Question about positive margins

chelle44

I had a lumpectomy just over two weeks ago. The surgeon took out a 1.9 cm tumour. Margins were clear on three sides. The posterior was laying on the chest muscle. There were positive margins. The surgeon feels confident that the entire tumour came out as it was mobile on the muscle. It is grade 2. Her 2 negative and hormone positive. Should I be concerned. Has anyone had a similar experience? I am waiting on my first oncology appointment so maybe that will help give me clarity. Just seeing if anyone has left a positive margin and carried on with treatment? Thanks

JohnSmith

Sorry you had to join this group.

In general, due to the diffuse type of growth, ILCs are more often associated with positive margins after lumpectomies and are more likely to require re-excision, and potentially mastectomy, for margin clearance.
However, I'm not sure of the protocol if ILC invaded the chest wall.
How confident are in the surgeon? Do they have surgical experience with the less common ILC subtype?

Hopefully you'll get a better answer to your question soon. This is a great support group!

MFalabella

Hi there,

My doctor had to shave the flese several times during my lumpectomy to get clear margin in one area of 1mm, but feels confident that all is well. It is totally common for docs to have to recise or to extra surgery to get all the tumor . I have ILC too.I had my lumpectomy on the 13th of July. Best Wishes, and gentle hugs

xoxoMichelle

chelle44

Hi Michelle. That was my surgery date too and I'm 44. My surgeon wants to leave the positive margin that's what's a bit concerning to me. I feel she has more knowledge than I do but I haven't heard of anyone else having positive margins and leaving them. Thanks for your responses. I hate this waiting part. I wish I could get into the oncologist right away

minatabo

Hello all,

I too am confused about the positive margin situation

I have cancer on both left and right. Left had 2 spots (largest IDC 4.4cm), and right 2 spots (0.8cm both IDC) - all 4 were removed with lumpectomy. Final pathology report indicates that 3 of the 4 spots had positive DCIS margins. The surgeon said because the 3 were right behind the nipple, its tricky to get clear margin. Anyone had similar experience?

With positive margins, I had the impression that chemo and radiation may help address those margins. (Shrinking or even getting rid of them so I won't need another surgery). But the surgeon said even after chemo, I will need double mastectomy. Can anyone help me understand what are the "usual" treatment options with positive margins after lumpectomy?

Much appreciated

Minatabo

Pammac47

Michelle,

Thank you for bringing up this topic, I too have positive margins. Mine was put before the tumor board and the decision was also mine to not re excise for clear margins because all the reading I did into research papers showed little to not enough improved statistics with additional surgery. So I am proceeding on with treatment. My margins are .001mm to chest wall and <1mm to anterior. So I think I will follow this topic as well.

cacher11

Hi, interesting question, mine was all margins positive except lateral, treatment to date, estrogen blocker (exemestane), pet scan, going for rib biopsy Friday the 13th, chemo was discussed. ILC + Lobular carcinoma in situ. 4.5x3.2x2.5 cm, all margins positive for carcinoma except lateral, Grade 2, estrogen positive score 8, tumor necrosis present, her2 =2+. I had had cancer in the same breast before which was ductal so this is different, they used radiation last time so no can do this time, Dr feels complete tumor was removed, I am hedging on chemo even more so now while awaiting results from rib biopsy. I watched my mom go through metastatic cancer and have no desire to do so. I would like to keep in touch with you and follow your treatment options.