Surgical Re-excision Dilemma

Good thoughts surrounding you as you make this difficult decision. The decisions about surgery were, for me, the most difficult ones I've had to make in this journey with breast cancer.

I  had a lumpectomy on my left breast with bad margins on 8/2. At first my BS gave me the choices you are facing but then he had my case presented at the Tumor Board where he is chair of the comprehensive cancer center. The Tumor Board did not feel re-excision was an appropriate choice but proceeding to an MX was recommended. The reasons were they had found DCIS in addition to my mucinous tumor and that there was unlikely to be an "acceptable cosmetic result". You might see if your case could be presented to a Tumor Board. I was told later that this showed a "high level of professional competence" on the part of my BS.  

Once I knew I needed to have an MX, the surgical options became even more complicated. One breast or two, reconstruction or not, if reconstruction - what kind, if implants - saline or silicone, if silicone - regular or gummies. The decisions seemed overwhelming to me. My husband and I finally just chose to make one decision at a time and then move on to the next.

My BS was clear that there was no medical indication for me to have a BMX but it needed to be a personal decision. I had a BMX on 9/8.

It was hard to know what to do but a friend, who has been through this breast cancer journey, suggested I get all my mammogram records as that had helped  her in making her decision. I did that and realized that over the past 20 years, I've  had a number of problems on both breasts (bleeding, cysts, etc.), each time the problems were found to be benign and I never thought about the problems again.

What helped me the most on the decision to have a BMX was a fact sheet from the National Cancer Institute (NCI). Here's the link: http://www.cancer.gov/cancertopics/factsheet/Therapy/preventive-mastectomy. NCI listed six reasons a woman might consider a BMX. I had three of the six! I circled them as my husband and I went over the fact sheet together. It was an easy decision after seeing those circles so clearly on the NCI list.

We also saw an ACS Cancer Navigator that helped us talk through the options and helped us know we had left no stone unturned in making our decision.

Turns out, they found "flat atypia" in my other breast and both the PS and MO have indicated they felt that I would have been back for treatment for cancer in that breast at some point. I think becuase it was so hard to make the decisions and I was able to make them just one at a time, I've had no regrets or looking back about the surgical choices that I made.

Good luck to you! Know that you will make the best choice.

You are welcome! Last summer, when I got overwhelmed with all the decisions, I'd go for a walk or watch a funny movie. Sometimes I'd declare thinking any more about the treatment choices was "off limits" for the rest of the day. My DCIS in the margins was a complete surprise, it did not show up on mammograms or the MRI. They did a re-excision during my lumpectomy surgery  and the margins still came up bad.