Re excision of pec muscle after mastectomy

ALH49

Hi All,

After five months of chemo, a lumpectomy and a double mastectomy with direct-to-implant reconstruction, I'm now about to undergo a re excision of my pectoral muscle because even with the mastectomy, the posterior margin at the pec muscle was way too close for comfort (we're talking "microns," not even millimeters, away from a couple of cancerous cells that were removed -- lobular, by the way.) I can't seem to find anything or anyone who has needed a re excision after a mastectomy. Even Google doesn't come up with a search for it -- it just sends you to "re excision after lumpectomy." I feel like I'm the only one in history who has required a re excision after a mastectomy and that's a scary thought. If there is anyone out there who has required a re excision of pec muscle after a mastectomy, can you please let me know of your experience?

stellamaris

that is scary. Is this a result of the pathology report? My margin after mx was 0.05 mm, bit they seem ok with that. Not even giving me radiation. Mine is ILC as well. I am nervous about the left boob. Hoping there is nothing there. Hugs

ALH49

If it makes you feel any better, they found nothing but benign tissue in my right breast -- all the trouble is in my left, even with it all being lobular. So the bilateral mastectomy decision turned out to purely be for peace of mind, not because there was any cancer lurking there. Yes, the re-excision decision was because of the pathology report -- though I think the breast surgeon knew coming out of surgery that it might be a problem. She told us right after surgery that there was a lot of scar tissue at the intersection between the pec muscle and the breast tissue -- more than she expected to find. She said that even though she cleared out all the scar tissue and all the breast tissue, scar tissue can be a breeding ground for more cancer cells but that we wouldn't know until the pathology report came back, so it was an agonizing week of waiting. I think microns are way smaller than even millimeters -- I think it means there may have been only a cell separating the benign from the cancerous -- so I think most doctors don't really consider it a close margin; they really see it as a more of a positive margin. After my original lumpectomy, the margins were less than 2 mm and that was considered clean. I opted for the mastectomies because they had also found LCIS and ALH in my breast at other margins and I didn't want to take any chances with that, especially knowing that lobular cancer is hard to track with imaging. It certainly hadn't picked up my cancer at all -- my gynecologist had found it during a routine exam last August and even the diagnostic mammogram she ordered didn't pick it up.

How have you handled the AI? What have been the worst side effects? That's part of my plan as well rather than tamoxifen since the chemo threw me into menopause.

Lovemymom76

Hope this finds you well! Writing to find out how the re excision went? My mom just had a simple mastectomy for ILC and positive margins were found. Surgeon’s nurse says that radiation takes care of this but an oncologist from a different hospital adamantly recommends going back to surgery for clear margins. Years after you wrote this, there is still nothing on the internet to research about this!

Palesa2018

hi, ALH49

How did you do after the re excision post mastectomy? Did they get better margins? Any radiation? I'm about to go through similar. I've had my mastectomy already, waited for Oncotype result which was low therefore no chemo. Meaning re excision to get better margins. I'm keen to have radiation and will be talking to surgeon about this.

Hope all is well with you.

Mariett

I know this is an old post but hoping someone who has been through this has answers as there really is nothing on the internet. I had a bilateral mastectomy 3 weeks ago and the margins were positive. Surgeon didn't think she could remove anymore skin and said radiation should take care of the positive margin. I was due to start chemo next week but now the surgeon wants to do a re-excision while she is putting in my chemo port. She said if the pathologist can give her a precise area to work with then she wouldn't have to remove too much skin. I am pulled tight as it is so don't think she will be able to get much more. I am hoping she can remove what she needs and the pathologist can say my margins are clear, then I can move on with treatment and recovery.