Palpable lump
Comments
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Cherisse, please re-read Beesie's post so you understand exactly what sentinel nodes are and do. You seem to have gotten misinformation about their function, and why they are removed during surgery.
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Hi Cherisse,
You have posted in several places and I can tell you are very upset. Emotions run high around our diagnosis and the early days before, during and after surgery. I hope I can provide a bit of insight into some of your concerns. I will agree with those who encourage you to post your details because that does help us tailor our words to your specific situation.
First, your surgical incision is called a periareolar incision which is standard for a central lesion. I believe yours was at the one o'clock position so this is the standard of practice. Did you have wire guided localization by radiology? It might have been done the day before or the day of your surgery. The outer skin location of the wire is not relevant. It is often placed in a way in which it will not interfere with the surgeon. However, the end of the wire will, hopefully, be pointed at the location of the lesion. Mine was close but not at the exact location according to my surgeon. That is where the experience of your surgeon comes into play. He/she is right in the surgical field and can determine if the location of the excision needs to be adjusted.
I can tell you are very very concerned about the removal of the sentinel node. Let me help you understand the significance of this. When you had your biopsy (perhaps stereotactic?) they removed a bit of tissue from the mass that was identified radiologically. The pathologist did a study on this tissue however it is not as conclusive as the surgical biopsy. Breast cancer can travel via the lymphatics or blood. To determine if the lymphatics have been invaded, the pathologists want to look at the first lymph node exposed to the breast drainage. That is the sentinel node which is the very first node that will drain the breast - thus, likely to have the most micrometastasis. I had a preliminary pathology of 1B G2 M0 but that was changed to 1A G2 M0 after the surgical pathology. The standard of practice is to remove the sentinel node in the axillary area and any other node that is suspicious or palpable. The blue dye that is injected helps to identify these. However, there are also inframammary and retromammary lymph nodes that also drain the breast.
It appears from your statements your surgeon did do a conservative, standard of practice lumpectomy. You can insist your surgeon only do the bare minimum, however, they are bound by the standard they are held to. I would encourage you to try to have patience. Your surgical pathology will give you greater insight to the detail of your own particular cancer.
I wish you the very best. I also encourage you to continue to post to ask more questions and whatever fears you have in the days ahead.
Jane
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First and foremost, I like to say how much it is appreciated to receive everyone's informative and thoughtful posts. Very helpful. Thank you so much.
I totally understand and understood the reason why sentinel nodes are taken out. I really do get it. But it is my right arm, I live for exercise, and it is the lymphedema risks that I am most concern and wanted to prevent that risk. Hopefully my right underarm will heal and never have to deal with it in the future.
The reason I am so frustrated to see I have to do a re-excision is because of having to go back to surgery. More anesthesia, possible blood clot, etc.
I made it clear to the surgeon I wanted the cancer lump out whatever needs to be done. I had no need or desire to have my breast look normal/perfect after surgery.
Maybe surgeons could simply ask patients what they would prefer: Would they rather have more of their breast tissue, a bigger "lump," removed during the first lumpectomy surgery in order to reduce the chance of a second operation, or would they prefer taking out as little breast tissue as possible (preserving the breast's appearance more), knowing that if the margins aren't clear, the surgeon will have to perform a second surgery? Judging from the available research, it seems likely that a woman will be more satisfied with the outcome of her lumpectomy if she has a say in whether to remove more or less breast tissue at the initial surgery.
My surgeon never communicated with me how and where the incision was going to be made and why. Super frustrated with this as I believe it would have prevented a re-excision. As a novice patient, I did not know what questions to ask and it would have been so helpful if more communication about the procedure was made before going under the knife.
Again, thanks everybody. My diagnosis from the biopsy was ER estrogen positive, ER progesterone negative, HER2 negative. There were signs of possible infiltration to vascular/lymph system. Hopefully the negative outcome for cancer in my sentinel nodes is a relief that the infiltration has not gone not to far. I will be seeing my pathology report today from the results of the lump. Oncotype DX. Recurrence score etc.
