More surgery following lumpectomy, anyone had same?

I had a lumpectomy (16mm tumour) and Sentinel node biopsy on 26.9.08 - great result that lymph nodes are clear but have to have more surgery 16.10.08 as margins were not clear (showed pre cancerous cells). Has anyone else had this, do they make another incision or undo stitches - i’m a bit squemish!! (even though I’m 49 and have had two births!)

This is a wonderful site and I feel stupid asking such pathetic question when I read what other women have to go through - but its great knowing there is so much support out there.

Hi Sue,

I had a lumpectomy, they didnt get clear margins but had to have mastectomy and recon. They opened up part of the old scar and extended it and its healed as well as the first time. (well that part has!) They wont ndo stiches as the stiches will have dissolved by then, i think they just cut through the old wound site.

I had a segmental mastectomy after lumpectomy. they opened the same scar and cut out a further quarter or so of my breast, it’s noticeable as my breasts are small. My nipple has moved towards the place the scar was so it doesn’t face in the same direction it did. I doubt anyone else is going to be as fed up with it as I am though as people don’t go around looking at whether your nipple is in the middle or not

Big thank you Louise and Molennium for answering my question. I guess I was lucky as I had my op on Thursday and they just opened up and took another two slices of tissue from the area the DCIS was found. I get the results on Wednesday. I am seeing the Oncologist on Friday as I am to have 8 chemos, then rads then Herceptin - and Tamoxifen. Are you ladies having ongoing treatment? Have been told I will loose my hair but not so bothered about that as having an IV put in every three weeks - hate needles! I am currently surfing the web to look for wig shops, at least with it being winter I can wear beanie hats!

Good luck ladies, and Molennium sorry to hear that you are feeling down about the place of your nipple. Think possitive, you still have the nipple, easy for me to say tho.

Take care

Hi Sue
My experience was very similar to yours - I’m 43 and last year I had a WLE but clear margins not achieved. So I had a re-excision but there were still areas of DCIS around the perimeter of the. The surgeon told me the next step was a mastectomy, but I asked if he’d consider trying a third WLE. He ummed and aahed but agreed to do so - and this time got clear margins. I do have a hollow in the lower part of my cleavage but wear ordinary underwired bras and and no-one would ever know. My nipple didn’t change position, but obviously that depends where the operation site is. Asking for a third op was definitely the best thing for me - but I know others would want the whole thing off for peace of mind. Because I didn’t have a mastectomy I had rads too. My chemo started about a year ago, and finished in january - I’ve got loads of hair back and am trying hard to move on. Still look at this site tho!!!
Good luck with your next stage of treatment - you’re right about it being a good time of year when everyone else is wearing hats too!
Best wishes
Tracey x

Hi Tracey
Many thanks for your message, must admit I’m trying to think positive about the results but glad that you have mentioned going for a third WLE - I’ll push for this too if results come back with DCIS.
I think its great that you take the time to come back and look at the site as its thanks to positive people like you that keep us newcomers spirits up!
As I mentioned, I really do hate having a canula put in and am dreading this more than the side effects of chemo, and now I have read that Herceptin is put in intreveniously as well! Still nothing else for it - a friend said that prehaps I can ask for the cream that numbs the area before hand. The thing that keeps me strong is that I am lucky, think of the poor children that get cancer and have to have treatment - if they can be brave then so can I.
Thanks again Tracey, and do move on - I jobshare with an amazing woman who had BC 10 years ago (aged 45) she had a radical mastectomy and total node clearance, and is a prime example of think positive and just get on with life.
Take care
Sue x

