Question about cancer found in "cavity shave" margin

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sos1125
sos1125 Member Posts: 64
edited December 2015 in Surgery - Before, During, and After

I recently had a lumpectomy with "cavity shave margins" where the surgeon excises the main tumor and then shaves additional margins from all sides. The main tumor was 1.1cm and one margin had a .3cm tumor in it, so the pathologist is saying my cancer is "multi-focal." Since the pathologist evaluated only the margins on the cavity shave pieces, I am wondering whether the .3cm "new" tumor is actually part of the main tumor that was excised (surgeon just missed that piece on first excision). Did anybody here have similar results, and if so, did the pathologist go back and look at the margins on the main tumor to establish whether second tumor was actually part of the main mass (just missed on first excision)? The pathologist I had only looked at the cavity shave margins.

I have read that prognosis is considerably worse for multi-focal cancer and am really wondering whether I should have gotten mastectomy instead of lumpectomy.

Thanks for any info.
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  • grammakathy
    grammakathy Member Posts: 407
    edited December 2015

    have you asked for a copy of your pathology report? My report indicated marks that the surgeon made to orient the sample to where it was on my chest. I would expect that your report would give the details you are looking for. Best wishes sos - we learn so much as we travel this road

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  • sos1125
    sos1125 Member Posts: 64
    edited December 2015

    Hi, grammakathy, thanks for this info. I do have the pathology report, but the report just indicates "right medial margin" and the like and indicates the color of the ink used on the sample. I asked the surgeon whether the small tumor could just have been missed on first excision and she said if the pathologist had thought that was the case she would have indicated a "transacted tumor" and would not have done separate ER, PR, HER-2 tests on the piece. Then I asked her how do we know we got all tumors if there was suddenly a second tumor not previously identified in imaging, and she said the second was so close to the first that it looked like a piece of the first. I find myself seriously wondering whether I should have simply gotten a mastectomy. This bothers me enough that I am going to get a pathology second opinion from MD Anderson. What I wish they would do is just look at the margins on the actual tumor, I think that would tell the story.

    Thanks again for the input, I appreciate it. Hope you have a lovely holiday.

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  • grammakathy
    grammakathy Member Posts: 407
    edited December 2015

    SOS - I understand how you feel. Even after having a mastectomy, I was surprised when my MO said that there could still be stray cancer cells in my blood and lymph systems, and even in the extra fat I was carrying. None of us are ever sure the cancer won't return until we die from some other cause. Because of this, I just did everything I could to decrease anything that would feed cancer cells - tamoxifen (after trying Arimidex and suffering from too many side effects), losing a lot of weight, and eliminating as much sugar as I can from my diet to keep my weight down. And I made a decision to focus on what I want to do in my life. Hopefully you will be reassured when you have the second analysis of your pathology samples. You are taking things step by step and thinking them through which is what I did with my diagnosis. That was enough for me to make the decisions I needed along the way without regrets. Hugs!

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