I did not take aspirin before my surgery. I really never take it but there is a study going on right now showing that aspirin can prevent metastasis. I will stop taking it a week before surgery.
Regarding the new lump as a hematoma. Not sure, it is a swollen hard lump close to the incision area. it feels big about an inch+ on the surface. Will meet with surgeon today to find out what it is.
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Cherisse, I have been here long enough to have seen many situations where people told their surgeons to be sure to get wide margins, and the surgeon took out what he/she thought to be extra tissue, and yet a re-excision still was necessary. Cancer is a sneaky bugger and this happens. If you read the links I provided in my earlier note, you'll see that some people require 3rd or even 4th excisions (or a move to a mastectomy). I can guarantee you that in every one of those situations, the surgeon thought that the margins would be clear with the initial lumpectomy, and then certainly with the first re-excision.
As for the location of the incision, I don't see how you are concluding that the location was wrong and a re-excision could have been prevented if the surgeon had gone in through a different location. That's not how it works. The surgeon determines how much tissue needs to be removed based on the size of the tumor, as it appears on imaging. Where he makes the incision doesn't change this calculation - the same amount of breast tissue would have been removed no matter where the incision was made.
I appreciate that you are angry about your diagnosis and about the need to remove nodes. But it seems to me that you are working overtime to find a place to direct this anger and someone to blame. We've all been there - shocked and angry at being diagnosed. All of us who've had invasive breast cancer have had nodes removed; some of us have had nodes removed on both sides because of a bilateral diagnosis or a second contralateral diagnosis. None of us wanted that either, and we all worry about lymphedema. Yup, it stinks. But what stinks more is not having an accurate diagnosis and not getting the appropriate treatment for one's breast cancer, either being over-treated (with all the risks associated with every treatment) or under-treated (increasing the risk of recurrence). The simple truth is that you have invasive breast cancer, and you are dealing with what comes along with that. None of it is good or what any of us would chose, but this is what happens when you have cancer.
With luck, you will have a low Oncotype score and a low recurrence risk and won't need chemo. But there is no guarantee on that either. It's all part of the crap-fest that every one of us has had to deal with when diagnosed with invasive breast cancer. And it's no one's fault.
I hope your appointment with the surgeon today goes well.
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Beesie,
My appointment with the surgeon went very well. Just like you, I was given the reasons why some cancer might be left behind a little. On my pathology report it showed that just a little at the margin was missed. I understand more of why a re excision is made and no fault by the surgeon. I will get my next surgery date on Monday. I was very upset of hearing I had some cancer left in there and was mad as hell. I know, I wanted to blame someone but mostly was blaming myself for maybe not communicating well.
After the meeting with the surgeon I am more aware of how everything works. Why sometimes a re-excision is necessary. It's not the surgeons fault. It doesn't matter how much is taken out around the margins. When you don't understand you become angry. I was overwhelmed that I'm gonna die in 6 months or so if the cancer wasn't taken out.
Moving forward the cancer department at hospital I am going to are working on a more comprehensive program where by counseling and education is the first step. This will most helpful for individuals like me who are hit with devastating news and yet do not want to bother family with it. That was my problem. I had no one to talk to and did not want to be a burden. I found out on Aug 24th.
The day of my surgery on October 29 is when I told my daughter and son in law and they have so understanding and cool. Today my daughter came with me to meet the surgeon. It made a world of difference to have someone there with me. And the surgeon was so down to earth but explained everything and made me not worry so much. Surgeon said I have a very good prognosis. Before then I did not know if I was going to be dead in a few months. Emotions were out of control. I went from swimming, hiking, working, thankfully enjoying life and its seasons to being a person with cancer. It was a blow. As it is for everyone but I wanted to keep it a secret and that was why I vented on Breastcancer.org.
Anyhow, on this journey the members of breastcancer.org, such a you, gave me an outlet and a resource for this disease. I am more sensitive to others who have cancer. Very thankful that science has come along to way to treat people with better therapies. Ill give an update on my re-excision. I am not mad at my surgeon anymore now that I understand about the procedure and margins. Thanks again for your insights!!!