Please let us know how you get on - you sound like you’re feeling strong which can only be a good thing.
The canula insertion for chemo was ok - they try and choose a different site each time, and put your hand in warm water to dilate the veins. The anaesthetic cream is called Emla and you can buy it over the counter - but you have to put it on an hour before the procedure and if you don’t know where they’re going to put the needle it might not be much use!
If you’re really unhappy about it you could ask for a permanent line like a Hickman. which is left in. I didn’t have it but I’m sure there are others on here who could advise. I didn’t have herceptin so can’t help with that.
Last year seems like a bad nightmare - and when I think I’m doing well something comes up and reminds me and I’m back dealing with it again. For example I went to a beauty salon last week, and on the registration form had to fill in medical history. I wish I had omitted the BC stuff because there was then a problem with whether the salon would do a massage because of the medical issue. Eventually they did - but it just seems to infringe on so many aspects of my life.
Anyway I went back to work in April - having been off sick since diagnosis - even though I felt really well on chemo I just couldn’t face going to work emotionally.
I am back to full duties, doing everything I did before - I’ve booked a holiday to Florida next year and have found that I really appreciate things that I took for granted before.
When does your chemo start?
Keep us updated!

Tracey x

Hi Tracy,

Just in from appointment with surgeon for results of 2nd surgery and, guess what, margins still not clear! I am so pleased that you took the time to reply to my original post as I know you have gone through the same, so in a way I think I was slightly prepared for it. He said he will go back in and do a wider excision - as he pointed out I have enough breast tissue for them to take another chunk out! He is a lovely man and has each time moved tissue around to try and keep the shape of the breast - so 3rd op (24.11) and keeping the breast! I was due to see the oncologist on Friday but think this will be put back a week or so.

I’m a little frustrated because I would like to know when the chemo will start so I can make some social plans!

Anyway, glad to hear that you are back to doing what you did before, I’m sure the beauty salon were just airing on the side of caution - annoying all the same. And lucky you going to Florida - you deserve it!

I’m not intending working during chemo either - I work in a university and have a lot of contact with students who are disabled - its quite an emotionally demanding role so have been advised by the “team” to concentrate on myself.

Thanks again Tracey, your comments really helped today.

I’ll keep you posted!

Sue x

Sorry they didn’t get clear margins - you must be disappointed. I’m glad that my experience has been some help though. I too was worried about delaying the chemo because of more surgery - but as my nodes were clear my onc wasn’t worried about another couple of weeks. Have you had node clearance too?
As I said I was actually very well throughout chemo and didn’t have any problems other than succumbing to a couple of awful throat infections when my immune system was battered. Losing my hair was by far the worst side effect I found it really traumatic - and although I’ve got loads back I hate it being short. I did invest in a really good wig, but still felt very self conscious. Luckily I kept my eye brows and most of my lashes which helped me to feel that I looked ‘normal’!
My boys aged 7 and 5 at the time soon got used to seeing me bald, but I never got used to seeing myself like that!
Hope you get on ok with the onc on friday
Tracey x

Diagnosed 2 weeks after all clear from LCIS on other side 5 years ago. I have had 6 WLE. Each op I think is the last one but they can’t get clear margins. Had last op 10 Oct and won’t get results until 6 Nov. If this is finally clear, I’ll have radio for 6 weeks; if not clear then it’s a mastectomy. I have DCIS / invasive HER2 = grade 3. Having had LCIS 5 years ago my bcn suggested I think about a double mastectomy. Any ideas?

i had a lumpectomy and sentinal node biopsy on 7th Oct. Had results today and like you Sue there were’nt clear margins so gotta have more surgery on 4th Nov. If that does doesn’t work then a mastectomy. Nodes were clear thank heaven but hate the thought of having more surgery. I’mm still getting over the last one.
Take care

Hi Tracy

Thanks to you I have been kept possitive about my results coming back with unclear margins. I had the surgery on Friday and await the results next 31.10. I saw the onc dr - what a lovely man - really approachable, came to see me after I had come round from surgery at 9.00pm and stayed for an hour giving me information and answering our questions, and all from the comfort of my bed! He has confirmed that I will loose my hair, sorry you found this so traumatic - at the mo I feel ok about it, but then it hasn’t happened yet! Yes, my nodes were clear so that was fab news. Hope to start chemo on either 21st or 28th November - would like 28th then I will have Xmas and new year free, but downside my 50th (I only feel 20!) birthday is on Friday 3rd April, and I would be due my 7th on that day! - Going to ask if it could be done on the Monday instead. - Pls keep in touch, you keep me going! Sue x

Hi shelaghc
So sorry to hear about you getting bc a second time - you poor thing 6 WLE. I think it would be a good idea for you to start a new comment re double mastectomy as there will be more ladies out there who have been in the same boat and will be able to offer you support and advice - they may not read this post. Good luck and fingers crossed for clear margins.

