Surgical margins

Margins are one of the most complicated aspectsmof DCIS surgery. Different research studies have historically defined close margins in different ways; different ways of treating the tissue result in differnt kinds of interpretations. I freaked because my closest margin was .5 mm but my BS, medical oncologist, radiation oncologist, and the tumor board of the Multidisciplinary Breast Cancer Center of my university sais I should not have a re-excision. I never really understood the explanations of each doctor ( though I did feel I understood the explanations of everything else). Every case is different but close margins do not always mandate re-excision. I did have radiation after my lumpectomy

I hate the words close margins--I hate the words radiation. Could in each situation Radiation have been avoided by a mx with radiation doing damage to underlying tissue --------like the lung or heart. Could a recurrence be avoided by a BMX. We each have to make choices. Each person has to make a choice. What does this breast mean to me in the whole of my life. Do I risk having a recurrence. It's an appendage. Is it worth my life?

Terri, I am so happy for you!  How are you feeling after this surgery?  I was pretty sore after my third because my BS did a lot of reconstruction to fill in the gap left by all the surgeries.  It was worth it because now I won't need any other reconstruction; it's a little smaller than the other one, but with a good bra you can't notice.  Take your time recovering, rads isn't too bad, the worst is over!

Glad to hear you are feeling good!

Cherie-------Is a breast worth your life?------------your stats and still no clear margins?

Terri, congrats on your good results!

Cherie, and anyone else looking for more information about margins, there's a good article about the subject at the main Breastcancer.org site in the Surgical Margins section.

Judith and the Mods

Good luck, Cherie, and Terri, congrats! Rads were just fine and yes, it is all worth it to keep the breast and the sensation in my opinion.

sas- I don't think you sounded yucky either....and agreed on your second comment!

MamaMia----------never meant to scare anyone about rads, but awareness , YES.  Knowing that doc's don't tell patients about the other problems that treatments carry, is a big problem within the medical system for everything---------EVERYTHING-------The thousands and thousand's of medical errors made a year, the damage of drug interactions that can be avoided by a drug interaction check ---that you as a consumer ,either in patient or outpatient, that could be avoided b/c in wasn't done. Only a minuscule go through the reporting system. Second opinions at major medical centers, that don't lay down a full tiered plan of options. With less radical options , being offered as an option to the patient with a full explanation. No DNA testing to see if a drug is going to work and if someone is a slow/ medium/fast metabolizer for that drug. No analysis of all the drugs a patients list to see if there are too many drugs trying to go through the same pathway.

 Radiation therapy that can cause long term consequences to other organs, not fully explained in detail . Study well, the long term affects of radiation therapy. If you were given a choice at onset of therapy that said---"This is what we can do now-------but in the future you "May"(long term consequences of radiation therapy fall into the --probable versus possible category) experience these affects of this treatment AND a full explanation was given, so, that you totally understood and it was said to you if we do this , instead of that,  you can avoid radiation ----you may make a different choice.     

 I have seen the long term consequences of minimal information on all treatment therapies given to people over 40 years, not just cancer. AND it sucks. People trust what the doc says at the time b/c they trust that doc will give them the best info is why they go to that doc.

 Mamamia--------that one study proves nothing --------but it could be landmark study- meaning that it could go down in history as leading the way for this therapy------but only repeated confirmation of a study proves it's usefulness. The recent study announced this week about CLL on 3 people----------though incredibly -----incredibly exciting for all of cancer care , not just leukemia. It's 3 people-----------the research in this area is going to be off the charts for the next few years. In fact , if my Dh was one of those three he might be alive this year.

Cancer treatment is evolving, perhaps not fast enough for you and I------let's hope. But always try to get a second opinion for confirmation of care, do as much self study on the subject that you come to be very knowledgeable about what is said to you and options offered.

AND again the question on margins "Can we do anything else to avoid radiation" If according today's Standard of Care -------Radiation can't be avoided  for BC metastasis or for any cancer, then that's what we have to work with.

 But if a woman is given a choice that a mx is an option with no radiation versus lumpectomy with radiation and chooses the lumpectomy with radiation--------let it be well known that there are consequences to the radiation.

I had a mast and still needed rads....all for stupid DCIS.  It happens. I wasn't happy about the rads but given that I was 39 with 4 young children I felt the benefits outweighed the risks for me.  I have been very fortunate in that my SE's from rads have been minimal.  I am careful about diet (always have been) and exercise and I know this has helped.  I always try to remind women that a mast doesn NOT always equal no rads.   I  don't think you can ever have enough opinions before you decide on a treatment.  I had all my samples sent to a second pathologist just to be sure before having my mast and again after.  I had 2 dr's tell me if I didn't do rads it would come back.  My bs was 100% sure and the RO gave me at least 35%.  Between those 2 numbers I felt I needed to do it.