positive margins

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cc2e
cc2e Member Posts: 6
edited June 2014 in Triple-Negative Breast Cancer

I am trying to find answers,opinions for my mom who was diagnosised a few weeks ago with IDC, since then she had a lumpectomy last week and is getting ready to stat chemo followed by radiation. She is a triple negative. My concern is that the surgery showed that the lymph nodes appear to clear but there is still a positive margin but it is DCIS not IDC. The surgeon and oncologist agreed that they want to go ahead and start chemo instead of going back in and trying to get clear margins. When I questioned this I got the answer that the margin was very small and the radiation would take care of it and another procedure would delay chemo. I am calling again tomorrow for more explanation as I am having trouble wrapping my head around not going back to try and get clear margins. Just wondering if any had a similiar experience, IDC first, then DCIS found...did you have surgery again before starting chemo?

thanks for any sharing of experience and opinion. Everything is moving so fast that I want to make sure I am asking the right things

Carrie

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  • Luah
    Luah Member Posts: 1,541
    edited February 2013

    Carrie: My understanding is that DCIS is certainly worrisome but non-invasive. So it may be a matter of setting priorities in treatment. Your mom's docs are probably anxious to move on to chemo so that if any cancer from the IDC tumour has spread, (and I'm not suggesting it has, but this is always a risk with invasive ductal carcinoma) it can be wiped out. As my onc said to me, "No one dies of cancer in the breast, its danger lies in distant spread." Because TN is not receptive to hormones, chemo is the only systemic therapy we have at the moment, and the good news is that it has been shown to be especially effective on most TNs.

    Some questions to ask: How they will know the chemo/rads have taken care of the DCIS after the fact? Would they consider going back in at a later date to clear the margin? What are the relative risks and benefits of additional surgery versus moving on to chemo right away? What would they do if it was their sister/mom/wife? Hope this helps.   

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  • shadytrake
    shadytrake Member Posts: 142
    edited February 2013

    Hi Carrie,

    I was just Dx with this same thing just after the tumor board met about my case.  I have some of the same questions as you do but I am scheduled to begin chemo on 2/18 (had my port inserted on 2/13) and I don't want to delay the chemo since TN can be aggressive.

    What I am going to do is go back over the questions I asked about my margins initially and prepare new questions for the DCIS.  I want to find out if they will need to go back and excise more area.  My RO told me today "probably not" because the chemo and the radiation will likely knock it out.

    Granted, my tumor size was very small and I don't know your mom's tumor size.  My motto is to ask questions until you (and your mom) understand and feel comfortable with the treatment.  If you don't feel comfortable, ask more questions.

    I actually honestly told my RO that initially I was concerned with his age (37) and that he might not have enough experience, but he came recommended by both my BS and my MO who I trust.  And a friend who is a Radiologist said he probably is up to date on the newest techniques and research.  He was okay with the grilling and said if I didn't feel comfortable, he could refer me to his older colleague who is a woman.

    Anyway, back to your topic.  I will ask my questions on Monday to my MO and post his answers.  I will also request a report from the tumor board.  You ask your questions, and post the answers from the Drs and we can compare notes.  I have a follow up appt with my BS in March and will ask him the same questions.  I'll post his responses here as well.

    Healing thoughts to your mom and calming vibes coming your way. 

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  • shadytrake
    shadytrake Member Posts: 142
    edited February 2013

    Edit to update my dx.

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