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Glad to hear that your appointment went well.
What about the lump you feel? Hematoma? Post-surgery swelling?
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Most likely a seroma. It seems to follow the path of removal. From incision site at rim of nipple to where the lump was located. I see my original surgeon on Monday and will find out more. Thanks.
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Hi Jane,
Going on this journey I have been researching, reading, YouTube, etc. on breast cancer. I meet with my surgeon on Monday for postop and schedule a re-excision. ugh. I am more aware of how some of the cancer is missed the first time. In hind site though I wonder if I could had said something to the surgeon like please take out as much of the surrounding healthy tissue as possible. It's ok. I never said please try to take out as little to preserve breast. Not sure how surgeons make their final decision on what comes out during surgery. For i.e. 1mm clear margin vs. 2mm or up to 4mm, I wonder if I am at fault for not letting the surgeon know its ok to take out more normal tissue before surgery. Or would it have mattered? The surgeon took out three sentinel nodes. I was asking for just one. Do you think surgeons really need to take out 3 versus 1? Many YouTube video's on the matter say the first sentinel node is the only node that needs to be taken out. It's been one week and two days since my surgery and the underarm is still very sore. I hope your day is going well and that you have some time to let me know your thoughts on this. Also, if you have questions for me to ask the surgeon before going into the re-excision surgery that would be so helpful. Thank you.
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Cherisse, go back to my post of October 22nd in your Sentinel Node thread. I explained there why the surgeon can't choose to just take one node. If several nodes "light up" from the dye/isotopes and the surgeon only takes one, the results are as meaningful as not having an SNB done at all.
And read back in this thread on the discussion about margins. If the surgeon goes in planning to have clear margins but often ends up with involved margins, how do you think a surgeon can plan for 1mm vs. 2mm vs. 4mm? If you look at your pathology report you will likely find that 4 - 6 different margins are identified, with the margin size reported for each. If margins end up being so uneven around the cancer (and this is usually the case), obviously the surgeon isn't able to target in so finely at a specific margin size. As Jane indicated, there are guidelines and standards that the surgeon follows; sometimes it works out as planned and sometimes it doesn't.
It sounds as though you are over-thinking this and still trying to lay blame, but now on yourself for not being directive enough with the surgeon. Your situation, both with having 3 nodes removed and needing to have a re-excision, is not unusual. Nothing went wrong. It just didn't go perfectly, but that is often case with breast cancer surgery because there are so many unknowns before hand. Either you trust that the surgeon knows what he's doing and is trying to do the best he can, given all the uncertainties of breast cancer, or you don't.
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When I had my dye injection on the day before surgery, the techs noted 2 nodes lit up. I thought I would have 2 removed. But over the next 20+ hours until my surgery, a 3rd one lit up, too. Of course the surgeon would take all 3.
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Hi Cherisse,
It sounds as though with time and talking you are getting a better understanding of your surgery. I get the sense you are a very private person. I'm so glad you shared your diagnosis with your daughter & son-in-law and she went with you to your appointment. I would encourage you to have her or another close person in your life with you when you go to your appointment Monday. I have found in these emotional times, it is difficult to 'hear' everything that is being said. I'd encourage you to think back on your preoperative conversations with your surgeon and perhaps wonder if the miscommunication might have been aggravated by not really 'hearing' what he told you. I confess, my initial conversations about my own diagnosis where complicated by my mind being overwhelmed by the enormity of this diagnosis - and I'm in the business!
Now, what to ask next week? First, I would ask how close and where the margins were. My own BC pulled up the 3-D image of my lesion after the surgery. For some background, each side of the lesion is marked with a different color ink when it is removed so the pathologist & rad onc can orient further diagnosis & treatment. The same is done for all subsequent removals. I believe the standard of practice is to have 3mm beyond the edge of the lesion to the ink. There are some who say it's good just to have no lesion 'on the ink'. For me, it was good to know where the lesion was & how it was oriented. That information is for me & my peace of mind only & just because I'm nosy that way.
