Path report in: confirmed no invasive, but not clear margins

Thank God is right Julia!!  Woo Hoo for You!!  Your BEST option is the reexcision.  It is always the patients choice, but take it from a gal who wishes I had been caught at stage 0...clear the margins with surgery and then go on about your life!!  I don't know that they would actually do radiation at stage 0 anyway?  It is costly and not without its side effects, granted surgery has risks too but get the surgery and be done. 

 Congratulations to you! 

At the very top of the page, in the blue area above the maroon, the second section "Symptoms & Diagnosis" has a section on understanding your pathology report.  It can change from initial diagnosis to final - as mine did. 

Doctors use a staging system to determine how far a cancer has spread. The most common system is the TNM staging system. You may hear the cancer described by three characteristics:

• size (T stands for tumor)
• lymph node involvement (N stands for node)
• whether it has metastasized (M stands for metastasis)

The T (size) category describes the original (primary) tumor:

• TX means the tumor can't be measured or found.
• T0 means there isn't any evidence of the primary tumor.
• Tis means the cancer is "in situ" (the tumor has not started growing into the breast tissue).
• The numbers T1-T4 describe the size and/or how much the cancer has grown into the breast tissue. The higher the T number, the larger the tumor and/or the more it may have grown into the breast tissue.

The N (node involvement) category describes whether or not the cancer has reached nearby lymph nodes:

• NX means the nearby lymph nodes can't be measured or found.
• N0 means nearby lymph nodes do not contain cancer.
• The numbers N1-N3 describe the size, location, and/or the number of lymph nodes involved. The higher the N number, the more the lymph nodes are involved.

The M (metastasis) category tells whether there are distant metastases (whether the cancer has spread to other parts of body):

• MX means metastasis can't be measured or found.
• M0 means there are no distant metastases.
• M1 means that distant metastases were found.

Once the pathologist knows your T, N, and M characteristics, they are combined in a process called stage grouping, and an overall stage is assigned.

Good news!

My first came back non-invasive as well, and my 2nd came back non-invasive, but it came back multi-foca with the margins STILL not clearl.  If it had come back unifocal, I would have been a candidate for radiation.  Now I'm looking at a mastectomy.

 My dilema is one side or two....

Go for the surgery....sure beats 4-6 weeks of radiation and possible side effects.  Good luck

Just my story - not to scare you but to have you realize the lack of realibility of the testing.  I had calcifications only with annual mamo (first time they have appeared in 8 years) , then biopsy to confirm cancer - DCIS.  Then lumpectomy without clear margins.  I then decided on mastectomy.  They did an MRI of both breasts just to be sure.  Found a lump in the good breast the mamo missed!  I decided on a bilat mast at that point even before the biopsy on other breast.  They said they needed to to biopsy to determine if they needed to do SNB.  THEN after the bilat mast ~ my dx changed from DCIS  to DCIS with a 2cm invasive section the mamo had missed.  Still not sure if the MRI revealed the 2cm.  Anyway, I am very happy I chose bilat mast given the sneaky invasive cancer that was missed with just the lumpectomy.  Plus I did not want radiation, chemo or tamoxifin due to the longer term effects and other health issues that can be caused.  Best wishes

I felt mostly naive and shocked that I had trusted mamos.  I am just thankful that it is over and I had a great outcome. 

Crunchy, don't worry about putting your husband and parents thru another surgery.  This is all about you and what works for you.  Take care.

