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I don't understand margins

Dakota128's picture
Dakota128
Posts: 14
Joined: Dec 2012

This is the second posting I have done, the first one was Wondering and I still don't understand what my local breast surgeon meant when he said he couldn't do the surgery because I had no margins or enough tissue for him to work with because I had bilateral breast reduction. I was a 46DD and now I'm a 46B..
Can someone please explain in layman's terms if you can?
I'd appreciate it...

Sincerely
Dakota aka Deborah

RozHopkins
Posts: 458
Joined: Dec 2010

Sorry I didn't have the margin problem so hoping a few of the other ladies will step in. Guessing they need to know exact cancer affected areas before planning where and how to treat. The tissue comment as you are large breasted don't get.

disneyfan2008
Posts: 5332
Joined: Oct 2010

I do not understand any of this either...

Denise

carkris's picture
carkris
Posts: 4523
Joined: Aug 2009

ok I will try again my post did not go through. When they do surgery they want an area around the cancer that is clear of cancer. I dont understand why a B would not be enough, but perhaps with the reduction they took a lot of tissue from that area? I would get a second opinion and ask them to explain exactly what they mean.

carkris's picture
carkris
Posts: 4523
Joined: Aug 2009

ok I will try again my post did not go through. When they do surgery they want an area around the cancer that is clear of cancer. I dont understand why a B would not be enough, but perhaps with the reduction they took a lot of tissue from that area? I would get a second opinion and ask them to explain exactly what they mean.

ksf56's picture
ksf56
Posts: 203
Joined: Apr 2012

I can only tell you about what I went through and alot of ladies have this happen. When I had my first lumpectomy, they hadn't gotten enough of clear margin around the tumor and I had to go back for surgery. The second time around they were able to get a large enough clear margin. I was a 36B at the time but my tumor was small. I'm wondering about the size of your tumor - how large is it? When they take the tumor out they have to get a certain amt. of non-cancerous tissue surrounding the tumor out also to meet the correct criteria. I think you better find out what the surgeon means.

I wish you peace!
Karen

Rague
Posts: 3297
Joined: Aug 2009

What type (DCIS/LCIS/IDC/ILC/IBC) BC?

As I understand it very simplistically - margins are sort of like the hull/covering on a seed. While it is still a non-growing seed it has a good 'margin' around it so it is, in effect, encapsulated within itself. When it starts to sprout it puts out roots which spread to the surrounding soil. So in effect when there are good margins, it is not invading the surrounding tissue and can be gotten out intact. When no good margins it is invading surrounding tissue also so not a 'seed' but spreading roots. Does that make any sense to you at all?

THis is why with IBC (Inflammatory Breast Cancer), chemo has to be done first. IBC does not form as a 'lump' but rather as nests or bands with no clear distinct 'edge'/margins. The neo-adjuvant chemo (chemo before surgery) is used to try to shrink it and get margins so the surgeon has a chance of getting it out. I have seen recently others besides IBCers are sometimes being give neo-adjuvant chemo but not sure the reasoning on it with them.

Not sure what he meant by 'not enough tissue' unless that is because it has spread to surrounding tissue. My best suggestion would be to call the Dr and talk to him (or his PA or RN) for what he meant. Are you scheduled to see a chemo Dr?

Was anything mentioned about node involvement? Or if the scar tissue, from the reduction, is involved? I don't know about the potential for cancer to spread into scar tissue and how it has to be handled but I do know that infections in scar tissue have to be handled differently than in 'normal'/healthy tissue. (OT but many years ago I had a horse who got an infection within a large scar area and he had to go on human anti-tuberculosis meds to fight the infection as they allow the anti-biotic meds to 'get into' scar tissue to fight the infection.)

If you don't understand something keep asking them to explain til you do understand.

Winyan - The Power Within

Susan

cinnamonsmile
Posts: 1049
Joined: Dec 2010

I believe she posted in another spot that she has DCIS.

Gabe N Abby Mom's picture
Gabe N Abby Mom
Posts: 2415
Joined: Sep 2010

My situation is a little different, but it may give you another possible explanation. As others have said, talk to your doc again until you understand. You are paying for his services, and that includes education sometimes.

In Jan 2011 I had a bilateral mastectomy w/axillary node dissection on the left. Then in Aug 2011 I had a local recurrence, another surgery to remove that. Now, with yet another local recurrence, there just isn't enough skin or breast tissue left to do another surgery and remove the latest local recurrence. I did ask the surgeon recently if we could remove a rather large area, and have a plastic surgeon do a 'flap' (some reconstruction where tissue is taken from another area of the body, like stomach or back.) The surgeon said it would be possible, but he thought recovery would be difficult and that I would just get another local recurrence anyway.

I'm not a surgeon and haven't examined you, so it's hard to say exactly what your doc is talking about. But I do hope you are able to get the answers you deserve. Best wishes.

Hugs,

Linda

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