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Repeat lumpectomy? And treatment decisions. Need advice

Breast Cancer | Last Active: Jan 28 8:37pm | Replies (72)

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@lifetraveler

Hi! Jaynep & my comrades in fighting the war with cancers:

I just had my surgery to remove that mass of Breast Cancer on 12/26. Just read the post surgery Pathology report of mine from the portal of the hospital as following:

"Invasive ductal carcinoma, intermediate histologic grade, measuring 40 mm in
greatest dimension.
Carcinoma extends to posterior margin focally (2 mm front).

Margin Status for Invasive Carcinoma: Invasive carcinoma present at margin
Margin(s) Involved by Invasive Carcinoma: Posterior
(block 3G), focal (2 mm front)"

This seems like I did not get "clear" margins, right? 2nd surgery shall be the next step? ? Due to the holiday season, I am hesitating to contact my oncological surgeon. I was hoping to get a clear margins to opt-out of the rediation treatments, for I am 71+ and don't want to deal with any side effects of rediation treatments. Any experienced advice is highly appreciated!

Wishing you all a very healthy and blessed Year 2024! God bless you all!

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Replies to "Hi! Jaynep & my comrades in fighting the war with cancers: I just had my surgery..."

Don't you have a follow-up visit with your surgeon? I had one automatically scheduled for ten days after surgery. Surgery site was examined and it was at that visit I was informed that they didn't get clear margins and proceeded to schedule a second surgery.

I had a 1 mm anterior margin, focal, all other areas were 2 mm, DCIS, intermediate grade, ER+ 100% PR+ 95-98%.
I chose to not have the second surgery to increase the margin:
-Because I had already decided to do radiation as it was intermediate grade, with the likelihood of recurrence without radiation.
-Because it was on the anterior (skin) side, which I felt a second surgery would compromise the thickness of skin where the radiation is aimed, and more likely cause skin breakdown.
- Because it was focal - which means only a point was touching.
I’m 69 yo, had radiation in October 2022, 5 consecutive days, 600 gy each, total 3000 gy. I had the option of doing 15 sessions, same total 3000 gy each session 200 gy. I had read the Italian research on the 5 days and thought it was sound. I do believe the cancer center is now doing 5 days radiation with an off day in between each day.
I had no skin breakdown, no sunburn. My breast remains mostly soft, lumpiness is felt when I’m lying down but I can’t tell if that is from surgical reconstruction or radiation. Nothing noted on my 1 year MRI except expected reconstruction changes. I do not have an insert. My breast was reconfigured smaller with existing tissue.
At one year out, I started having some pain. Different pain than I’ve had and is only located in the radiated area. Intermittent, mod level. An OTC lidocaine patch helped. It has receded the past few days, some minor sensitivity to touch. Possibly there is some radiation fibrosis - or it could be fat necrosis or calcifications causing the pain. I’ll ask at next appointment.
Knowing what I know now, I would still choose radiation.