Mastectomy vs re-excision

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vnelson
vnelson Member Posts: 15
edited June 2014 in IDC (Invasive Ductal Carcinoma)

Hi guys, I am new at this so please be patient with me. I found a lump in my breast March 3, 2009. Six weeks ago I had a lumpectomy. Diagnosed with Ductal Adenocarcinoma. Saw Oncologist, ordered PEG (negative) and MUGA. Said what I have is aggressive and I will be having chemo, radiation, and oral meds. The surgeon called and said cells were found along the bottom margin of the specimen and he wants to go back in and do a re-excision, this time going into the muscle. He says he does not expect to find cancer cells there; however, will need to go further. He said neither he nor the Oncologist believe I need to have a mastectomy. I don't know what to do. Can anyone give me any advice?

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  • idaho
    idaho Member Posts: 1,187
    edited May 2009

    It would be helpful if you posted your stats.  Grade? stage?  Anyway, If you want to have a mastectomy it is your choice.  If you have a mastectomy you maybe won't have to have radiation but you will probably want to have reconstruction.  It is a hard choice, study all you can, and hopefully someone else will come along with more help.  Tami

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  • dlb823
    dlb823 Member Posts: 9,430
    edited May 2009

    vnelson ~ If the bc wasn't in your lymph nodes, and if you had an MRI that was clean except for the lesion that was removed, I think there would be two main considerations in evaluating re-excision vs. a mastectomy.  The first is the size of your breasts and how good the cosmetics result will be if they take more tissue.  Sometimes surgeons feel that they have to take so much that you'll actually have a better cosmetic outcome with a mast + reconstruction.

    The other question I think is peace of mind, and that's something only you can decide.  In other words, if your surgeon does the re-excision and gets good margins, in view of the all the additional treatment you'll be having, will you feel confident that you've done everything you can to prevent a recurrence?   It's an extremely personal decision, and probably more what is at issue here than one being a clear choice for medical reasons.

    As a practical suggestion, if you are still in a quandry after thinking about it, you may want to get a second opinion from another breast surgeon, especially if it would ease your mind and make you comfortable with your decision.

    Good luck, and pleae keep us posted ~   Deanna 

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  • LisaAlissa
    LisaAlissa Member Posts: 1,092
    edited May 2009

    If the point of the second surgery is to remove "some muscle," then a simple mast. won't do that.  I assume no one is thinking about a radical mastectomy (breast tissue plus all underlying muscle--a description of the various kinds of mastectomy is here:

    www.breastcancer.org/treatment/surgery/mastectomy/what_is.jsp )

    If the only margin that needs "cleaning-up" is the "bottom margin" (against the muscle) then taking more breast tissue may offer no advantage--if those margins are already clear.  Based on what you say, if they do a simple mastectomy, they'll need to excise some of the muscle anyway, but I can't think that you would want a radical mastectomy (taking all underlying muscle) unless your doctors say you need it. 

    I agree with Deanna, if you are concerned about the cosmetic result of the proposed surgery, ask your surgeon to arrange for a consultation with a plastic surgeon before surgery to discuss that--what the cosmetic result will be and which underlying procedure will work better with any needed reconstruction.  Another option would be to ask for a second-opinion referral to an oncoplastic surgeon. 

    Best wishes with your decisions,

    LisaAlissa

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  • vnelson
    vnelson Member Posts: 15
    edited May 2009

    Thanks guys - I really appreciate the info. I have made the decision to go with the re-excision next Wednesday. I feel good about the decision and am praying I made the right one.

    Best wishes to all of you,

    VNellie

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