I would ask the specifics of what comes next - date, time, how much expected tissue, duration of anesthesia, etc. You might want to ask to speak with your anesthesia provider since you alluded to such a long wake-up. I would also like to know if the dye was taken up by all three nodes. I would like to know when you might expect the final surgical pathology and if part of the tissue was sent out for further testing. My own personal preference is for Oncotype testing. I wanted to know if I have been referred to a medical oncologist and when/how he/she would contact me for further appointments. I wanted to know the specifics of how recovery will proceed from this surgery. I had heard about these shooting pains & yes I did have them. I wanted to know specifically when I was to call the surgeon back with a question & when I should rely on my printed post op instructions. I was not concerned about lymphedema since I know even nonsurgical trauma can cause this. But, if this is still a concern of yours - yes, ask about it. Many folks here have referenced referrals to a physical therapist but you might get a better answer from your MO. For now, follow your post op instructions & don't get aggressive with activity until your physicians say its ok.
Cherisse, there is nothing you could have said to your surgeon to make him/her change what the surgical outcome is. Surgeons, oncologists, pathologists, radiation oncologists & everyone else you will meet in this journey all want to do their best so you have the very best outcome possible. You will go on to recover, decide on treatment and get back to your life of physical activity just as we all have done. But, this is indeed a journey. There will be highs and lows. You will meet some people on this site who are stage IV right out of surgery yet who have lived very long and full lives. Then there are those like you & I who are fortunate to be a low stage. We too will probably continue to live long and full lives. All of us though started out with anxieties and fears. I hope you continue your conversations with us, your children and anyone else in your life who can share the journey. It is hard to do this alone.
Best of luck on Monday. As they say on here frequently - we are in your pocket, which means, you will be in our thoughts on Monday. Keep us posted on how things go!
All the best,
Jane
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Cherisse,
One more thing to add. To your concern, "It's been one week and two days since my surgery and the underarm is still very sore.", I can tell you that after my SNB, my arm was numb down to my elbow for 3 months and my underarm was numb for over 6 months. That's not unusual and it doesn't mean that lymphedema will develop - I don't have lymphedema.
And the shooting pains that Jane mentioned... in case no one told you, as the nerves in your underarm regenerate, you may experience shooting pains. The first one that I had nearly had me jumping to the ceiling - it was so sudden and so sharp. But it lasted no more than 2 seconds and after I searched on this site and realized that it was perfectly normal, I didn't worry about it. I only had it happen a few times, and some people never get these pains at all, but it helps to be aware that this can happen and it's not a sign of any problem. It's actually a good thing because it means your nerves are coming back to life.
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Hi Jane,
Thank you so much for offering those insightful questions and education on the ink/margins. I look forward to getting answers from the Surgeon this Monday.
In hind site, I regret not seeking a counselor and educator on the matter before going through the process of meeting a surgeon, oncologist, radiologist and biopsy procedures. Scary. It seems that one has to learn things along the way with a breast cancer journey. One of my coping mechanisms has been to let out these thoughts even if they are redundant. (I apologize Beesie) or seeking to confirm answers already given. Jane, You are right when you say that I am taking time and talking to deal with this. It's good to know that I could not have prevented a second surgery with any communication beforehand.
To be honest, (being redundant again sorry) If I had known that I would have shooting pains and these other possible complications I probably would have opted out of this procedure altogether even though I know it is the gold standard. That's just me. Kind of dumb. Trying to beat the system...lol. The radioactive stuff was really painful upon insertion. No one told me about that either. But it is done and it is a relief to know that the nodes were negative.
Maybe ten years from now there will be a process where the sentinel nodes could be biopsy with a tiny core needle instead of surgery. Also, maybe the MarginProbe will be more accurate. Many surgeons do use this device and it has reduced the overall re-excision rate. Because there is still cancer in my breast I'm not out of the woods and what is the cancer doing in there? Vascular infiltrating's possible? The oncotype dx results will be in next week.
