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repeat surgery after lumpectomy

shineyone
Posts: 2
Joined: Oct 2012

I just had a lumpectomy 1.5 weeks ago and apparently she did not get clean margins and wants me to have a 2nd biopsy due to inconclusive calcifications in the tissue sample that did not shop up on the mammogram, and if that sample comes clean to do an additional surgery for clean margins. Feeling rather insecure about this and if I should proceed or find a different surgeon or? Is it anyones experience that a pathologist is actually present in surgery to confirm clean margins?

cinnamonsmile
Posts: 1052
Joined: Dec 2010

I had a large lumpectomy done. The surgeon saw some tissue that looked suspicious that did not show up on the mammogram, ultrasound or MRI. I am glad she took it out, because it was cancer. I did not have clean margins at all. If I had not chosen a mastectomy, I would have had another lumpectomy. Some women have 2 or 3 lumpectomies in order to get clean margins.
I did not want to leave a chance that there was any cancer left in me. In my situation, it was best that I had a mastectomy.
I don't think your surgeon is out of line for wanting clean margins, since that is pretty much standard from what I have been told. But you can always get a second opinion.

shineyone
Posts: 2
Joined: Oct 2012

Thanks for the response,cinnamonsmile. I am still trying to determine why I need the biopsy to justify the 2nd surgery and still would also like to know if it is usually standard to have a pathologist in surgery to determine clean margins rather then having to wait for that answer and needing additional surgery.

cinnamonsmile
Posts: 1052
Joined: Dec 2010

What does your surgeon say about your questions?

DebbyM's picture
DebbyM
Posts: 3294
Joined: Oct 2009

I know that sometimes they do have to go back in order to get clean margins. This didn't happen to me, but, some have posted about it on here.

Good luck,

Debby

camul's picture
camul
Posts: 2130
Joined: Dec 2010

in a biopsy, woke me in the middle, said it was positive but she didn't get clean margins. We had discussed this ahead of time and she said if she felt a mastectomy was needed she would let me know. Her advice was to close it up and reschedule for a week later. The pathologist was there during the surgery.

I took her advice and one week later had a mastectomy. My lymph nodes were clear, they took 19. But it had spread to the nipple, I have never been sorry. I had 8 1/2 years dancing with NED!

laughs_a_lot's picture
laughs_a_lot
Posts: 1368
Joined: Mar 2011

Of a pathologist in the OR, though someone checks the lymphnodes and disects them while the surgeon is in surgery. I do not know if that person is a pathologist or not.

I had to have a second surgery but it was due to a mamogram on the lumpectomy breast and I believe I was 6 months past surgery when they did the mamogram. They did not do a biopsy as the suspicious cells were along the incision line anyway so they just decided to take them out. The surgeon admitted it could just be scar tissue or micocalcifications but since my tumor was large we both thought it good to get it out and wait for the pathology report. The cells are gone and it was not cancer. Now there will be nothing odd to question on my next mamogram. This second surgery did result in a fluid build up (called a seroma) under the scar but it was removed in the surgeons office.

It is fairly common to go in for a second round of surgery but I suspect there are less complications from a lumpectomy versus a masectomy.

Lighthouse_7's picture
Lighthouse_7
Posts: 1566
Joined: Jan 2010

This is very common it's called re-excision. It happened to me and I'm still going strong 3 years later.
Good luck.
Hugs,
Wanda

DianeBC's picture
DianeBC
Posts: 3888
Joined: Jun 2009

Wanda is right, this is common. I am very sorry that it happened, and, will be praying that your surgeon will get clear margins now.

Keep us updated,

Diane

Bella Luna's picture
Bella Luna
Posts: 1575
Joined: Aug 2009

It happened to me. I had to undergo another re-incision to get clear margins. It worked! It's been 3 years for me and I am going Strong! My best to you.

DebbyM's picture
DebbyM
Posts: 3294
Joined: Oct 2009

I don't actually know if the pathologist is in the surgery room, but, they did confirm to my husband that it was bc, while I was still in recovery. We knew it was from the needle core biopsy previously, but, I guess they just wanted to reiterate the diagnosis to us.

Good luck!

debsweb18
Posts: 190
Joined: Jun 2012

After surgery, they told me the margins were clear and no lymph node activity. However, 2 days later when the final pathology report came in, it showed my margins weren't clear and there was one small tumor on 1 lymph node. Since my surgeon had to remove so much scar tissue from a prior biopsy (removal of cysts)along with the tumor, she recommended a mastectomy because I would lose so much breast in total if I had a recision. I had my mastectomy 11 days after the lumpectomy. I don't know why you need another biopsy. Maybe they want to make sure there's nothing else in another part of the breast??? I would ask your surgeon why so you'll be more comfortable about what they're doing.

Deb

disneyfan2008
Posts: 5504
Joined: Oct 2010

I have two friends who had to have it re-done..for same reason..

I"ll check back for update...wishing you the best

Denise

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

I had my biopsy dec. 15th, the surgeon removed the 2.5cm tumor and tested for margins at the same time. When I awoke he said positive for cancer and hopefully got it all, but won't know till the long term 5 day biopsy.......Then that showed unclear margins so I had re-incision dec. 27th with lymph nodes....then got another call stating still positive and need another reincision, I had that on Jan. 7th....
My girlfriends mom just had the same reincisions!! I don't think it's uncommon at all..
All is good now!

I'll be including you in my prayers for peace and healing!!
Hugs,
Joyce

survivorbc09
Posts: 4378
Joined: Jun 2009

As everyone else wrote, this happens a lot. I was also checking to see if there was an update inre to when it might be scheduled. Let us know and wishing you good luck.

Hugs, Jan

Pink Rose
Posts: 495
Joined: Nov 2012

I had a friend that had to have more surgery as she didn't get clean margins. And, I think this happens more than we think.

Good luck

Kathy09's picture
Kathy09
Posts: 99
Joined: Jun 2009

I had three lumpectomies to get clear margins, surgeon told me if there is a fourth....its going. All is well for now.

Angie2U's picture
Angie2U
Posts: 2993
Joined: Sep 2009

Did you have your 2nd surgery yet, or, is it scheduled?

Thinking of you,

Angie

tanase914
Posts: 1
Joined: Oct 2012

Sorry to hear about your situation. I would suggest to find a better surgeon.
I do not have breast cancer but my mother does. Shes getting her second surgery now after lumpectomy in april and 5 months of chemo. Never lose hope. Livestrong!

Lynn Smith
Posts: 1265
Joined: Mar 2011

I had a clear margin surgery.When I went in for my 2 week follow up my doctor said Good news and Bad News.I got all the cancer but want to go back in and check margins.Well I was hesitant but if any doubt all isn't gone and to MAKE SURE I wanted it done.Glad I did because 2 days before the clear margin surgery I felt something.Got in the prep for surgery and showed my doctor.He said we will see when he goes in.It was a benign tumor.I was thinking in my mind fluid from the first surgery.

You always here it spreads when they go back in but mine was non invasive where it was.I felt OK going back in but still some apprehensive thoughts in the back of your mind.But what can you do.It must be needed.

Lynn Smith

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