Splitting hairs over margins.

Kar324

So, had my post-op appointment @ UPENN on Monday, 2/15/16. The pathology report indicates that all the disease was taken out and that it was all DCIS, low-intermediate grade. One area showed a focal comedo necrosis. My surgeon was pleased with the report, however she states that one margin was " close" 1 mm. She stated herself she was " on the fence" about re-excision but also stated that the guidelines should be 2mms with DCIS. The amount of breast tissue taken was 5 cms x 2.5 cms and the amount of DCIS was 0.2 cms and 0.8 cms, to total 1 cm of disease.( I had a partial mastectomy due to multi-focal disease in the same quadrant.) It seems that most was removed during stereotactic bx, bc, mammogram showed possibly 4 cms of involvement. Anyway, bc this margin was "close" but technically, negative, it was MY decision to proceed with RT or to re-excise. I'm so torn on what to do, I still have limited ROM on the left side and have been out of work. I still feel as though I'm recovering from surgery, which was on 2/3/16. I'm just exhausted, confused, and really just over all of this. I want to get on with my life. I'm already bracing myself for RT and am just starting to feel a little stronger, albeit, my left arm has some issues with ROM and have some pain in my chest, due to the surgeon being " aggressive". Does anyone know the ASTRO thresholds for beginning RT? Should I do a re-excision? I've researched everything I can, including the VNPI. Any and all feedback welcomed. Going on record to state, I despise this disease. Thank you all in advance..just when you thought it was safe to breathe...

New-girl

I hate cancer too...especially breast cancer.

Kar324

Thank you for the feedback...????? Great forum.

farmerlucy

Kar - So sorry for the angst. I don't have any experience with this but might suggest posting in the DCIS forum since I've seen this issue many times. Also I would imagine that rads and hormonal therapy would do a good job mopping up any stray cells if you decide to do no further surgery.

I hope you start feeling better very soon.

Kar324

Thank you farmerlucy, I will post in that forum.