Hi veggibab
Don’t be worried about having more surgery - I was but it has not been a problem and I have recovered really quickly, quicker than the first op. As you will have read, I have just had my third op to try and get clear margins. Also Tracy’s surgeon was going to do mastectomy after second unclear margins and she asked for a third try - I think you should do the same - really it is quick surgery and you will feel fine after. Let us know you results and again fingers crossed for us all to get clear margins!

To give you all a laugh - my youngest son (20) workes in Holland and on the phone I said that if unclear margins this time I may have to have a mastectomy - he said “dont worry mum its not as though you want more children” I explained that mastectomy is breast removal and he said “oh I thought it was like a vasectomy”!!

Sue x

Very worried to hear that you had chemo for DCIS. I have been diagnosed with this and all info I have been given says they dont give chemo for this, so I havent factored it in to my recovery so to speak.
Hospital havent mentioned it so far, but then I have found unless I actualy ask a question I dont get told

I had invasive cancer as well as DCIS but low grade and oestrogen positive, no lymph node involvement and certainly chemo wasn’t suggested as it would have been of marginal effect on my risk of recurrence. However maybe the kind of cancer Sue had was higher grade, more likely to recur and not oestrogen receptive. I’m glad I didn’t have chemo but each woman’s cancer is different.


Hi Horsemad

Please don’t worry - Mole is right, I’m not having chemo because of DCIS (this only showed up around the margin of the tumour).

The reason I am to have chemo is because of a number of factors - 2cm+ tumour, Grade 3, my age (49) and because HER2+ is an agressive type of cancer, which is why I’ll also get Herceptin. Chemo is being used as a “belt and braces” treatment - to try and make sure the cancer does not return.

I have gained a lot of support and picked up a lot of tips from the forums, but try and remember that everyone’s treatment is different and is related to their particular diagnosis - the experts are your surgeon, breast care nurse and oncologist.

Hope this has helped.

Sue x

Me again, forgot to say get my results from 3rd op today - so fingers crossed for clear margins.

Sue x

Good luck Sue


Thanks Mole - your luck worked! Yipee clear margins at last!

Have done a deal with oncologist - he wanted me to start chemo on 7th Nov - but I have a ladies night for BC to go to so no can do! I wanted to start on the 28th - so I would have Xmas and New Year week free - no can do as too late, so I am having a Portacath inserted on the 20th and start chemo (E-CMF) the same day.

No doubt I will be moving onto the “having treatment - chemotherapy” section if I have any questions, but will still visit here to keep in touch.

Did you have radiotherapy? Are you on Tamoxifen? Am I too nosey!

Sue x

Fantastic news Sue - I bet you’re so pleased. Now onto the next challenge - I didn’t have the same chemo regime as you’ll be having - but hopefully you’ll sail through.
Where in the country are you? Are you going to sort out a wig etc soon? If your local hospital does a Looking Good Feeling Better session, put your name down. It’s a great couple of hours and you get an amazing bag of cosmetics to take home. I used my Dior blusher today which I got in my goodie bag last year!
Enjoy your ladies night
Tracey x

Hi Sue

Congratulations on your clear margins. I had my first cavity shave yesterday and am very sore. Sore book than last time.
Asked my surgeon about having a second cavity shave before a nmastectomy after your woderful advice on here and she said she’d be willing to consider it depending on the lab results.
Thanks for the advice.
Hope you are all ok.
Love Veggiebab