Margins not clear

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Margaret22
Margaret22 Member Posts: 12
edited February 2018 in Surgery - Before, During, and After

This is my first post. I was diagnosed with stage 1 breast cancer to left breast. I underwent a lumpectomy with sentinel lymph node removal and biopsy. The tumor was 1.6 cm total. No cancer was found in lymph nodes but a margin was not totally clear medial and posterior. They recommended no further surgery and radiation due to size ( I believe). The surgeon I used is fantastic and quite reputable but I can’t help question this decision. Has anyone not had clear margins and been sent to radiation for remainder of cancer killing? Thanks for any responses.

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  • Moderators
    Moderators Member Posts: 25,912
    edited February 2018

    Hi Margaret, and welcome to Breastcancer.org,

    We're sorry to hear of your diagnosis, but we're really glad you found us. You're sure to find our Community an amazing place for advice, answers, and support. We're sure someone will be by shortly to weigh in with their experiences and suggestions, but we wanted to extend a warm welcome while you wait for replies.

    We look forward to seeing you around the boards! Please let us know if you need any help at all.

    --The Mods

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  • edwards750
    edwards750 Member Posts: 3,761
    edited February 2018

    Margaret - I had a lumpectomy too. I was Stage 1b. Tumor was small. After the surgery the margins weren’t clear enough so I had a second surgery to do that then had radiation.

    I would ask my doctors why.

    Diane

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  • letsgogolf
    letsgogolf Member Posts: 263
    edited February 2018

    My margins were not clear either until my doctor went back in and removed more tissue. My surgeon has margins checked while patients are still in surgery because of the frequency of having to go back in. Saves patients a possible second operation, which I so appreciated. Does make for a much longer surgery, however. Mine begain at 2:20pm and I went to recovery at 5pm. Most of that time was spent waiting fo the pathology lab to inspect and relay findings.

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  • moth
    moth Member Posts: 4,800
    edited February 2018

    Hello, I believe it depends on what was found in the margins (DCIS vs IDC v LCIS for example) and how many millimeters.

    My provincial guidelines say that if it's " < 2 mm, a re-excision is not routinely recommended but could be considered if the risk of ipsilateral breast tumour recurrence is high and systemic risk is low, for example. A radiotherapy boost is usually recommended in the setting of a close margin."

    LCIS in margins doesn't constitute positive margins under our guidelines either. Other considerations are the patient's age and tumor endocrine status.

    I would recommend you ask to meet with your bs or MO and get answers to these specific questions:

    -what exactly was found in the margins? What type of cells?

    -how wide were the margins?

    -what is the estimate of ipsilateral breast tumour recurrence?

    -please show the clinical guidelines outlining best practices which you are using to make this recommendation?


    You could also consider a second opinion with another oncology surgeon.

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  • Margaret22
    Margaret22 Member Posts: 12
    edited February 2018

    Thank you everybody! This was immensely helpful. I know it is in Situ focally positiveposterior and medial but that's it. My surgeon is out today but I'll talk with her next week regarding all of those questions...especially the ones from moth. Great info. I am happy that I have found this forum and plan on using it a lot more. Thank you very much.

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