Surgeon missed the margins. 2nd surgery

Posted by freebird67 @freebird67, Apr 1 6:16am

Good morning all,
Had lumpectomy 3-18 went back on 3-28 thinking surgeon would release me to oncologist but No ! She told me they missed the margins. I was kinda dumbfounded at first, she explained to me that they have to go back in and cut more and scrap. Then asked me.... do you have a problem with this ? Of course I have a problem with this, who wouldn't ! She just told me cancer cells were pushing on the margin. So I'm headed for another surgery this Friday.
I'm loosing faith in the medical system fast. The nurse came in to schedule my surgery and said it happens like no big deal.
So I guess my question is, have any of you gone through this ? Did it change anything for you ? I did do some research about it and didn't like what I read. But have no choice on this. Thank you and
Have a blessed day

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I know this can be a shock because something similar happened to me. According to NIH, about 20% of lumpectomies result in a second surgery. Some women prefer mastectomies for that reason. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8441089/
However, not every patient is fully aware of this risk. The surgeon can't see the cancer on a cellular level, so the pathology report is necessary, and sometimes another surgery. You don't need to loose faith based on this, as it is a common part of the process. However, it is quite upsetting particularly when you are recovering from the first surgery. My surgeon missed a cancerous lymph node shown on the PET scan. However, it was in a tricky area, and could cause a great deal of bleeding, so I opted to have it treated during radiation alone. That wasn't state of the art, and the radiologist would have preferred surgery, but he was very open to what I wanted if it was within reason, so that is what we settled on. Remember you can always get a second opinion, and maybe find a surgeon you are more comfortable with. However, in my non-medical opinion, this could happen with any surgeon.
Will be thinking of you on Friday. Will you have a chance to recover a bit after that and wrap your head around this? Wishing you all the best.

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So sorry my mammos did not show my IDC cancer at all. If I did not feel a rock lump I probably would be dead. I had to show them with my finger the lump because ultra sound swiped over breast but not the spot. You have to be your own advocate.

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Yes, I had two lumpectomies and then a mastectomy. Unless the facility has a the ability to biopsy the margins in the operating suite, such as MD Anderson, for example, this is unfortunately not a rare occurrence. I, too, was very upset until my primary doctor explained it to me. I do like and respect my breast surgeon and oncologist, I wish my primary doctor was my oncologist. He always explains things and doesn’t make you feel as if you are over reacting-even if you are🌹

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I know how frustrating this news can be because I too had to go back because my margins were not clear with the first lumpectomy. Since I was going in for the second surgery anyway, I decided to have a reduction/lift at the same time....silver linings! I wish you all the best!

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Hi! @freebird67 :

I am so sorry for what happened to you during this journey:( Our thoughts and prayers will be with you throughout your surgery Friday.

Best wishes for a successful surgery and speedy recovery!

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My surgery was in 2016 for estrogen positive tumor. I had chemo first. Then surgery. Came back and was told they did not get clear margins in the surgery. The tumor board thought they should do a second surgery. I was concerned as you are.

I also had cancer in the internal mammaries which they do not surgically remove.
I talked to my surgeon and she said that the radiation could take care of the margins as it was also going to take care of the cancer in the internal mammaries.

8 years later, I have had not evidence of cancer as a result of the margins from the original surgery. I think they were taken care of by the radiation. I am glad I did not have a second surgery. Each case is different. Good luck as you continue your journey to good health.

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My breast cancer recurred in my chest wall and pectoral muscle 7 years after my double mastectomy. When the chest wall tumor was removed there was a positive margin. The surgeon didn’t want go back in and decided to let the radiation get it. I have no way of knowing if it did other than wait and see. What got me is to know we only needed to take 2 mm more for a clear margin. Why cut it so close especially if 20% end up with a positive margin?

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@jaynep

Yes, I had two lumpectomies and then a mastectomy. Unless the facility has a the ability to biopsy the margins in the operating suite, such as MD Anderson, for example, this is unfortunately not a rare occurrence. I, too, was very upset until my primary doctor explained it to me. I do like and respect my breast surgeon and oncologist, I wish my primary doctor was my oncologist. He always explains things and doesn’t make you feel as if you are over reacting-even if you are🌹

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Thank you for your response,it is appreciated. But I don't feel I'm over reacting because I do feel these are things that should be discussed before hand which was not. And was not discussed much when told it had to be done again. This gives a patient time to wonder
Ok what does this mean ? Is there cancers in there roaming about or ???
Bedside manners lacking for sure. Do I think I'm the only one? Absolutely not !
But like anybody I'll get it done and move to next stage.
Thank you and blessings

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@lifetraveler

Hi! @freebird67 :

I am so sorry for what happened to you during this journey:( Our thoughts and prayers will be with you throughout your surgery Friday.

Best wishes for a successful surgery and speedy recovery!

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Thank you . I think it was shock. Was not expecting it all.
I was upset mostly because I wasn't told this could happen.
Communication could be better.
Have a blessed day 🙂

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@californiazebra

My breast cancer recurred in my chest wall and pectoral muscle 7 years after my double mastectomy. When the chest wall tumor was removed there was a positive margin. The surgeon didn’t want go back in and decided to let the radiation get it. I have no way of knowing if it did other than wait and see. What got me is to know we only needed to take 2 mm more for a clear margin. Why cut it so close especially if 20% end up with a positive margin?

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Thank you for your response.
Exactly what I was thinking. I wouldn't have cared if they had taken more as long as it was out ! I have just started to really heal and now back to doing it again. An explanation before hand that this could happen would have been nice.
I know drs are busy but this sort of thing can be avoided.
Have a great day 🙂

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