Hoping someone can help me with my pathology questions

Options
scorp1111
scorp1111 Member Posts: 27
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

Just heard today that my re excision (2nd time around) was clean... There was no DCIS, completely benign and the margins read:  lateral 0.7 cm and deep margin was 1.2 cm... I was thrilled with these margins considering the first time around the lateral was <1mm and 1.5mm from deep... I was confused that the first time around the report read that the anterior margin was only 1mm, but later in the report it states that separately submitted additional anterior margin (0.8cm) is negative for malignancy...  Why was the anterior margin separately submitted?  What is the margin?  Is it somewhere between 1mm and 0.8cm?  Also the first surgery stated the DCIS was 0.8cm in size... The re excision (2nd time) now is saying the DCIS is approx 3 cm in size... How did the DCIS get bigger when the 2nd excision was totally clean/benign?  

 The DCIS is intermediate grade, Solid, Cribriform and i am 47 years old....Radiation is recommended by my surgeon and i am waiting to get an appt with the radiation/oncologist....Was hoping that my margins were good enough to skip radiation, but now that the DCIS is approx 3 cm. i am thinking that radiation will be strongly recommended... Any thoughts?

Lastly, i am going to have a 2nd opinion on my pathologies (you need to read both reports 1st and 2nd surgery) to get the full picture.  My surgeon (who i loved), in Colorado recommended that i send it to David Page at Vanderbilt University Hospital in TN.... She said he is one of the most talented and knowledgeable Pathologists for DCIS... Anyone heard of him?  I was actually thinking of sending it to someone in NYC, but after reading about David Page online i was pretty impressed with his research papers and knowledge of DCIS....

Thanks for any comments on the pathology questions and thoughts about 2nd opinion on pathology...

Appreciate all of your imput and support... Blessings to all.... Happy Passover and Easter... 

· Share on FacebookShare on Twitter

Comments

  • Jelson
    Jelson Member Posts: 1,535
    edited April 2010

    congratulations on a positive outcome, it really sounds like the worst is behind you!! I think you are right to get a second opinion on the pathology since your experience has been abit complicated and it sounds like you have found an expert - with regards to any lingering doubts about radiation - how do you fare on the Van Nuys scale at this point?

    Julie E

    · Share on FacebookShare on Twitter
  • hipchik47
    hipchik47 Member Posts: 268
    edited April 2010

    Hi scorp, I agree with Jelson, the worst is behind you.  I had my path report read by 2 patholigists.  Both were read exactly the same.  Since the report is on a disk its easy to send it anywhere, so pick the dr u want and send it off. You will feel much better with 2 drs reading.

      I would go with rads.  You don't want to look back later and say I wish I had done the rads.  Hipp

    · Share on FacebookShare on Twitter
  • dsj
    dsj Member Posts: 277
    edited April 2010

    I think the separately submitted anterior margin means that the surgeon took out an extra piece there, but I can't really help you answer any of your other questions (though others more knowledgable might).  The long and the short of it is that weeks of reading I have decided that trying to figure out how margins are calculated is really too complicated for a layperson to understand--especially when they go in and take extra margins.  But however it's calculated, it sounds like you got really, REALLY good news. 

    I think Vanderbilt is supposed to have one of the best pathology labs in the country for DCIS, and your surgeon's suggestion to have them read your pathology sounds like a great idea.  However, I imagine they will want to examine the slides themselves, not just the report on the disk.

    You should breathe a big sigh of relief.  However it's calculated it looks like you have clean and adequate margins.  whew.  

    · Share on FacebookShare on Twitter
  • SJW1
    SJW1 Member Posts: 244
    edited April 2010

    Scorp,

    Congratulations on the good margins. For a 2nd opinon re radiation or not, I heard Dr. David Page is excellent, but you know from previous posts that I regard Dr. Michael Lagios, co inventor or the Van Nuyys Prognostic Index, as the premier DCIS expert and pathologist. After consulting with him several times, I can not say enough good things about him.

    Contact me anytime via PM if you would like specifics or have questions.

    Best wishes,

    Sandie

    · Share on FacebookShare on Twitter
  • Jelson
    Jelson Member Posts: 1,535
    edited April 2010

    scorp1111 and swalters -

    I just knew Sandie would chime in on recommending Dr. Lagios - if you hadn't shown up Sandie, I woudl have directed Scorp1111 to one of your previous posts. 

    Julie E

    · Share on FacebookShare on Twitter
  • sherryb
    sherryb Member Posts: 7
    edited April 2010

    Colorado, hum, I am in Colorado and had the same problem with my path report. My Radiology Oncologist had trouble reading the report, very convoluted. Here's one for you, my biopsy showed that one area was neg and the other positive. During surgery I opted for a breast reduction, thank goodness, because not only did the neg biopsy turn out to be positive, but there was another spot as well. Good thing I opted for the breast reduction, because I would have had dirty margins and another surgery, mastectomy.

    Good luck getting an interpretation on the path report, I have a medical background and it was difficult to read. I don't know anything about the DR you are requesting info about, but I have a friend in WA that is a radiologist, who specializes in Mammograms and biopsies and I read the report to him and he was able to mutter through it.  

    · Share on FacebookShare on Twitter

Categories