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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It happened to me too, in 2019. More common then you would like, but some cancers grow faster and its possible for it to be larger then the target area they anticipated. Or so I was told :(. Also no one told me about the lotions for the radiation till my first week was finished! They were out of samples and forgot! So ask ahead of that, as it works best if you have started using it pre treatments. It is unfortunate , but YOU GOT THIS!!! We are warriors! 😉

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@2scottymom

It happened to me too, in 2019. More common then you would like, but some cancers grow faster and its possible for it to be larger then the target area they anticipated. Or so I was told :(. Also no one told me about the lotions for the radiation till my first week was finished! They were out of samples and forgot! So ask ahead of that, as it works best if you have started using it pre treatments. It is unfortunate , but YOU GOT THIS!!! We are warriors! 😉

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Thank you for the response and heads up on the lotion for radiation. It's little things like that, that eases anxiety.
Yesterday I had my 2nd surgery, it went well. I feel pretty good this morning so far. A have a little heartburn , feel a little dried out and shaky.
I think I need to calm down and take one step at a time.
So I hope you have a great and 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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I had to have a second surgery due to unclear margins but that came back clear, so that makes me wonder where it was. I didn't have radiation nor chemo. I was diagnosed stage 1A, no lymph nodes. What was your original diagnosis? And how did you find the recurrence?

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@sirene

I had to have a second surgery due to unclear margins but that came back clear, so that makes me wonder where it was. I didn't have radiation nor chemo. I was diagnosed stage 1A, no lymph nodes. What was your original diagnosis? And how did you find the recurrence?

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Hi @sirene
In response to your questions, my original diagnosis was stage 1A 7mm, no lymph nodes, ER+ PR+ HER2 neg. I was found to be BRCA2+ and a few years later CHEK2+. Ki-67 < 20 moderate. I only recently discovered in the original reports that I had LVI which is considered a negative prognostic factor, but its significance is debated by some. Never mentioned to me. Maybe back in 2013 they knew less about it. I had a double mastectomy, ovaries/tubes removed, no other treatment. I was told tamoxifen wouldn’t make much difference in my case so just skip it and avoid the side effects. They said 3% chance of recurrence. Current oncologist doesn’t agree.

7 years later I felt a hard immobile painless marble on my bony chest (no reconstruction) in the shower. Luckily, I happened to have my annual ultrasound appt two days later and they immediately scheduled a biopsy and spoke as if they knew it was cancer. I hope they would have found the lump if I hadn’t. The cancer was now highly aggressive Ki-67 50% in my chest wall and pectoral muscle. I had the 1.2 cm tumor removed and then 37 radiation treatments. I have been on Kisqali and Letrozole for 3 years and will stay on those as long as they’re effective. Next 6 month CT scans of chest, abdomen and pelvis are in a couple weeks. 🙏🏻

I’ll pray it’s one and done for you. 🙏🏻

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@freebird67

Thank you for the response and heads up on the lotion for radiation. It's little things like that, that eases anxiety.
Yesterday I had my 2nd surgery, it went well. I feel pretty good this morning so far. A have a little heartburn , feel a little dried out and shaky.
I think I need to calm down and take one step at a time.
So I hope you have a great and Blessed day ! 🙂

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This also happened to me. I don't recall my surgeon mentioning it as a possibility, but I had done some research and found out that it was a possibility, so I wasn't completely surprised. I had invasive lobular carcinoma, stage 1a. This type of cancer (ILC) is impossible to see visually until it gets pretty large (often stage 3). The surgeon doesn't know that it has been completely removed until the pathology results come back in about a week. My ILC was detected on mammogram due to unusual pattern of calcifications, so I was "lucky" it was found early. Since mine is pleomorphic (an unusual sub-type) the margins must be clear of "in situ" lobular carcinoma (LCIS). The surgeon I went to for a second opinion explained that this is a kind of "baby cancer" which is likely to develop into cancer if not removed. You might want to ask whether you have ductal cancer (85% of breast cancers) or lobular (about 10%, but the second most common kind). If you have lobular, it is not surprising what happened. I'm sorry you had to go through this.

