small margin?

mjane68,

Sorry to know you have joined this club, but there is an outstanding group of contributors here-the info plus the psychological support has been invaluable to me.

If you read the literature, you will find that the emphasis today is on achieving negative margins, not that each margin has to be a certain size. At times it is simply not feasible, but as long as you have all negative margins I would say you are good.

Good to know that your surgeon did the sentinel node biopsy and only removed two nodes with minimal tumor cells. Again, the emphasis today is in approaching via the sentinel node to minimize unnecessary removal of too many nodes and causing lymphedema (swelling).

Sounds like you have a knowledgable surgeon-a good thing.

Know that there will be a pathology report that will be coming shortly. It will give you knowledge about whether your tumor is responsive (or not) to estrogen, progesterone, and HER2, all of which promote the growth of cancer cells. This data will help your oncologist determine whether you will benefit from chemotherapy and/or hormone therapy. There are two other diagnostic tests - Oncotype and MammaPrint- that can be applied to your tumor to help further define treatment. Ask questions to make sure you understand and know your pathology.

Radiation is designed to kill stray tumor cells- those too small to be visually removed with surgery. A radiation oncologist will look at your surgery, your margins, and plan treatment that targets those areas of concern. Sometimes the lymph node area in the underarm (axcilla) will also be targeted.

Finally, a medical oncologist will make the recommendations on chemotherapy and hormone therapy.

Much more of a customized approach than years past, where there was much less data and treatment was pretty standard.

Know that you as a patient can choose to accept the recommended treatments or not. But be sure to have enough information to be comfortable with your choice.

My own situation very similar to yours. I had a 3.5 cm tumor, poorly formed, and all negative margins, but one being very close to the chest wall. I had radiation, no chemotherapy, but long term hormone therapy based on my pathology. I spent most of 2018 in some form of treatment but by year end received a clear mammogram and no evidence of disease.

Apologize for the length of this note, but wanted to address your concerns and give you the sense that a plan will shape up.

Best wishes going forward. We support each other here

You too!