Any success stories - lump only, no re-excisions necessary?

I had lumpectomy then radiation therapy and tamoxifen for DCIS with very little pain from surgery.  It does depend on where the tumor is, but usually it really is not bad.  I did not exactly have a re-excision but I had an unusual diagnostic path.

I do want to point out that the surgeon will be trying to balance the goal of getting wide, clear margins vs. the goal of not taking more of the breast than necessary.   A really low re-excision rate is not necessarily the best because it may mean the surgeon always takes a large amount of breast tissue.  I hope you will not need a re-excision but if you do you will get through it OK. 

Good luck!

Hey Natters - I skipped over the stero biopsy 8 years ago and went right to the lumptectomy (radialogist said I was too small for the stereo).  I ended up with margins of 9 mm or greater and did not need re-excision.  I never even heard of re-excision back then.  My calcifications were located towards the back of the breast, as yours are.  The surgical part of my recovery was uneventful, very little pain, but getting over the general anesthesia was another story. It was weeks before I felt back to normal.  I wanted to have it done under local but my surgeon wouldn't do it that way.  I'm glad for you that you have a surgeon who will.

The area of my DCIS was small, and I was told I could pass on the radiation as it really wouldn't make all that much difference in my case.  I also passed on the tamoxifin, my doctor felt the side effects were not worth it for me.  I hope my doctor was right in both of these suggestions.

As you go into surgery be aware that nothing is definite until the final pathology.  They may find something more, they may find absolutely nothing - I'm hoping the later for you!!!  And if you want some extra assurance it is okay to request a 2nd pathology report.

One book I read which I found extremely helpful in making treatment decisions is "Assess Your True Riskof Breast Cancer" by Patricia T. Kelly.  Unfortunately it was written just over 10 years ago so it may be a bit outdated - when I was diagnosed it was fairly new.  It has lots of info and studies that are specific to DCIS.

If you have any questions please feel free to ask.

Hi Natters, I had a lumpectomy with 8mm margins and no re-exicision necessary. Mine wasn't towards the back, but it was way far in around the 4 o'clock area. My tumor area was bigger than yours and they still got it all out with good margins. There are no guarantees, unfortunately, but with such a small area to remove, I am optimistic that you will have nice margins.

We each have different types of treatment that we fear.  Some will go to great lengths to avoid radiation therapy or chemo or hormone therapy, regardless of the strength of the data supporting their use.  If you are anxious to avoid surgery and have large enough breasts to be able to spare a little more breast tissue, telling the breast surgeon you really want to avoid re-excision and please be a bit generous in the excision is a good way to try to achieve that.  No guarantees, of course. 

Most likely the surgery will be easier than you fear.  By the way, even with heavy sedation and no general anesthesia you will not be aware of anything during the actual cutting. 

Hello, Natters.  Welcome to the club that no one really wants to belong to.  

Doctors have to assume you have the "average" concerns that "most" women have, until you tell them differently.  In my case, not particularly caring about my body image and with a very supportive husband, I was eager to have the surgeon take enough tissue to be sure of getting the DCIS.  I even drew a little Venn diagram, showing how taking a smaller amount might miss the true margins, while taking a larger amount of tissue would be more likely to get it all.

I was thrilled to hear afterward that the surgical path report showed clear margins of 1.4 cm on all sides.  They are looking for clear margins of 1 or 2 mm!  So this is a pretty darn good result.

And I was actually pleased by the appearance of the breast after my lumpectomy, and made sure to praise the surgeon on doing good work.   

It's normal to have these jitters.  Try to find a way to reach a peaceful place - for me, biting off one decision at a time was helpful - and express your fears to your doctors.  I have a great team and was very gratified that they were willing to listen to my concerns. 

Natters, I was also a first-timer to surgery (I did have wisdom teeth out in the dentist's office, but that was it) and I was apprehensive about it, but it wasn't a big deal.

I had "conscious sedation" but I don't remember a thing from the time they wheeled me out of pre-op until I woke up in recovery. I was able to go out to eat 8 hours later - although the painkiller made the dinner come back an hour later. After that I needed nothing but Advil. I was tired for a week or two after surgery and more so during and after radiation..I still am not back to 100%, four months after rads. But I am a low-energy person at the best of times, so your mileage will probably vary!

I didn't need reexcision, in fact it turned out that all my cancer was in the biopsy samples, the lumpectomy was all margin. The scar is gone already, but there's still a little puckered area where the incision was.

