2 lumpectomies, no clear margins. Do I go for a 3rd?

HarleyMama

48 y/o DCIS stage 0 grade 1. I've had 2 lumpectomies in 5 weeks and no clear margins. Was told I could have a third to try again or opt for a mx. I just don't know what to do. I am even considering a bmx. I have an appoint with PS on Wednesday. Anyone else had this issue. My head is just spinning.

MTwoman

DKfedder, I would encourage you to discuss this with the PS. The reason I ended up with mx is that my PS thought additional lx would give me a negative cosmetic outcome (the margins were very close on one side, I got a hematoma during my lx AND there were more areas of DCIS found in another quadrant that needed to be removed). I think that the concerns of a general surgeon and BS can be quite different, depending on how much breast work the GS performs. Have you had an MRI that could help clarify the extent of DCIS? Given that you have an appointment tomorrow, I'd bring in a list of questions (what will be the cosmetic outcome if we do lx again? what if we don't get clean margins again? etc) and then make your decision based on the information you get from the PS. Sorry you are having such a rough go getting it all out. Good luck tomorrow, we'll be 'in your pocket'!

fd1

DKfedder - I had a lumpectomy + two revisions and in the end had to have a mastectomy. I would do the same thing again. I did not have a particularly good result from my reconstruction (mainly because I did radiation right after) and my range of motion in that shoulder never completely recovered. I think the chances of having good cosmetic results and not having any other problems are higher with a lumpectomy generally. The funny thing is that there was no cancer in any of the tissue after the mastectomy. I could have kept my breast. Sigh.

LAstar

That's such a tough decision. I had 2 lumpectomies. I had a MRI between LX #1 and #2 that indicated that the DCIS was more widespread than we thought, but I still went with #2 because I wanted to try to avoid MX. I've read that MRI doesn't pick up low grade as well as high grade DCIS, but you might ask your BS about it. If you try a 3rd LX and still can't get good margins, you'll know you did all you could, and a lumpectomy is a quicker recovery than a MX. I had decided before lumpectomy #2 that I wouldn't go for #3, so it was an easier decision (but still a hard pill to swallow). I have no regrets though. As you can see, hindsight is 20/20, but you have to make the decision that feels true to you with the knowledge that you have now.

I wish you the best! These are tough days but you will get through it! Life is pretty sweet when all this is behind you.