"leftover" cancer cells after lumpectomy

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Skygirl30
Skygirl30 Member Posts: 3
edited June 2014 in Stage I Breast Cancer

Hi I'm not sure if I'm in the right section but I'm writing on behalf of my mother who was diagnosed with stage 1 breast cancer about 9 months ago (1. 2 cm, grade 2, triple negative) The mass was soft and rather oval shaped with some "papillary" strand-like features. Anyway my mom had been told it was probably benign until the pathology report proved otherwise.  Our lives just haven't been the same. Just last year, I'd never heard of triple negative or hormone receptor positive tumours. There was no history of cancer in my immediate family. Last year I found out I have an "official" risk factor due to my mom (even though many people who have cancer don't have a family history.) I still sometimes feel as though this happened out of the blue.

When I read all the amazing responses I had to join this site. After this long journey, I want to help others just as others have helped me and my mom.  My mother's oncologist decided the best course of treatment was to start with chemo first (4 rounds every 3 weeks). The tumour began shrinking after the first round. In fact she felt a pain in her breast because of it. By the fourth treatment, the small mass was no longer palpable. On the ultrasound, only a small dot appeared, suggesting leftover scar tissue. She also had 12 weeks of taxol followed by a lumpectomy and removal of a lymph node and the sentinal biopsy.  It turned out the lymph nodes were clear (i hope its true) the post-surgical biopsy revealed clear margins but a few cancer cells remained. its not much but it still freaks me out. the chemo did a great job but this worries me for some reason. soon she will start her radiotherapy sessions....sometimes i panic too much. ive always been anxious but this experience has made it worse. is it normal to have a few remaining cells?  hopefully the radiotherapy will kill any residual cells, if any.

my thoughts and prayers are all with you. A big hug to everyone going through this. thanks.                     

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited July 2011

    Sorry to hear you and your mother are going through this. Usually when I've heard people say "clear margins" they mean that all the cancer has been removed. It sounds like they suspect some cancerous cells are left. My surgeon said that about 5-10% of lumpectomies require a follow up surgery (they miss something; the margins aren't clear). Was that discussed? If not, maybe time to ask more questions or get a second or even third opinion? BTW, you are welcome to post here but there is also a forum on Triple Negative, so you may get other answers there. Best of luck!

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  • Skygirl30
    Skygirl30 Member Posts: 3
    edited July 2011

    Thanks Peggy_j        her surgeon said he is satisfied with his plan. he would have liked the tissue to be completely cancer-free but sometimes its not the case. the margins were in fact  clear. he just said that a few cancer cells remained where the tumour used to be. He was confident that he removed everything. radiotherapy should complete the treatment. Still as you said, sometimes i wonder about getting another opinion. but her surgeon is wonderful and she couldnt have gotten better treatment. She was followed at the Jewish General Hospital in Montreal. Thanks and best of luck to you too!

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited July 2011

    If it were me I'd get a second opinion ASAP.

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  • Wabbit
    Wabbit Member Posts: 1,592
    edited July 2011

    I think the surgeon was just saying that there were a few cells remaining after the chemo ... and that those were removed with surgery?  She still had a very good response to the chemo and it is not at all unusual for neoadjuvant chemo to not kill off an entire tumor. 

    In my case the goal was just to shrink the rumor away from the chest wall and we did only 4 rounds which shrunk it in half ... and then removed the rest with surgery.  And it's been 5 years now and all is well with me.

    If a few cells were left after surgery I would agree that a second opinion might be in order ... but I don't think that is what you are saying here?

    It's hard not to worry and you are a good daughter to be helping your mom through this!   

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  • LRM216
    LRM216 Member Posts: 2,115
    edited July 2011

    They cannot "see" cancer cells, so I am not sure what he is referring to.  I had my lumpectomy prior to chemo, also had a 1.2 cm IDC triple negative tumor that was completely removed during surgery, but I was left with a small amount of DCIS in two margins.  My BS immediately went back in for a re-excision of those margins, and thankfully, the re-excision left me with all clear margins.  I then had my chemo, and went as agressive as I could as my oncologist suggested. I then proceeded onto my rads - 30 treatments and 5 boosts.  Since she is triple negative, which can be really sneaky, I would definitely seek another opinion, no matter how much she respects and likes her surgeon.  This is her life, and with triple neg, I'd have gone for a second opinion like yesterday.  I wish her all the best.

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  • reesie
    reesie Member Posts: 2,078
    edited July 2011

    The only cancer cells that can be seen are the ones in the tissue they do the pathology on (unless there is a tumor that they can see on scan) - that would indicate that, like WhiteRabbit said, the remaining cancer cells they saw were the ones chemo didn't get rid of where the tumor used to be but were removed in the surgery.  Since there were clear margins, and the lymph node was clear it seems that they got it all.

    The purpose of radiation is to get kill off of any possible cells that might remain after chemo and surgery so I don't think you have anything to worry about.

    She might want to talk to her doctor just to confirm this is the case for peace of mind.

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  • Wabbit
    Wabbit Member Posts: 1,592
    edited July 2011

    iangould post reported as spam

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  • Skygirl30
    Skygirl30 Member Posts: 3
    edited July 2011

    Hi I really appreciate the detailed responses. Thanks everyone who posted. I think Reesie summed up my mom's situation and WhiteRabbit also. The surgeon said he got everything out.a few cancer cells were found in the site of the tumour, not the margins. The chemotherapy shrunk the tumour by about 95%. The remaining part, very tiny, is what contains the cells and was removed. The few cells were in the tissue removed. Her surgeon is very pleased with the results, however my mother will require about 3 weeks of radiationtherapy to further reduce her chance of recurrence and kill whatever cells are left if any. In her case, neoadjuvant therapy was best for her. The surgeon and oncologist wanted to shrink the tumour as much as possible and it worked very well. The remainder was excised surgically. Thanks again! 

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