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Positive margin in breast for DCIS

Breast Cancer | Last Active: Jul 28 8:15pm | Replies (10)

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I had a recurrence on the chest wall 2 weeks after mastectomy. Er/pr +, her2 -, Onco 23, grade 3. Had 8 rounds of chemo to shrink tumor. Surgery to remove 3.2 cm of cancer with 3 bad margins. Surgeon initially refused to go in again. Went thru 2 tumor boards in Canada where I live. First tumor board in Alberta - 7 people- said no surgery go to radiation to take care of it. Second tumor board out-of-province approved surgery. Surgeon then agreed to re-excision to fix margins. Thank God! It is my understanding based on the Cambridge breast cancer calculator that surgery is 56% of the cure. They removed another 1.2 cm of cancer. That’s 1.2 billion cancer cells. Radiation is meant to mop up or sterilize a few hundred cells. The motto of the story is that no one knows how much cancer is in there until they remove the tissue and do the pathology. Otherwise it is simply guessing. The only way you will truly know and be reassured is to have another surgery to correct the margins. As one surgeon told me “a positive margin is a positive margin”. To be safe go in again and have the surgery as cancer cannot be underestimated. If you just have the radiation you might find that you have bigger problems later on. Best of luck to you!

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Replies to "I had a recurrence on the chest wall 2 weeks after mastectomy. Er/pr +, her2 -,..."

after what happened with you now I’m scared. In Aug. I had lumpectomy plus 5 sessions of radiation on right breast. Four years before also had lumpectomy on left breast plus 5 radiation. I have yearly mammos but now worried about missed cells. And 4 years before all that that I had colon surgery for a tiny cancer! Every four years I’m cursed. . I’m over here in Ottawa. Best wishes.

That is kind of my point—you don’t know or can see DCIS so going in to clear again..and again is a crapshoot. Who knows how far or if there is a chance to clear a fully positive (not close) margin. DCIS stage 0 is tricky. Some never turn to cancer. If I even had one cleared or one close, I would say—hey, at least we know there is an end to it. If you two surgeries and decide to not do a third, was there any benefit to the second? Tough decision for sure and thanks for sharing your experience