Guide me friends My lumpectomy reports

Hi Dhanno, first you should ask for Oncotype to determine if you will benefit from chemo. Secondly, yes, you may not need radiation if you have a mastectomy, but there are many factors involved in that decision that you will have to discuss with your doctors. I am concerned that your surgeon couldn’t answer these questions. You might try to see someone else for a second opinion.

Dhanno- I too needed a reexcission, it's pretty common. I was told that if she needed more tissue than anticipated I'd end up with a MX vs the LX. I trusted my surgeon and told her I was good with it if that's what she had to do to get it out of me. She was able to leave my breast pretty much the same, probably a larger divot, but nipple intact.

Chemo would be decided between you and your MO. A lot will depend on your Oncotype DX score - a test on a slice of tumor sent to a lab, given a score on % chances of reocurrance. You can read more on Oncotpe scores on the main site here under the TAILORx results recently published.

Radiation after LX is normal protocal. I didn't have a MX but I believe most don't need radiation due to breast tissue being removed. You could ask your MO.

You're young, and you will get through this. This is a group no one wants to belong to, but its a strong group of women on this site and all are willing to support you. Best wishes on the reexcision.

PS - I'm small breasted. The rads breast looks perkier, not actually smaller.

Just chiming in to say many women need a re-excision for lumpectomy—I’ve read 25-40%. I did with my first one but not my second. I told my BS to “go big” this time around. ;-)

Did you have an mri at any point? Personally, I’d do that first before another lumpectomy. Dirty margins can mean they just didn’t get enough tissue around a single tumor site but they can also mean another undetected area of DCIS or IDC adjacent to the one they did detect. Mammogram and u/s do not pick everything up, but mri does. Then you’d know if another lumpectomy would likely be successful or if there is more going on and go ahead to mx and you can keep it to 1 more surgery to get the cancer out. Yes for many with smaller low grade HER2- tumors without node involvement going with MXmeans no rads needed.

1. Will I be needing chemo ?

- What is your EP/PR/HER2/Ki67 data? You will need to discuss the further treatment plan with your medical oncologist. All words from the surgeon is just a guess based on his/her experience. MO may order Oncotype or not based on his/her evaluation on your pathaology report. With tumor size larger than 2cm, one of my friends had chemo done prior to her surgery.

2 If lumpectomy fails then is there any chance to skip radiation after mastectomy .

- Your chest area could be given only one radiation treatment in your whole life. And radiation can make chest bone frangile, higher broken risk.

- I was 47 and chose to have bilateral mastectomy with no reconstruction last July with two tumors on left side, 0.8cm and 1cm. No radiation after surgery. And no chemo with Oncotype scores 14 and 16.

- With my past year experience, almost all doctors are only carefully providing treatment options, but not actively helping on patient to make decision.

Strongly suggest to do research on this forum. There are many first hand, very very useful information from our BC sisters! I learned from them on everything and then made my own decision.