4th Re Excision or Mastectomy?

Hi Ladies,

I’m new and was hoping to seek some advice…

I was diagnosed with Paget’s Disease and high grade DCIS back in September. After 3 breast conserving operations I still have one margin not clear, Paget’s has gone though. My Consultant has advised he can’t guarantee a good cosmetic result for 4th re excision and as before there is no guarantee it will remove the DCIS. He thinks a 25% chance of success and but will do the operation if I want to. He’s asked me to consider a mastectomy and I really don’t know what to do. I’m angry I’m even in this position as I sought help for 2yrs for my symptoms but was not taken seriously. I’ve saved my life by no taking no for an answer but now have to live with the consequences of this negligence.

DCIS is a funny one, I feel on the fraudulent side of cancer and relieved I don’t have invasive cancer. The treatment now being suggested is really harsh and something I’m struggling to get my head round though.

Has anyone else had a 4th re excision? Was it successful? Has anyone had a mastectomy with direct implant reconstruction at the same time (no need for expanders) Were the results good? I’m 38 and have a slim athletic build. Tissue reconstruction does not appeal because of scarring to other places and weakened core/back muscles which I need for yoga. I’m not brave enough either so fair play to anyone who has done this!

I know I’d end this quicker with a mastectomy rather than another re excision and follow up radiotherapy. The delay in getting radiotherapy because of the result waiting times and numerous surgeries is a concern as I’d be over the recommended 12 week time frame to get radiotherapy after surgery. On the other hand I feel like I’m giving up if I go for the mastectomy and would be upset to know if I had gone for the 4th op it would have worked once the results are back. I’ve also to date recovered fast from surgery and found the process straightforward and pretty much painless.


I’m trying to get perspective on this and take it back to what made me physically sick with my diagnosis - being terminally ill, the cancer in numerous places and having chemo were the top ones. None of these are in the mix right now so I have to be positive. For all the ladies getting treatment for invasive breast cancer I’m in awe of your strength.


N x

Sent from my iPad


First of all welcome to this lovely forum, where I know you will find support and help in making this tough decision. I’ll give you my story in case it helps. I had IDC, some DCIS and node involvement - I also have small boobs so I didn’t have the option of a lumpectomy and had a mx in 2017 and I had an immediate recon. I’m also fairly small and scared of big ops so wanted a recon but couldn’t face the tissue ones. My surgeon did a “pre pectoral” implant (on top of the muscle) and wrapped in a Braxon sling (google if you’d like more details) because it was a simpler operation, supposed to be less risky if having radiotherapy after and good if you are sporty. I think those were some of the reasons, it was all a bit of a blur at the time! My boobs aren’t symmetrical but I have got used to my “new normal” and just glad to be rid of the tumours.

Please feel free to ask any more questions if I can help in your decision making. Sending you big hugs.

Evie xx


I don’t know if you have made a decision yet, but just to let you know that I had a 4th re-excision recently and it was successful .

…I’m glad that I persevered as like you I always recovered quickly

 If you have any questions I’m here xx