re-excision after lumpectomy

momstrong

I understand that about 50% of the time they have to go back in to re-excise something because the margins were too close. Why does this happen? Don't they have a pathologist checking the tissue right as the surgery is taking place with the same microscope they use when they look at it later? Is it because they don't have time to stain the tissue?

SpecialK

Here is some info regarding the frequency of re-excision, and how post-operative pathology and margin checking is conducted. Just as with Sentinel Node Biopsy (SNB) the check in the operating room is not as comprehensive as later in the lab, and there patients initially thought to have clear margins or SNBs that are found not to upon closer examination.

http://www.breastcancer.org/research-news/20120131

april485

I am one of those that had a re-excision because of very close (less than 1mm and almost at the ink) margins. Since I was in a clinical trial for partial breast radiation, 2X a day for 5 days, the RO insisted on margins of at least 3mm all around. So, back in I went and now all of my margins are larger than 1cm all around.

Of course, my poor barely C cup breast took a beating and there is about half of it left now but as I am past the worrying about it stage of my life, I am not reconstructing which was my choice as the insurance most certainly would pay for it. I guess I just don't care that it looks so much smaller than the other side.

ballet12

I had two re-excisions, because the first surgery (at one hospital) was actually an excisional biopsy due to a diagnosis of atypical ductal hyperplasia. Over 4 cm of tissue was taken out for that "biopsy" and multifocal high- grade DCIS was found throughout, with no clean margins. I went to a second hospital and needed two re-excision surgeries to get clean margins. Like April, my breast is quite smaller than the other, but it's not really a problem (molded foam padded underwire bras are amazing things).

have2laugh

Came across some very interesting information from the NIH the other day at work. Lots of research being done that may change the future of cancer surgery. Exciting things being worked on-here's the link-couldn't make hyperlink for some reason-so have to cut and past in search bar.

https://newsinhealth.nih.gov/issue/feb2016/feature1

labelle

One of the questions I asked surgeons before deciding on one was, "How often do YOU personally have to go back in and re-excise after performing a lumpectomy?" Their answers varied quite a bit but none of the 3 said anywhere close to 50% of the time. You might want to ask your own surgeon how often he/she has to do this.

JoniB

i had a lumpectomy last week and asked the BS how my breast would look before I had the surgery. He discussed the scar but never mentioned the size changing. The tumor was supposed to be very small. I was shocked when I saw my breast a few days after surgery. It is really bothering me and have an appointmemt with a PS for next week. Has anyone has a mastectomy after a lumpectomy due to how the breast looks? I don't want to have the good breast reduced.