No calcifications in surgical specimen (awaiting pathology)

dl1129

Hi All,

I had my lumpectomy 5 days ago and am healing really well. The hardest part for me was post-anesthesia dizziness that persisted for several days.

I was still pretty out of it when the surgeon came and spoke to us. Confirmed yesterday that the radiography done on the specimen during surgery did not show any calcifcations. I can't draw any conclusions from this yet, but it sure is confusing to me. One part of me is wondering if I could have had unnecessary surgery and the other is wondering if this means a higher likelihood of positive margins because they weren't in exactly the right place? These are my non-doctor thoughts. My DCIS was diagnosed by a breast pathologist, so I feel confident in that (as confident as possible - a lot of trust). The area was very small. But I have a hard time imagining they got *all* the calcifcations during the biopsy? I have my follow up appointment in 5 days so I'll find out soon, but how common is this?

Elena1963

Hi

Did they saw calcifcations on your mammo before surgery?

dl1129

Hi Elena,

Yes. I had a stereotactic biopsy due to a very small cluster of micro-calcifications, which was considered low suspicion for malignancy. There were calcifications in the biopsy specimen. I had a titanium tag placed during the biopsy, and a seed placed prior to surgery. Again, I don't yet have the report from the pathologist on the surgical specimen, but they x-ray it (or whatever, I think he said x-ray) during surgery to be sure they got the right area, and when I awoke he said there were no calcifications in the tissue he took. I guess it's possible they got them all during the biopsy... just doesn't seem an exact enough process. Eager for my follow up on Thursday.

dl1129

I had my follow up this morning. I now realize I was too focused on the calcifications as a signifier. The surgical path report did find calcifications, incidentally, but they were too small to be seen on Xray during surgery.

Final path was 1.2 cm of pure DCIS, 5 out of 6 margins were clear at 2mm or greater, 1 was negative at 1 mm. The surgeon basically left the option of going back to get a 'truly' clear margin on the 6th up to me, which drives me nuts. I don't consider him to be very conservative, though, so I believe he would be very clear that he wanted to go back in if he felt it was necessary. He said that given all the other factors of my cancer, radiation is the key component to my treatment at this point, and that getting that last margin doesn't confer any benefit in terms of the likelihood of reoccurence. Also, that 1 mm margin is near the skin - he already took as much as possible without taking skin, so going back would mean doing so, which can then cause other issues.