Lumpectomy /margins not clear

Until you have clear margins you do not know what your diagnosis is. When the breast cancer goes up to (or almost up to) the edge of the tissue that was removed, it is likely that more cancer remains in the breast adjacent to that point.  Any remaining cancer could change the stage or other characteristics.  

With a 1mm margin, the risk of recurrence is very high.  And in 50% of cases, by the time a recurrence is found and removed, the cancer cells have already evolved to become invasive.  That changes the diagnosis from DCIS to IDC - and that can be a whole different ballgame.   

It's possible that when you have the re-excision, no more cancer will be found.  But it's just as possible that with the re-excision you would be saving yourself from a diagnosis of an invasive cancer.   

As JSwan said, usually a re-excision is a quick and easy surgery. If it were me, there's no way I wouldn't have the re-excision.

I had one close margin.  the margins were clear, but one was to small so I had a recision.  It really was no problem. the doctor didn't really want to do it.  He just wanted radiation to take care of it.  The radiologist agreed with me.  I would rather have more taken out then worry about it 5 years from now.  So I had a second surgery.

You know what to expect now since you had the first one.  I was wondering if I would be in pain afterwards since they were going back in, but I wasn't.  To me, it's worth a shot of a second surgery. 

I assume lumpectomies are much easier to recover from than MX's.  I would never just leave it close.  You would probably be worrying about it all the time.

good luck.

I have 2 close margins of DCIS and will have more surgery.  I just wish they would give me the date. Everything else depends on getting the surgery over with. I'm feeling cross, can you tell?

I had 4 close margins, plus I ended up needing an SNB anyway. So we did another lumpectomy. Nodes were clear but still had one close margin, so had another reexcision. STILL another close margin. After 3 lumpectomies, we opted for mastectomy. Wouldn't have done it any other way. The 2nd reexcision (without lumpectomy) was very easy - no major pain, had surgery on Thursday was back at work Monday, no problem. If you leave the margin, who knows how much more is still there, for me, apparently there was lots and that's what DCIS likes to do - spread out in the ducts, not continuously though.

I agree with most of the other posters - get the reexcision.

carms, 

I was assuming that because you had posted in the DCIS forum, that your diagnosis was DCIS.  But if you are waiting for Oncotype test results to determine if you will need chemo, then your diagnosis is IDC - invasive cancer - and not DCIS.  You may have some areas of DCIS in addition to the IDC but because the IDC is the more serious condition, your diagnosis, prognosis and treatment will be based on the IDC.

If you have IDC anywhere near your margin, or even if you only have DCIS near the margin but your tumor already included some IDC, then it would be very risky to not have the re-excision. You do not want to leave invasive cancer cells in your breast if it can be avoided.

My two surgeries were 8 days apart. I don't remember a lot of pain from the lumpectomy, but the SNB was a (rhymes with "witch"). 

Hi, BKZOE. I go to Northside in Atlanta, too! If they do another mammogram post-surgery, they are very gentle. It is not nearly as "clamped down" as a regular mammogram.

Definitely have a re-excision if they want one. I had a lumpectomy on Jan 4 with DCIS too close to 2 margins. Had the re-excision on Jan 27. Path report yesterday showed a new spot of IDC with different markers from the first (slightly larger also) and DCIS at the margins again. Not visible on the mammogram. I saw BS today and we decided on a MX on 2/22. She's also ordered an MRI to see if the left one is just as sneaky. My DH said today he could see how people could find a small tumor and decide on a bmx.

BK: I had another mammo. before my rads started. It was RO's idea (not my BSs), she wanted to have a baseline before rads started and I suppose also to make sure one more time that everything was out . . .which I'm glad about.