unclean lunpectomy margins, 2nd surgery?

Options
island girl
island girl Member Posts: 4
edited March 2014 in Breast Cancer #1
Hi everyone, I was diagnosed with stage one DCIS 3 weeks ago. I had a lumpectomy but now I have to have another surgery because two margins were "dirty." I am worried. Has anyone had this situation?

Comments

  • Jadie
    Jadie Member Posts: 723
    #2
    Options
    2nd Surgery
    Hi island girl

    I think that you will find this quiet common among us breast cancer survivors. It means that they did not take enough tissue from around the tumor. So they will have to do another surgery to take more tissue so they can be sure to get "clean" margins or tissue that is clear of any cancer cells. I also had to go back and have the second surgery. It was a bit more painful than the first surgery probably because I wasn't yet healed. I also had to have more nodes removed.

    You are very fortunate to have caught it so early. Take care and please keep us posted as to how you are doing.

    Jadie
  • mmontero38
    mmontero38 Member Posts: 1,510
    #3
    Options
    Hi Island girl, I didn't
    Hi Island girl, I didn't have your circumstance as I had a mastectomy, but it isn't uncommon for that to happen. I've known a few women that had to go back to remove more tissue because the margins weren't clear. It's better to err on the safe side and have them remove as much as needed to make sure that all the cells are gone. What stage were you and do you have to go through chemo? Hugs, Lili
  • cruf
    cruf Member Posts: 908
    #4
    Options
    DCIS
    I also had DCIS and had to return for more surgery. I decided to have a mastectomy and reconstruction at that time rather than worry about any stray cells that may have been left behind. That was 8 years ago and I'm very happy with my decision. Please feel free to e-mail me here and I will try to answer any questions you may have. HUGS!! Cathy
  • cabbott
    cabbott Member Posts: 1,039 Member
    #5
    Options
    Dirty margins
    This is really a very common problem. The surgeon needs to get clean margins to make sure that all the cancer in the area is gone. There is no way that the surgeon can "see" all the cancer cells when they remove a lump. After all, a cell is very very small. They ink a side or two of the lump to mark its orientation when they do surgery. Then the pathologist carefully examines all the edges to make sure they are clean. Often they are not. That means that the surgeon needs to go back and redo an edge or two. Sometimes a second surgery is all that is needed to "clean up" the area. Sometimes I have even heard of them doing a third surgery to make things right. If they don't feel that this can be done and give acceptable cosmetic results, they will discuss the need for a mastectomy and all the options and decision making that goes along with that. At this point though, I would probably go with a second surgery to clean up the margins and hope that this time the surgeon is pleased with the path report. They are fussy because they care about your health. Let us know how it goes.

    C. Abbott
  • Rose trémière
    Rose trémière Member Posts: 7
    #6
    Options
    2nd surgery
    Dear Island girl

    Hi. This happened to me and to my best friend. I believe that it is a common problem. No need to worry. It means that your doctor is extra careful and wants to make sure that he has done a thorough job. After my 2nd surgery (which went well), my margins were still not clean. I considered having a 3rd surgery or having my breast removed. My doctor told me that with radiation therapy and Tamoxifen, it is the same as if I had a mastectomy. He felt confident. I could live with that. So, no 3rd surgery. Everything is fine, two years later. My friend is also doing very well, 4 years after her 2nd surgery.

    Take care
    Gisele
  • KathiM
    KathiM Member Posts: 8,028 Member
    #7
    Options
    I send my hugs
    Nothing to add....my surgeon was, if anything, overly cautious the first round...I had just successfully battled cancer 6 months earlier in my colon.

