What does "Re-plan" mean?

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localgirl
localgirl Member Posts: 39
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

Hi all-

my re-excision surgery is on Monday (had a 1mm margin in one spot), and when I met with my surgical oncologist on Wednesday, she said she'll go in and take more tissue just from the one side with the small margin, and there's a 70% chance it will be free of cancer cells but if not, then we'll "re-plan".  Anyone know what that may mean?  I said "so you wouldn't just go back in and do it again" and the answer was "no", but she didn't elaborate, and since I wasn't thinking clearly, I didn't ask her to. 

 So if anyone knows what the next step would be if a re-excision wasn't clear, I would appreciate hearing it! THANKS

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  • debbie6122
    debbie6122 Member Posts: 5,161
    edited November 2010

    Localgal- Im assuming she means if there is no clear margins and more cancer than she thought she would have change course of tx,like maybe mx and chemo possibley, but not sure what you have done already. I will be thinking good thoughts for you ((hugs))))

    Debbie

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  • sunnyhou
    sunnyhou Member Posts: 169
    edited November 2010

    I bet she means either she will let radiation do the rest of the job or she will recommend a mastectomy. I am not sure how many excisions they will do before they go to a mastectomy. I would call on Monday and ask. Good luck.. Also.. how is your mom doing?  If my memory is right I think she ws diagnosed around the same time as you??

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  • localgirl
    localgirl Member Posts: 39
    edited November 2010

    Hmm, I was afraid of that, but I'll try to just focus on the positive until we know better.  Would seem that a 16mm mass would make a mastectomy overkill, but then again, I'm far from an expert!

    Sunnyhou, yes indeed, she is doing ok.  She had her mastectomy and is recovering now.  She is having a hard time with her drains but is scheduled to get them out Monday. They think that since the sentinal node mass was only 0.06cm in size they may not need to do chemo.  They are waiting on an oncotype (sp?) DNA test to tell for sure.  Next they have to deal with the cyst they found on her ovary during her MRI for her BC!  

    Also went off my birth control pill this week after reading that a contraindication for it was BC.  Will be nice to see what my own hormones are like after 2 kids - it's been a while! 

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  • Kitchenwitch
    Kitchenwitch Member Posts: 374
    edited November 2010

    Localgirl, I don't think you can skip to radiation to clean up stray cells without getting clean margins first. I've heard there are some breast surgeons willing to do up to 4 and even 5 re-excisions -- probably most surgeons do around 3. It all depends on the path report, and I hope your next one gets you those clean margins. Don't forget you can always look for a 2nd opinion - three lumpectomies is not really unreasonable, in my opinion, if you want to try to save your breast.

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  • sunnyhou
    sunnyhou Member Posts: 169
    edited November 2010

    Localgirl

    any news? Hope your mom gets news that she doesn't need chemo. Fingers crossed. Also, good luck with getting off the BC pills. I was on and off of them and then with my last child I said tie my tubes. I had a c-section so it was rather simple and easy! just thinking of you!

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  • localgirl
    localgirl Member Posts: 39
    edited November 2010

    Well just back from surgery yesterday, and the doctor said it went well but that of course the pathology would be the telling factor. 

    Yeah the BC pills has been interesting, I can already tell a difference being off of them only for a week!  We have 2 kids and while we are done, my OB said when I asked her about tying tubes "just make sure you are really done and consider the scenario that one or both of your kids died - would you want to re-start the family!"  That one got me thinking!  So whereas I thought it was an easy choice going to tubal ligation, now my husand and I are at least giving that possibility some thought.

    Mom said it would be another 2 weeks for the oncatype test to come back, but she did indeed get her staples and drains out yesterday and is feeling much better. They also said she would have to wait a few weeks to get a permanent prosthetic so that she could heal more.  Then she goes in to see the other doctor about her ovarian cyst.  Poor thing - so much at once.

    I swear I think the hardest part of BC so far has been all the waiting!!

    Thanks for checking in - I'll post when I hear my results.  Fingers crossed :) 

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  • debbie6122
    debbie6122 Member Posts: 5,161
    edited November 2010

    Localgirl- So glad you got your surgery done, and yes the waiting really sucks dosnt it. I will be thinking good results for you. (((hugs)))

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  • Mantra
    Mantra Member Posts: 968
    edited November 2010

    I don't often post on this forum but your title of your topic caught my eye and I was wondering what it was referring to. Yes, the waiting is so difficult but when you hear good news, it will all be worth it. I know my surgeon said she would do three lumpectomies if need be but it seems like two might be your magic number.

    Your tubal thoughts instantly brought me back to 30 years ago when I had to make that decision. I was 28 years old and my doctor said if I could answer one question, he would do it. I figured it would be the same question as yours . . . what would happen if one of your children passed away. I was fully prepared with an answer. Instead, his question shocked me and I honestly wasn't able to give him the answer he needed. He said "you're 28 years old. Your husband takes your two daughters out for ice cream. All are killed in a car accident. If you can tell me without any doubt that at 28 years old you will not want to remarry and have more children, then I will book the surgery. I was rendered speechless. Had never thought of it that way. I did end up having it done, but with a different doctor. Fortunately, it was not a decision I regretted even though I divorced two years later.

    Thinking positive thoughts for you and your mom. I too went through a whole ovarian cyst thing at the same time as my BC but after a ton of tests and different doctors, it turned out to be nothing more than a simple cyst . . . even though I was post menopausal. One doctor said to get my ovaries removed. Two others say to wait a few years. Still thinking about which route to go.

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  • debbie6122
    debbie6122 Member Posts: 5,161
    edited December 2010

    I had a tubal years ago i didnt think it would bother me but it did, even though i didnt want any more children after i had it done i cryed for days i guess more of because it was so "permanant" and i had no control over that situation any longer but still glad i had it done. Im kind of in shock that the dr. would use death for your kids as a example, that to me is terrible. Good luck with what ever you decide.

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  • localgirl
    localgirl Member Posts: 39
    edited December 2010

    Wow, I'm glad I'm not alone in having to struggle with those thoughts - Mantra your "what if" was even more severe than mine!  It's so hard to imagine what that would feel like I'm not sure where to start.  I agree debbie that I was surprised as well, but in a way I guess it's good to make sure we've thought through the ramifications.  Anyone's discuss vasectomies with spouses as an option?  Maybe I'm derailing my own thread, but this is really a tricky subject.

    In other news, I went back to MDA today because my surgery site after the re-excision is far more swollen and hard than the first time.  Luckily she said it looked fine to her, but it certainly feels a lot worse this time.

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  • debbie6122
    debbie6122 Member Posts: 5,161
    edited December 2010

    Localgirl-  I thought about mentioning that your husband might think about him getting a vasectomy, you have already gone thru so much why not let him do this, it is much simpler than what you would have to go thru, just a thought but he could also use a sperm bank incase you did change your mind down the road and wanted more kids. :)

    Im glad your MDA thinks it looks fine,  im sure it is, after surgery it will be swollen and tender for some time- Hope it gets better have you heard anything else back on path report?

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  • localgirl
    localgirl Member Posts: 39
    edited December 2010

    Nothing yet on pathology unfortunately.  I have my next appointment on Wednesday so I'm hoping that we'll know something by then. 

    I definitely feel some in-depth conversations coming up!  On another note, my headaches are totally back - didn't miss those being on the pill!  Have to get back on my magnesium, but was waiting to finish with pain meds before starting my vitamin regimine back up.  

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