Thanks for letting me know about shooting pain things. Both of you. It will help not to worry if I should feel them. No one told me about that or possible re-excisions. I was hoping to get back to swimming in two weeks time which helps so much with mental stress. It gives me energy to get things done. The re-excision really hit hard and brought me back to anguish....of all people! That being said, your insights and knowledge have really helped. Beesie too. And I know I must frustrate anyone with my thoughts who have already recovered from Breast Cancer using the gold standard in treating Breast Cancer. I'm probably still dealing with denial. I hope I haven't been insensitive to those dealing with stage iv. There are a lot of physically healthy people who deal with depression so at the end of the day it helps to look for things to be thankful otherwise we'd all be in the same boat that sinks. Right? Got to have hope. Medicines today provide miracles for tomorrow.
Thanks so much for being in my pocket for the Monday meeting. I will share the answers from the Surgeon regarding the re-excision f you would like.
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Hi, my breast cancer peeps here's an update after my post opt meeting today.
The re-excision will be necessary to get a little cancer left at the margin near the skin. The lump was very close to the skin, I could easily feel it. Originally the lump was around 13mm. At the time of the wire placement before surgery, the lump was measured at 16mm on the mammogram. My surgeon mentioned that 21mm was taken out and consequently was surprised to find that the pathology report reflecting positive at the margin. Somehow it was reassuring to see it was upsetting to the surgeon as well. As I have more become informed on how some cancer can be left I understand. It happens. I'm ok with the re-excision. So It is what it is and I will be going in soon for the re-excision. However, before I do I have to contend with my left breast issue.
My left breast was biopsied at the same time as my right breast cancer surgery. On the mammogram for the left breast, there are calcifications showing in a linier fashion. The linier calcifications are about 5cm long. Based on the biopsy findings, the calcifications show that they are atypical lobular hyperplasia.
Some women with atypical lobular hyperplasia may benefit from undergoing surgery to remove abnormal cells and make sure no in-situ and invasive cancer cells are also present in the area. However, most cases of ALH do not require treatment.
It is difficult to predict which cases of atypical lobular hyperplasia will remain benign and which may become malignant, so surveillance is essential.
Does anyone have experience with ALH? Would you recommend surgery or just have the left breast monitored for now. It is suggested to have more calcifications biopsy with a core needle. Should I do this now or wait?
I appreciate any feedback. Thank you for your time.
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Atypical Breast Hyperplasia https://www.ncbi.nlm.nih.gov/books/NBK470258/
"Atypical hyperplasia lesions are pre-malignant, and so if found on breast biopsy, many authorities believe the patient should undergo complete surgical excision to exclude malignancy and prevent the development of advanced neoplasia. Surgical excision for core biopsies that show ADH is considered standard of care. However, ALH may be an incidental finding in small biopsies, and standard surgical resection of these lesions is more controversial. In general, excision is usually recommended in high-risk patients. In carefully selected lower risk patients such as those without a family or personal history of breast cancer, without BRCA1 or BRCA2 mutations, solitary lesions, or lower BI-RADS score, surveillance, and/or medical therapy such as estrogen receptor modulators are possible management options. Short-term follow up with increased mammography frequency should be recommended for patients in whom surgical resection is not performed."With your personal history of breast cancer and with the linear appearance of the calcifications (linear calcs are the classic appearance of DCIS on mammogram imaging), you don't seem to fit the low risk profile noted above. As an FYI, I had clustered calcifications (less suspicious than linear). I started off with a needle biopsy finding of ADH. My excisional (surgical) biopsy, which is standard of care after ADH is found, uncovered high grade DCIS and a tiny microinvasion of IDC. The upgrade rate with ADH is 20% and I fell into that 20%. I believe the upgrade rate may be slightly, but not significantly, lower with ALH.
Evaluation of breast calcifications https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27977...
