why do i need another lumpectomy?

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englishteacher
englishteacher Member Posts: 30
edited June 2014 in IDC (Invasive Ductal Carcinoma)

Why do I need another lumpectomy? Someone explain please: FINAL DIAGNOSIS. A. LYMPH NODE NEGATIVE. B. RIGHT BREAST INVASIVE DUCTAL carcinoma, HISTOLOGIC GRADE 1 MEASURING 1 CM. CARCINOMA is LESS THAN 0.5 mom from inked cauterized superficial/ anterior margin. Does this mean the surgeon made a mistake?

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  • dlb823
    dlb823 Member Posts: 9,430
    edited February 2013

    What you're experiencing is, unfortunately, pretty common.  Deciding where cancerous tissue begins and ends can be a bit of a guessing game.  But if the surgeon happens not to get a wide enough margin, if not corrected, it can increase your risk for a recurrence.  

    Here's an explanation of margins from BCO:

    http://www.breastcancer.org/questions/margins

    Some surgeons feel that anything over 1 mm is adequate, while others ideally want a 2 mm margin.

    So sorry this has happened to you, but the fact that your margin is clean but just not wide enough sounds like it will be pretty straight forward for your surgeon to go back and achieve the desired margin.     Deanna

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  • doxie
    doxie Member Posts: 1,455
    edited February 2013

    englishteacher,

    This happened to me, though I was forewarned it might.  I had an excisional biopsy to remove the entire tumor to determine if it was cancer.  None of the drs thought it was BC, but perhaps a rare presentation of skin cancer.  I was told that I would have to have a second surgery to get better margins if it was cancer.  When the surgeon went back in, he took the nipple, a cyst and fibroadenoma, and of course I had to have the SLN biopsy at that time.  

    Did I need to have that extra surgery for a better margin?  They found no more cancer, but the original margin was less than 1 mm.  Retrospectively, no, but I can't imagine any doctor suggesting I forego that second surgery.  And I would have always worried that it was not all gone.

    Since you've already had the SLN done, relative to that, it should be a simple surgery with an easy recovery. 

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  • crazyride43
    crazyride43 Member Posts: 154
    edited February 2013

    I also had a re-excision.  My margins were all clear the first time, but my surgeon wanted 2mm.  Not a mistake on her part, but as dlb823 said, surgeons are somewhat "flying blind" when they are removing our tumors and they want to make sure we have the highest possible chance of avoiding a recurrence.  The second surgery was easy, about an hour, under sedation not general.  It really didn't set back my healing or recovery much at all since she used the same breast incision.  It was the SLNB incision that hurt the most in recovery! 

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  • edwards750
    edwards750 Member Posts: 3,761
    edited February 2013

    I had a lumpectomy and had to have a follow up surgery to even the margins. Heard it is pretty common.

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  • englishteacher
    englishteacher Member Posts: 30
    edited March 2013

    Thank you DLB, DOXIE, CRAZY, AND EDWARDS. 2nd lx Wednesday next week. Then internal balloon radiation and hormone therapy.

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  • kira1234
    kira1234 Member Posts: 3,091
    edited March 2013

    englishteacher I had the internal balloon radiation almost 3 years ago. If you have any questions you are more than welcome to ask away!

    Also I needed the resection as well. No big deal at all.

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