Margins are Not clear...Lump...Mact or Bil Mact...What to do...

sohardbnme

I have to decide after chemo, if I want another lumpectomy, mastectomy or bilateral mastectomy... I have some time to decide because I just started chemo Monday... Nevertheless, I want to weigh my options... I am considering removing both breast and using abdominal tissue...

Here is my treatment journey so far... I welcome any input...

May 24 - Went to a GYN appointment for uterine fibroids and doctor found lump.

June 2 - Breast ultrasound and Mammogram, discovered two clusters of micro-calcifications in left breast

June 9 - Met with Breast surgeon, she gave referral for biopsy

June 16 - Stereotypic Biopsy

June 21 - Diagnosis: 06/21/2010, DCIS, Grade 3 & IDC, Stage II, Grade 2, PR+ HER2+ER+

June 30 - Lumpectomy, 2 cancerous lymph nodes removed

July 7 - Pathology report stated 11/13 positive lymph nodes; in addition, my margins are not clear.

July 14 - Met with medical Oncologist, he wants me to start chemotherapy before another lumpectomy or mastectomy surgery to clear margins. He gave me a BCRA test.

July 20 - PET scan

July 22 - PET scan results... 2 additional lymph nodes detected... did not spread past lymph nodes and BCRA test results... negative

July 24 - Muga

July 26 - Port inserted

August 2 - Chemotherapy

August 4 - Zolodex shot

carkris

I have had to say I have
I have had to say I have neverhad a normal course of anything. for such an average person, I get the weirdest things. In 1994 I had my first mastectomy, they had difficulty getting margins, and I had scant but scattered DCIS. however a year later I got a local recurrence. now in 2009 I was looking to get a propholactic mastectomy. I could not take the stress of mammos and biopsies and I ended up with BC in the remaining breast. So I just wish I had done it at the same time as the first go round. I notice that many including young people here do it. but its harder being younger I think. The Braca test should help you decide as it increases your chances of getting it in the other breast if it is positive. The docs can sit with you and discuss risk, percentages and then you have to follow your heart. As for me I wish I had gotten rid of both in the beginning but hindsight is 20/20

New Flower

Welcome
Sorry you have difficult choice. I ddi not have time to think. I underwent radical modified mastectomy (left side) with immediate reconstruction. They did not get clear margins even with radical mastectomy, so I had skin re-exision 4 days after mastectomy. For immediate reconstruction it is better to do both at the same time. On the other hand it will increase your chances of having lymphedema.
Tough choices!!! Take time and make decision that is right for you.
Good luck with your treatment

New Flower

Katz77

sohardbnme
I have hindsite now! I had mastectomy on right side with 18/20 positive, HER and ER and Pr postive, stage3c also. We could be twinkies. I left the left breast. Was freaking out cause the tumor on the right grew from a 1cmish to a 5.3cm in 2 months. To me it was an emergency surgery. Didn't give the left a thought, cause it ONLY had microcalcifations. Well guess who is opting to have it removed? ME. Micros are, to me tiny bombs waiting. Esp for a high risk person. I wish I had known this at the time of the other mast. Oh well, like I said hindsite is wonderful. It is after all your decision. I did ask the onc what he thought and he said good idea. Made me laugh cause I thought I was being over paranoid. Good luck with ur decision. Keep me updated since we're twinkies. Would like to know. Katz

Heatherbelle

checking in
Hi Rachel Checking in with ya -been having a busy weekend here. How are you feeling? I'm feeling better each day after the chemo, and this Wednesday I get another fill at my plastic surgeon's!
Wanted to see how things are going with you!
*hugs*
Heather

NDY2010

Katz77 said:

sohardbnme
I have hindsite now! I had mastectomy on right side with 18/20 positive, HER and ER and Pr postive, stage3c also. We could be twinkies. I left the left breast. Was freaking out cause the tumor on the right grew from a 1cmish to a 5.3cm in 2 months. To me it was an emergency surgery. Didn't give the left a thought, cause it ONLY had microcalcifations. Well guess who is opting to have it removed? ME. Micros are, to me tiny bombs waiting. Esp for a high risk person. I wish I had known this at the time of the other mast. Oh well, like I said hindsite is wonderful. It is after all your decision. I did ask the onc what he thought and he said good idea. Made me laugh cause I thought I was being over paranoid. Good luck with ur decision. Keep me updated since we're twinkies. Would like to know. Katz