"Linear, segmental: These are suspicious calcifications arranged in a line or showing a branching pattern, suggesting deposits in a duct. They tend to be distributed in a linear manner because most common malignancies are ductal, beginning in the terminal ducts."As part of the diagnostic process, have you ever had an MRI?
Do a search on "ALH" in the "High Risk for Breast Cancer" and "Benign Breast Conditions" forums and you will find lots of posts from others with ALH. -
Hi Cherisse,
You sound so very much better. I think you might have gone beyond what any of us would recommend. Have you met with an MO yet? What did the surgeon say about taking out the affected area in the left breast? I think both of them, and perhaps a rad onc, might have the best input into your decision making. I think your family & genetic history might factor into this as well.
Take your time, listen closely to what your doctors advise, take someone with you, then ...... think. For so much of this journey, our decisions are made with the best input we have at the time. We choose the very best we can for our own risk levels. We must be comfortable with the choices we make - then, live our lives the very best we know how.
All the best,
Jane
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Hi Jane,
Thank you for your response. I do feel better now that I understand that there was nothing I could do regarding avoiding positive cancer at the margin next to skin. Before I go under for re-excision on right breast, my surgeon is recommending that I have those linear spots biopsied on the left breast. If they show cancer then the surgeon recommends a lumpectomy on the left breast at the same time as the re-excision on the right breast. The linear spots range to about 5cm. So that's a lot if that area has to be surgical excise. So I asked, if that is the case, could I have breast reduction on both breast so they match. Surgeon said that was doable however a sentinel biopsy on the left side would have to happen. In my mind that is a deal breaker. I do not want to have another sentinel biopsy. It is my understanding that because of the gold standard my surgeon is required to do a sentinel biopsy. That being a reality I will opt out doing a left breast surgery and keep an eye on it with mammograms in the future. Ideally, I would like to get this all done and maybe there is a surgeon out there that would do it without the biopsy. Probably not.
The right breast sentinel nodes lite up a little with the blue ink but the 3rd one was very light blue. Meaning the uptake was minimal I guess.
Beesie had very good information on ALH. She recommended going to the ADH and ALH forum for more information and what others decided to do with this diagnosis.
The right breast does have a small seroma and the surgeon said the water will filter back into the body. Or at time of next surgery it will spill out. Surgeon said most likely there will be more bruising for the second surgery. Question: Will the left over cancer spread into the seroma as its melting back into my body? Is the left over cancer still mutating? Growing?
When is the best time to do a re-excision? Sooner the better?
Jane, I have meet with my MO and Radiologist. The MO is waiting for the Oncotype DX to come back to decide best treatment moving forward. We talked about doing Aromatase inhibitor and maybe, to counter any side effects, with Cymbalta for joint pain.
The radiologist went over radiation treatment, however, it will not be an option for me. Any trauma to my skin creates psoriasis and that is too much to bear. It never goes away. I already deal with it on various places on my body where trauma occurred and consequently psoriasis developed and its horrible. The cortisone creams do not work and can cause even more cancer. Fuel the fire. Psoriasis is an itchy, sometimes bloody skin condition that won't go away. Since you are in the medical arena I'm sure you know about this condition. I have enough of psoriasis to deal with and want no more. The surgeons' are cringing at this. There is a one dose shot of radiation targeted directly at the spot in the breast but I do not think any facilities around this area have that machine.
If I decide not to do a left breast biopsy, how long does it take for an ALH to develop in a potential neoplasia? I am trying to think of best decision but at the moment I'm undecided. ALH apparently does not have cancer probability as much as ADH.
Thank you so much for your input and time.
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Cherisse, if you don't have the core needle biopsy but opt instead to have an excisional biopsy on the left breast to remove the entire line of calcifications where the ALH was found, an SNB is not required, nor it is customary.
Whether an SNB is recommended after that depends on the excisional biopsy findings. I did not have an SNB with my excisional biopsy after my needle biopsy finding of ADH. I did however have the SNB when I subsequently had my MX, after the excisional biopsy had found both DCIS and the microinvasion of invasive cancer (and there remained lots of involved margins). I had no choice about the SNB because of the invasive cancer.