If I had known when I was diagnosed what I know now, I would have taken off more time before surgery to really declutter my house and have it professionally cleaned, and get a bunch of other ducks in a row. I also would have done more aggressive exercises for my arm on the surgery side...I wasn't told to do them until I started developing some soreness.

Good luck!

Natters-

I found recovery from the needle biopsy more painful than from the lumpectomy. Many women, less active than you get seromas/hematomas, they just happen. And though - not in any way exercizing as intensively as you, I did kayak almost every day (averaging about 12 miles) all through 7 weeks of radiation. Think of those crazy scifi movies from the 1950's- radiation caused ants, rabbits, tomatoes, you name it to grow gigantic. It was as if radiation gave me more energy - I hope it does the same for you!! I think the issue with radiation and activity is not keeping your skin dry - (not possible for me since I was experiencing  non bc hormone treatment related hotflashes) it is keeping your skin from chafing - which I accomplished by liberally coated myself with aloe gel and wearing compression sports bras.

Hope all goes well with your major competition. 

Julie E

Julie E

I too am 41, recently diagnosed with DCIS.  Of course, there are other adjectives, "solid type with comedo necrosis, focal microinvasion is suggested (but not proven by immunohistochemistry)"  It was advised due to the calcifcation extent, to have a mastectomy in my left breast, however, due to the mammogram results (I only had a biopsy of the left breast), I have chosen bilateral mastectomy.  I am freaked out- the surgery date is July 13, but am wondering if anyone has any suggestions to the type of reconstruction- flap, or just saline.  My Plastic Surgeon says there is no pressure to decide right away- he will place spacers in , and when it comes time to do the next surgery of implantation, I could opt for flap intead  of saline.  I am all for the for less surgery- so saline is my inclination, but has anyone out here had any success with using their own cells for this second surgery of implantation?

Six years ago, I was diagnosed with DCIS, Grade 3, but very small.  I had clean margins, so no re-excision.  Finished my five years of tamoxifen last year.  My onc suggested switching to an AI, but at this time, I have opted to not take another med.  I did have a complete hysterectomy the year after my bc diagnosis, so I am not as concerned about estrogen as I would be if I hadn't had the hyst. I already have a lot of joint pain from previous injuries and falls from my years as a horse trainer, and I am opting for quality of life in not doing the AI. Life is very good!

The first two years of tamoxifen, my hot flashes were rough, but they did ease over a period of time. I did have odd side effects the first month of taking it, but they pretty much disappeared once my body adjusted to it. I found it very "doable", and have no regrets about taking it.  Do get a pelvic ultrasound as a baseline, before you start tamoxifen.  It can aggravate existing conditions like polyps, endometriosis, etc., and the baseline will help determine if the tamoxifen is causing trouble as time goes on.  My onc was not the one who told me that, my new gyn told me the following year, and I found that recommendation supported on the pharmaceutical site.

Rads exhausted me very early on, but I don't think that is the norm.  No matter how tired I was, I walked every day, and that definitely helped me.

Good luck as you go forward.  Hoping for clean margins for you.

Natters, I had to have a re-excision and just wanted you to know that I was working out 2 days later although not heavy weight on my surgery side. I found the two lumpectomies less painful than a root canal or even a cavity being filled. I took one extra stregth tylenol on the evening of surgery and needed nothing after that.  Hang in there!

Did not have to have re-excision after lumpectomy. Didn't need pain pills either. Found it much easier than my fears expected.  I did have to have chemo, and got a port put in a few weeks later. THAT hurt like &$#^$ and I was on pain pills for days.  But the lumpectomy was pretty much a breeze. I would say in some ways it hurt LESS than the recovery from the biopsy.

Good luck. You can do this.

Amy

Hi Natters, I had a lumpectomy near the chest wall.  The BS got 1+cm margins.  The path report showed some muscle tissue.  I wore a yoga bra during recovery and it was pretty comfortable to sleep in.  I had a horrible anesthesia hang over the day after surgery, but was normal the day after.  I was cleared for full exercise after 3 weeks, but didn't feel fully myself until about 5 weeks.  As far as boating goes... I helped my son hang our sit on top kayak about that time.  I think the advice I got to focus on healing really helped me. Good luck to you! 

Wishing you clean margins and a speedy recovery!