Hi everyone, I started out on the just diagnosed part of the discussions but now need all of your help since we are in the DCIS boat.  I was diagnosed on Nov. 19. I had two stereo biopsies on my left breast.  The one area was benign, the other was DCIS grade 3 solid cribiform and comedo.  I was told it was the best to have blah, blah, blah.  I felt pretty calm about the whole thing.  It seemed pretty cut and dry.  Lumpectomy, radiation, and tamoxifen (ER,PR+). I had my lumpectomy on Dec. 9. Not too bad and the surgeon told my husband that she took a little more tissue just to be sure. I found out Tues. the path report shows that I did not get clear margins.  I was not prepared for this at all.  Even the radiologist told me on surgery day as she was placing the guide wire (so much fun!!!) that it is such a small area. I met with my surgeon today and she said the "area" is larger than she thought.  She even used me in her breast seminar yesterday because the mammo, mri, and biopsy did not indicate this. The path says approximate span of 2cm. I am scheduled for my re-excision on Monday. I am nervous because my incision is still tender and she said they will do local sedation. I was totally out mask and all last time. Part of me wonders if I should go with a masectomy. The bad thing about DCIS is that it is usually not a "mass" at least mine wasn't.  Picked up from microcalcifications on a mammo.  Is there more in there that we haven't found? Will radiation get it? I am just so emotional. Angry, sad, why me. Thank you for listening.  This site has been a lifesaver to me. Any thoughts from you would greatly appreciated.

How do I view the DCIS conference video? I feel like I can't get enough info on this.  My reexcision is Mon. afternoon and part of me just wants to do a masectomy and be done with it.  The surgeon thinks we should try to get a clear margin - easy for her to say. She didn't just have a lumpectomy a week and a half ago. I'm very anxious about the surgery and if I'll be awake or feel anything. This stinks!!

I was diagnosed just the other day with DCIS - there was a bit of a noise inside my head so I'm not sure about the rest of it - I know they said something about a 3 (not stage, I know) and necrosis and early.  I meet with BS this Wed so I guess I'll find out more then.  I've met with a friend who just went through this and she filled me in on a lot.  I'm the 4th generation in my family (and the youngest at 48) to get this, and everyone else died of it.  So I'm scared.  I would much rather have a bilateral masectemy than risk having to do this again in a few months or years.  I'm not THAT much in love with my breasts.  I'll still be a woman.  I do worry about that much surgery, even without reconstruction (not doing that).  And I wonder if my surgeon will be conservative and if so, if I should get a second opinion.  Guess I'll find out after more tests.  With the holidays, it's hard to get things scheduled.  I'm also very worried about getting back to work as soon as possible- I'm the breadwinner in my family - without me, my partner and kids would be in poverty.  I'm interested to see what happens but scared of pain and suffering - both mine and my family's.

sorry to hijack your thread CrunchyPoodleMama!

Yes, Boromom, I followed up with 7 weeks of radiation - 28 treatments and 8 boosts so 36 in total. I had more boosts than the norm because my anterior margin was 1.5mm, less than the desired 2mm - getting a wider margin surgically would have meant loss of part of nipple and areole? The Tumor Board at the hospital agreed that re-excision was not necessary - lucky me. Before I started radiation, I asked for an MRI because I wanted to know whether there was anything missed in my Left and whether anything was brewing in my Right - esp since nothing had shown up on mammography. I got the all clear  and started radiation.  Slathered myself with aloe vera gel and calendula cream, wore sports bras and was fine. I waited a month after the radiation to start Tamoxifen. The only change that I might be able to attribute to the tamoxifen is that my hot flashes changed from very frequent and short, to less frequent, longer and wetter. I don't really know whether that is even from the tamoxifen since before that my flashes seemed to change over time.

I was lucky not needing a re-excision, but also because a friend with Stage 1BC who had encouraged me throughout my diagnosis. had had a re-excision which she assured me was commonplace and no big deal. So I knew going in that it was a possibility. 

With regards to tamoxifen, last year in the Fall well before I was diagnosed, I had numbness in my arms, stiffness in my fingers and developed a trigger finger. Over the winter it all went away! I can assure you that if I had been taking Tamoxifen at the time, I would have attributed these symptoms to the tamoxifen.  In any event, I requested the cyp2d6 test  and found out that I am an extensive metabolizer ie more likely to benefit from Tamoxifen and therefore I am glad to take it! 

It sounds like you have a reasonable plan - re-excision, if still no clean margins - then you contemplate mastectomy. 

I wish you wide clean margins on Monday.