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@californiazebra

Hi @sirene
In response to your questions, my original diagnosis was stage 1A 7mm, no lymph nodes, ER+ PR+ HER2 neg. I was found to be BRCA2+ and a few years later CHEK2+. Ki-67 < 20 moderate. I only recently discovered in the original reports that I had LVI which is considered a negative prognostic factor, but its significance is debated by some. Never mentioned to me. Maybe back in 2013 they knew less about it. I had a double mastectomy, ovaries/tubes removed, no other treatment. I was told tamoxifen wouldn’t make much difference in my case so just skip it and avoid the side effects. They said 3% chance of recurrence. Current oncologist doesn’t agree.

7 years later I felt a hard immobile painless marble on my bony chest (no reconstruction) in the shower. Luckily, I happened to have my annual ultrasound appt two days later and they immediately scheduled a biopsy and spoke as if they knew it was cancer. I hope they would have found the lump if I hadn’t. The cancer was now highly aggressive Ki-67 50% in my chest wall and pectoral muscle. I had the 1.2 cm tumor removed and then 37 radiation treatments. I have been on Kisqali and Letrozole for 3 years and will stay on those as long as they’re effective. Next 6 month CT scans of chest, abdomen and pelvis are in a couple weeks. 🙏🏻

I’ll pray it’s one and done for you. 🙏🏻

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May your next screening comes back clean. God bless you!

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@freebird67

Thank you for the response and heads up on the lotion for radiation. It's little things like that, that eases anxiety.
Yesterday I had my 2nd surgery, it went well. I feel pretty good this morning so far. A have a little heartburn , feel a little dried out and shaky.
I think I need to calm down and take one step at a time.
So I hope you have a great and Blessed day ! 🙂

Jump to this post

Hopefully the radiation team will give you more info on moisturizing after treatment, but in a nutshell it's 4x per day (lotion-free during treatment). Diligence in this regard will save you all kinds of skin damage and pain. I used Udderly Smooth not only because it worked, but it is a light, fluffy consistency that goes on easily (no friction on tender skin), non-greasy and is much less expensive than a good lotion. After 33 treatments, it was nearly impossible to tell the treated breast from the untreated. Good luck.

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@dlmdinia

Hopefully the radiation team will give you more info on moisturizing after treatment, but in a nutshell it's 4x per day (lotion-free during treatment). Diligence in this regard will save you all kinds of skin damage and pain. I used Udderly Smooth not only because it worked, but it is a light, fluffy consistency that goes on easily (no friction on tender skin), non-greasy and is much less expensive than a good lotion. After 33 treatments, it was nearly impossible to tell the treated breast from the untreated. Good luck.

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Thank you , I think I will try the Udderly smooth. Sounds great ! Again thanks for the support !

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@freebird67

Thank you for the response and heads up on the lotion for radiation. It's little things like that, that eases anxiety.
Yesterday I had my 2nd surgery, it went well. I feel pretty good this morning so far. A have a little heartburn , feel a little dried out and shaky.
I think I need to calm down and take one step at a time.
So I hope you have a great and Blessed day ! 🙂

Jump to this post

Glad it went well! Drink lots of fluids, rest up! You got this! I had a few nodes removed the first surgery, the second was not as much cutting , they used the same incision. Rest up and kick its butt!

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@californiazebra

Hi @sirene
In response to your questions, my original diagnosis was stage 1A 7mm, no lymph nodes, ER+ PR+ HER2 neg. I was found to be BRCA2+ and a few years later CHEK2+. Ki-67 < 20 moderate. I only recently discovered in the original reports that I had LVI which is considered a negative prognostic factor, but its significance is debated by some. Never mentioned to me. Maybe back in 2013 they knew less about it. I had a double mastectomy, ovaries/tubes removed, no other treatment. I was told tamoxifen wouldn’t make much difference in my case so just skip it and avoid the side effects. They said 3% chance of recurrence. Current oncologist doesn’t agree.

7 years later I felt a hard immobile painless marble on my bony chest (no reconstruction) in the shower. Luckily, I happened to have my annual ultrasound appt two days later and they immediately scheduled a biopsy and spoke as if they knew it was cancer. I hope they would have found the lump if I hadn’t. The cancer was now highly aggressive Ki-67 50% in my chest wall and pectoral muscle. I had the 1.2 cm tumor removed and then 37 radiation treatments. I have been on Kisqali and Letrozole for 3 years and will stay on those as long as they’re effective. Next 6 month CT scans of chest, abdomen and pelvis are in a couple weeks. 🙏🏻

I’ll pray it’s one and done for you. 🙏🏻

Jump to this post

Did they do genetic testing on you in the beginning? Are you saying that you had lymph nodes involved but were not told? Prayers that CT scans are clear.

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