  But having some of those additional facts will help you understand your situation.   

So sorry another surgery has been recommended, but it's very common, and most of the time women do it to ensure a safe margin.   (((Hugs)))  Deanna

sarajaneevans

My surgeon warned me of the same possibility linda- I feel very confident with him - and know the importance of getting clean margins- without them you could be right back to square one in no time I suspect-my surgery is scheduled for may 16th. I don't really know anything except my diagnosis and the procedures to take place that day-but if I need to go back for the margin surgery I will be there for sure---

Good luck...

edwards750

I had the same thing happen Linda. Had to go back and get clear margins. I asked my ONC about it and she said def want to do it. Need clear margins....not that unusual at all. diane

freidaJean

Well good news here!  Met with the onc and she said a clean margin is a clean margin, no matter the width.  After going over the path rpts with me line by line, she said that a second surgery wouldn't really be beneficial - YIPEE!  Started rad this Tues and have that to look forward to for 6 1/2 weeks.

Thanks so much for your responses, it helped with the questions I asked.