Hello, this is my first post here and I have learned a lot from browsing these posts 
I had a lumpectomy on 6/20 with positive margins. I am scheduled for a re-excision lumpectomy on 7/7. I’m wondering if anyone has had similar experience and what the end result was ? I have a lot of precancerous or high risk tissue all over my breast, hyperplasia, sclerosing lesions, etc. I feel like they won’t be able to get a negative margin and I really don’t want to go through a third lumpectomy. Do they then give you an option for mastectomy? And it seems like they only do one side? They won’t offer double mastectomy unless you have cancer on both sides ?
Thanks, everyone.
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Dear Coleitt,
Welcome, we are all here for you.
I’m not medically trained to give advice, however I think you need more reassurance from your team. Maybe contact your breast cancer nurse, she should be available to you and have all your notes available explaining how you are feeling. She can make you another appointment with your consultant if needed, please don’t worry or think your being a nuisance you need to have the best treatment available to you.
Please keep posting to let us know how you’re feeling, wishing you well.
Hugs Tili 
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Hi, its a tricky situation you are in which unfortunately means that some decisions may require your input - we all hope for simple, straightforward but sometimes its not to be.
You say you have a lot of tissue involvement, as you are now post 1st post op, they should have a clearer idea of the measure of it all. Ask your BCN what they estimate the size to be if unclear on this, then its a comparison of size of tissue removed against the size of your breast to begin with.
As an idea, I had 16mm IDC, surrounded by another 1 cm DCIS - so 26mm. Then there was a lateral shave done of 1cm, plus you have the margines in other directions. I could estimate approx 4 cm area in total maybe. Good news in my case is that I really can hardly tell any difference in my E cup boob. This may be also down to position as it was upper quadrant. The aim is whatever plan ends up with the optimum cosmetic effect as far as medics are concerned, however, some people prefer to have a mastectomy to remove all of it regardless of cosmetics. It’s individual what effects your mental health more, which is why the decisions are personal.
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Hi Tili-
Thank you so much for your reply. I really wish I had a breast cancer nurse/navigator. Either they don’t use them or it wasn’t offered to me but now I will ask at my next appointment. I’m going to Dana Farber Cancer Center in Boston. Originally, my first abnormal mammo happened in February of this year, formal diagnosis in March, and then I transferred my care to Dana Farber. But they are soooo busy and have patients coming from all over the US. Each appointment reaches out 3 weeks it seems.
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Besides the initial consultation when all the information wasn’t yet there (I needed another biopsy), I haven’t been given the options of any decisions. I have a 21mm mixed IDC/lobular tumor for the largest one with DCIS and the other abnormal high-risk tissue all through the breast. They want to leave alone everything except the tumor and moniter. I am very wary about this re-excision because I don’t want to go through all the chemo and radiation just to have a mastectomy later when it comes back. So I have decided if they don’t get negative margins this time, I am going to advocate for a mastectomy. I wasn’t mentally at that point tho until now. Thank you, entropy, for your insight !!!
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Its understandable how you feel if you have altered breast tissue over a wide area. You don’t have to wait for them to suggest a mastectomy, you can suggest it at any time and they would hopefully take your lead on that. If you want to try for good margins 1 more time, that is a reasonable option too as long as you don’t feel pressured to go with that plan. I think it may be good to enquire if their plan is that the chemo and radiotherapy would be expected to have an effect on the rest of the tissue, only an oncologist would know such details so they would be best placed to answer that. It’s also possible that different approaches are used in the US than over here in UK, so it would be wrong to advise you. Go with what you feel at peace with.
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