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Beesie I have sent a message to my surgeon to see if the left breast excisional biopsy clearing all linear calcifications is an option. That would be wonderful. Then I could be somewhat done with both breast after the surgery. Or I may opt to keep an eye on left breast with the idea I could do this sometime in the future.
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Minus two,
The larger lump is a seroma. Probably developed because I use my right arm for daily things. The surgeon said it will absorb back into body or spill out at re-excision.
*Margins of excision: Positive at superficial/ventral margin for a span of approx. 1mm. IC extends to within less than 1 mm of the inferior/caudal and to within 1 mm of the deep/dorsal margins.
*Lymph nodes: negative
*Tumor cells are estrogen receptor positive 95%, progesterone receptor negative.
* Pathologic TN status: T1cNO (sn)
*Left Breast: Focal atypical lobular hyperplasia
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Hi Beesie,
My surgeon replied to my message saying that if the 5cm is removed I would need a plastic surgeon. Is this true? What does a breast look like with 5cm removed at the ventral 12:00 o'clock position? I'm stuck with making a decision. So I decided not to have the core biopsy on left breast and focus on re-excision on right breast to get all of that darn cancer out! Hopefully the left breast will take a long time before becoming invasive. Or maybe the Amatase Inhibitors will shrink the ALH. Ideally, Id like to have the left breast taken care the same time a re-excision of right breast, but I got the impression that my left breast with 5cm removed would look horrific?! I don't know. This journey has been intellectually stimulating but I feel that the emotional component of this journey just sucks. No kid gloves here.
It is helpful to know that before going under the knife again is this: "The success rates of re-excision lumpectomy after the finding of initial positive margins in ILC, can be used to help patients make informed surgical choices. Given a high likelihood of success, attempting re-excision lumpectomy is reasonable, and, is even more likely to be successful in patients without nodal involvement". I'm hoping that I have the same results as your Mom. -
Beesie,
My surgeon said that if I opt go with excisional biopsy (lumpectomy) on the entire 5cm with the linear spots, I would need a plastic surgeon to fix the distorted breast.
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Cherisse, are you small breasted? I had a pretty substantial area removed during my excisional biopsy, and if not for the finding of cancer which necessitated the MX, I would have been fine with the result. I was a 34 barely-B. But I suppose it may depend on the location.
Why did you delete all your posts? Everyone else's responses are now out of context and won't be of benefit to anyone reading who might have similar questions and concerns.
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Beesie,
I am 5'3" and weigh about 116 lbs. My breast are 34-36 B+ C. The 5cm area (about the size of a lime) would be removed at the 12 o'clock position. I would think lifting the breast after removal would suffice but when the surgeon said I would need a plastic surgeon, it got to complicated to make a decision.
I deleted my posts because after reading them I thought they were too wordy...went into the weeds. Also, I thought I was being annoying.
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"Good Surgeons have both a low re-excision rate and low mastectomy rate and will work with a plastic surgeon to remove the least amount of tissue possible and then re-shape the other breast so that they match. Using 3D specimen tomosynthesis during surgery has helped the best surgeons reduce their re-excision rates even more."
"When it comes to cancer, one cell can be the difference between a full recovery or recurrence of the disease." "Surgeons performing lumpectomies should aim for perfection."
"If you are facing breast cancer, you should demand the very best from your cancer care team. This includes the smart use of the most advance surgical techniques and technologies available including the probe that dectects all cancer when undergoing a lumpectomy." -
Cherisse, you have to trust your team. That's the bottom line. You can research and you can advocate but even health care professionals, when they're on the other side of the bed, have to let go & TRUST the team. We simply cannot question & second guess every step, every decision, esp when we're talking about people who literally are the experts in their field.
Have you got pathology results? It would help if you updated your sigline with the dx if you have it already & whether you've got chemo, rads, or hormone therapy planned? -
Moth, I never said I did not trust the cancer team. Simply said, they could do better with state of the art equipment.
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- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team