Mastectomy ? For Katz77
Were you actually given the option to have the left breast removed too? I'm asking this question wondering if the surgeon would even consider removing a supposedly "healthy" breast and also would your insurance go along with that option too? I agree hindsite is so wonderful now that we have acquired so much more knowlege about breast cancer.

I just joined this board in Aug and am not familiar with how to make a personal contact with another participant but if you read this I would like to discuss more of your cancer story (herceptin experience, arm care, etc) . My cancer sounds so close to yours (stage 3C, Er+PR+HER+, 10 nodes out of 13 positive. I did add you to my "friend" list (not sure even what that means tho). A also note that on your profile that you're in the medical field. My profile is mostly missing since I was never prompted for all those profile questions & even when i hit edit, i still never get asked so I don't have a profile on here just yet.

Sohardbnme, Back to you----I hope you will find the right solution to your dilemma too. Getting the best medical advice is certainly the key to making an informed decision.

Jean 0609

Hey there!
This is a decision only you can make. I had a lumpectomy in March. My margins weren't clear. I was then given the decision to have another lumpectomy and then radiation, or a mastectomy. I opted for the left mastectomy with immediate reconstruction (tissue expanders) in May. I think we are on the same chemo schedule. My third was last Wednesday (which I think was your first). I have one more to go. Then I'll be able to schedule my exchange for my permanent implants. I was also HER+ so I have to do Herceptin for a year. Sending thoughts & prayers your way to help you in your decision. Hang in there and keep us posted. Hugs, Jean

sohardbnme

Jean 0609 said:

Hey there!
This is a decision only you can make. I had a lumpectomy in March. My margins weren't clear. I was then given the decision to have another lumpectomy and then radiation, or a mastectomy. I opted for the left mastectomy with immediate reconstruction (tissue expanders) in May. I think we are on the same chemo schedule. My third was last Wednesday (which I think was your first). I have one more to go. Then I'll be able to schedule my exchange for my permanent implants. I was also HER+ so I have to do Herceptin for a year. Sending thoughts & prayers your way to help you in your decision. Hang in there and keep us posted. Hugs, Jean

Tissue Expanders
Jean,
Thank you for your post...
What are tissue expanders?...

After chemo, I will have to decide on what procedure...Then radiation...
Lastly, reconstruction...

sal314

Sorry for What You're Going Through...
It's such a hard decision that only you can make. It's so good that you are taking your time to consider all your options. All I can tell you is go with what your gut tells you and what you think will give you the most peace.

I had a lumpectomy almost nine years ago. My doctor ended up having to take much more tissue than he thought he would to clear the margins. I lived with half a breast for about 5 years and then finally decided to get it fixed. I had a mastectomy and latissumus flap reconstruction with an implant in 2006. I'm really happy with the results and looking back, wish I would have just done that originally. I decided that if something every appears in the other breast, I'm gonna just remove it and have reconstruction. No more messin' around. It's too stressful!:)

Blessings,
Sally

Jean 0609

sohardbnme said:

Tissue Expanders
Jean,
Thank you for your post...
What are tissue expanders?...

After chemo, I will have to decide on what procedure...Then radiation...
Lastly, reconstruction...

Tissue expanders
Tissue expanders are like a balloon. They are put under the skin to stretch the skin after a mastectomy. Then you visit your plastic surgeon and they will inject saline into the expanders to expand them. Like blowing up the balloon. You may feel tightness after the saline, it depends on the person and how much is put in. Lucky for me, I felt no pain. Then once they get to the size you want, they remove the expanders and replace them with implants. I'm finished with the saline, however, have to wait until after chemo to have my implants. Hope this helps.