HELP! Need help with margin info

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Cathytoo
Cathytoo Member Posts: 667
edited December 2015 in Mixed Type Breast Cancer

I have a 2.5cm mixed tumor.  Areas of DCIS intermixed with invasive carcinoma scattered throughout, Grade 3.  I need a re-excision because of some close margins.  

The report reads: Margins uninvolved by invasive carcinoma.  The closest margins are: Inferior margin  >5mm Posterior margin >5mm

Margins uninvolved by DCIS (if present) are:  Superior margin 0.55mm  Anterior 0.55mm

All others are between 1.1mm and 2.5mm

The surgeon said she took more tissue than usual.  But, this doesn't seems like good clean margins to me.

Can anyone explain?

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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited December 2015

    I find your report confusing too. It does seem that there are larger margins around the invasive component than the DCIS, which is reassuring. It sounds as though a re-excision is planned because of narrow (although clear) margins. I'm not sure I understand your question, but think maybe it's that you are wondering how it could be that your surgeon took more tissue than usual while still achieving only very narrow margins? If so, it would be that your tumor extended further than imaging or visualization could show.

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  • Cathytoo
    Cathytoo Member Posts: 667
    edited December 2015

    Do you know what is considered a good clean margin.  I read somewhere 11mm.  Does that sound right?

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  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited December 2015

    Cathy, 11mm seems like it would be a lot. My smallest was 1mm (she couldn't go any farther without taking out muscle, so we had to be content with that. We also radiated it thoroughly.)

    Standards are changing as far as what constitutes a clean margin. Some say as long as there are no tumor cells on the ink you're o.k., others are much more conservative in that they want much bigger margins. Don't be afraid to have a good discussion with your surgeon to clarify anything you're not comfortable with.


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  • slv58
    slv58 Member Posts: 1,216
    edited December 2015

    Hopeful, can you explain why surgeons are hesitant to take out some muscle to gain wider margins? I've read it often that surgeon stop at muscle, does it cause damage that is irreversible? I'm just curious. My closest margin was 4mm at chest wall. 

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  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited December 2015

    Shari, I'm not sure about that but have assumed that muscle injured in that fashion would not heal as well as breast tissue and that the risk of greater, permanent effects would be considerable.

    It's an interesting question and I'd be interested in a more authoritative answer!

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  • SoCalGrl
    SoCalGrl Member Posts: 105
    edited December 2015

    I'm actually going back under next week because my margin was .15mm near my DCIS. This was supposed to be my exchange surgery after chemo but my MO said she wanted radiation because the margin was too close for comfort. My breast surgeon thought the margin was fine but consulted a radiologist that ended up agreeing with my MO.

    If I'm not mistakena "good" margin is considered 2mm, but doctors are different. As you can see even my MO and breast surgeon disagreed.

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  • marijen
    marijen Member Posts: 3,731
    edited December 2015

    I just checked my pathology report, it looks like good margins are .5cm and I am also going back next week for one margin.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited December 2015

    Desired margins are usually 2mm or greater, less than that is a subjective call if the margins are narrow, but clean, as to whether or not to do an additional excision.  A dirty margin needs more surgery.

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