    Hugs, Kathi
  • island girl
    island girl Member Posts: 4
    #8
    Options
    cruf said:

    DCIS
    I also had DCIS and had to return for more surgery. I decided to have a mastectomy and reconstruction at that time rather than worry about any stray cells that may have been left behind. That was 8 years ago and I'm very happy with my decision. Please feel free to e-mail me here and I will try to answer any questions you may have. HUGS!! Cathy

    dirty margins
    Hi, Thank you for replying. I have been offline for a while, my computer was in the shop. My margins were still unclean after the second surgery. I am going back a third time on Tues.. My surgeon said I will need a mastectomy if this deos not work but he wants to try because the amount of "dirt" is very small. Did you have chemo or any treatment after your mastectomy? HUGS Sue
  • island girl
    island girl Member Posts: 4
    #9
    Options
    Jadie said:

    2nd Surgery
    Hi island girl

    I think that you will find this quiet common among us breast cancer survivors. It means that they did not take enough tissue from around the tumor. So they will have to do another surgery to take more tissue so they can be sure to get "clean" margins or tissue that is clear of any cancer cells. I also had to go back and have the second surgery. It was a bit more painful than the first surgery probably because I wasn't yet healed. I also had to have more nodes removed.

    You are very fortunate to have caught it so early. Take care and please keep us posted as to how you are doing.

    Jadie

    dirty margins
    I now have to go back for surgery again because they were still dirty. I hope the third time is a charm!
  • island girl
    island girl Member Posts: 4
    #10
    Options
    cabbott said:

    Dirty margins
    This is really a very common problem. The surgeon needs to get clean margins to make sure that all the cancer in the area is gone. There is no way that the surgeon can "see" all the cancer cells when they remove a lump. After all, a cell is very very small. They ink a side or two of the lump to mark its orientation when they do surgery. Then the pathologist carefully examines all the edges to make sure they are clean. Often they are not. That means that the surgeon needs to go back and redo an edge or two. Sometimes a second surgery is all that is needed to "clean up" the area. Sometimes I have even heard of them doing a third surgery to make things right. If they don't feel that this can be done and give acceptable cosmetic results, they will discuss the need for a mastectomy and all the options and decision making that goes along with that. At this point though, I would probably go with a second surgery to clean up the margins and hope that this time the surgeon is pleased with the path report. They are fussy because they care about your health. Let us know how it goes.

    C. Abbott

    dirty margins
    Well they were still dirty. Hopefully the third time will be a charm!
  • cruf
    cruf Member Posts: 908
    #11
    Options
    island girl said:

    dirty margins
    Hi, Thank you for replying. I have been offline for a while, my computer was in the shop. My margins were still unclean after the second surgery. I am going back a third time on Tues.. My surgeon said I will need a mastectomy if this deos not work but he wants to try because the amount of "dirt" is very small. Did you have chemo or any treatment after your mastectomy? HUGS Sue

    DCIS
    Hi! I'm sorry you have to go thru all this. I only had lumpectomy but because the margins weren't clear the 1st time, I decided to have a mastectomy and reconstruction. I was given a choice but that is how I went. I'm very happy with that decision and never questioned it! I did not need chemo as it was stage 0 and DCIS is a noninvasive BC. Because I had the mastectomy, I didn't need the radiation either. I'm now 8 years out and doing well! Good luck and if you have any questions, feel free to e-mail me here. HAPPY HOLIDAYS!!!!!!!! HUGS!! Cathy
  • mmontero38
    mmontero38 Member Posts: 1,510
    #12
    Options
    island girl said:

    dirty margins
    Hi, Thank you for replying. I have been offline for a while, my computer was in the shop. My margins were still unclean after the second surgery. I am going back a third time on Tues.. My surgeon said I will need a mastectomy if this deos not work but he wants to try because the amount of "dirt" is very small. Did you have chemo or any treatment after your mastectomy? HUGS Sue

    Hi Sue: I went through 8
    Hi Sue: I went through 8 rounds of CAF which is cytoxan, adriamycin (the red evil) and 5FU every 3 weeks. Probably one of the toughest things to have to go through but I made it and should you have to have chemo, you will too. We will all be here for you. Hugs, Lili

Discussion Boards