Mx or third excision?

Hello All
I had WLE and ANC on 7 Feb, followed by second excision on 7 March. Unfortunately the second shave still didn’t get clear margins and I’ve got to decide whether to have a third excision or just to go straight to a mastectomy. At the moment they are not pushing me one way or the other, but I know that they are keen to get on with chemo, as I had Grade 3 IDC and 2 positive nodes.
At the moment I’m leaning towards giving it a third go, and then if that doesn’t work it’ll definately be a mastectomy and I think I will be able to accept it better.

I just wondered if anyone else had been in a similar situation, and/or have had 3 excisions.

I have only had one go… but I know they went back in on the first op and took more as margins were not clear. I think you may want to weigh up whether you want to keep your breast and how much of it will be ‘gone’. I think about 3 and a half oz of mine went so one is a quarter smaller than the other - which doesn’t worry me. If you are leaning towards a third go then go for it… at least you’ll know you gave it every try. If they aren’t pushing you then it’s not a crucial decision and you can decide. My first reaction, on dignosis, was for them to ‘take everything away’ (the whole breast) and if i’d gone that route then all to the good - but the surgeon persuaded me it wasn’t necessary so I took the advice. Good luck to you with your decision and let us know.

Hi ya, I’m sorry you are in this position it’s a tough decision to make. I had lumpectomy and didn’t get clear margins so surgeon wanted to go back in and tryagain. I asked why he didn’trecommend mx and he said I didn’t need one. I had second op and didn’t get the margins so I had mx. I believe that if he had gone in a 3rd time I would have lost a large section of tissue and would look lopsided. I feel long term the mx was the best option, but I would have always wondered if I would have been safe. Mx is a longjourney and I will have to wait a long while for reconstruction, and will no doubt involve further reconstruction on the other breast. You must that know whatever decision you make is the safest one long term for you.
There are fillers that can be used to reconstruct the breast tissue if you do decide in the 3rd op, so if you do go down that road maybe it will be easier for you to deal with. I was just eager to start my chemo because by having the ops and then waiting for results were tough. I wasdiagnosed 20th Sept and had final mx 20th Dec, currently half way through chemo and will have rads 23rd May, I just want this all over as quick aspossible.
Good luck
Maggie x

Have you seen your path reports? These should tell you how much they cut out altogether and what margins they got right the way round the tumour. What has your surgeon told you ?

I had a lumpectomy followed by a cavity shave. The shave was needed because although all the margins were clear, one of the sides was only clear by 5mm which isn’t enough. I only knew this when I saw the path report after the lumpectomy and was able to ask the surgeon exactly how much more she would be shaving off. It may be that your shave got clear margins but just not wide enough??? I hope you have enough information about this before you make your decision.

Linda xx

Hi… just to put an alternative view, I opted for an MX rather than lumpetctomy because there was a possibility that I’d need one in the end anyway, and it had spread to lymph nodes already. For me, it reduced the risk of recurrence. When I had the surgery, there was a lady oposite on her third op and it was more painful because they had to keep cutting into scar tissue. I’ve not had recon, as I don’t feel I need it, or want more surgery, but the mx itself was a doddle.

However, you DO need all the information to make your decision, and it’s a decision you have to be happy with “forever”, and it has to be the right time for you. If you would feel better having done everything you could to avoid mx, that’s important. For me, risk was the trump card, but it was very clear which way my surgeon was steering me (whilst giving me the choice), and I followed his lead. Yours don’t seem to be giving you that steer…

Bless you - hard decisions!


Hello everyone, thank you so much. I’ve been turning if over and over in my head since Friday, and it really helps to hear from other people what their experience is. Family and friends are great, but most just think I should get on with it, and things like whether I will end up with any nipple sensation are not very important to them!
Linda, I’ve not seen the latest path report, I was so stunned that I didn’t think to ask. Last time there were clear margins all round except for one area and its near the bottom edge of my breast. They only took 37 grams the first time round and I think probably similar second time, but I have quite small boobs to begin with.

Maggie, sounds like similar situation. And timescales are about the same, I found my swollen lymph node in Dec, so hence the anxiety to get on with it. Thanks for the reminder about fillers - I’ll ask about that.

Toriaconey, like you I’m not so bothered that right breast is smaller, though when facing the first op I didn’t think that. Amazing what you get used to.
You’ve all given me a bit more food for thought and useful things to discuss with the consultant this week.

Jane, that’s exactly what I’m grappling with, the ‘forever’ decision - nicely put.

Warm hugs.


let us know how it goes Deborah

Jane x

Hi everyone, I’ve decided to go for a third excision and am booked in for 11 April. If it doesn’t work this time, then at least I’ve already worked it through in my head so I’ll be more prepared for the Mx if needed.
Thanks again for all the advice!

Hi Panacea Good luck with your third excision! I have been lurking at your post as I find myself in a similar position. I have had two excicions and awaiting results which I get Thursday to see what the next plan will be. I hope all goes well this time round and they get the little blighter!! Good luck.

Good luck Deborah. For what it’s worth, I would have made the same decision. My surgeon told me they are only supposed to do these cavity shaves if they are confident they can get wider margins without too much deformity of the breast. I don’t know if that is also the case at your hospital of course, but it probably is general. Fingers crossed for you xxxxxxxxx

Hello Everyone
Just thought I should let you know that I had my third excision last Monday, and I’m hopeful and optimistic that it will have worked this time. Thank you so much for all your support. I feel very happy that I’ve opted to do it this way, and if the worst comes to the worst I will feel that we’ve given it our best shot. I get my results on the 19th.

As I felt so unwell after the second op, and ended up staying overnight, and my nurse suggested I could be sensitive to morphine. I discussed it with the anaesthest and he gave me fentanyl instead and I had a much quicker recovery and felt more ‘normal’ afterwards. He came to see me afterwards and thanked me for letting him know! Another lesson for me in speaking up about things.

Spookymoo, how did you get on? What’s next for you?

I’ll be starting chemo now either late April or early May.