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Positive margin in breast for DCIS
I know you can’t give advice, just looking to hear your experiences on missed margins.
Had stage 2 ER/PR, Hers2-, 1.8 breast and one lymph node. Initial plan was no chemo, lumpectomy with some lymph nodes removed, radiation followed by Tamoxifen. Path came back and talked to surgeon this morning. 5 lymph nodes good, 1 cancer removed, 1 cancer cells removed and feels good radiation will take of rest. As for breast, all 4 margins positive for —-situ carcinoma in medial margin; in situ carcinoma present in lateral, deep and cranial margins. So no invasive cancer in any margin but DCIS remains.
Those that had similar, did you go in again to attempt to remove or did you rely on anti hormone and radiation to keep you from reoccurrence. They sent in tissue for reoccurrence score so currently unknown.
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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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7 Reactionsafter 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.
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2 ReactionsYou are not cursed, just had a rough go. Maybe you’re on the other side of it all. Take care
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
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1 ReactionThank you. I hope they were right when I got the all clear. We all have to be vigilant. Best wishes to all.
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1 ReactionHi Lynnn in Ottawa, Keep being vigilant! I had extremely dense breast tissue which makes it difficult or near impossible to discern breast cancer. I had mammograms annually (slightly less than a year apart because I mistakenly thought that was the recommendation). Apparently, everything looks white on the imaging if you have extremely dense breasts. Thus, my exams were less than a year apart with my initial diagnosis where I elected a mastectomy other a lumpectomy. I was never given the choice of a double mastectomy which I think would have been the best path forward. However, as soon as some calcification was found on my opposing breast with a mammogram I used it as an excuse for a profalyctic mastectomy (which reduces the chance of BC risk on the opposite side to 5%). I am really really happy they are both off. Yay! No more mammograms (MRI can track which doesn’t use radiation). I had to lobby hard and wish they would have given me the choice of a double mastectomy in the first place. I also felt horrible walking around with one breast.
I wish I could have had both removed. I always have a nagging worry from one mammo to the next. Good for you to be rid of both.
Our piano teacher had a history of lumpectomies (one on each). After a recurrence she had them both removed. She was originally trained as a nurse and is a no- nonsense type personality. It is ridiculous that women have to fight for this in Canada in today’s age. We really do not live in an egalitarian democracic society. Medicine is super elitist and needs to change.
Just wondering was initial diagnosis IDC?
Yes, initial was IDC. I mulled it over and given one more shot.