well the MRI did not show up any more disease, but the histology has shown that there is defo cancer in the margins, she did say this could keep happening and there would be no choice but a full mastectomy. At the moment the decision is ultimately mine, but the consultant suggested going in again and seeing if they can get clear margins and if they can get them then radiotherapy, but she cant guarantee there is not microscopic disease else where in the breast, so its really my decision what to do.
I am having my surgery on the 1st of July and then going back ten days after to discuss what has been found.
The surgeon is brilliant and really understanding of how I feel, and has told me in no uncertain terms that if I decide to go for a bilateral mastectomy at any time she will go along with my wishes and do that for, whether its a few months or a year down the line, so at least I feel I have time to think things through!
SGL, I had to have a re-excision after my WLE because the margins weren’t clear. There were traces of DCIS in the margins so my surgeon went in again. As I came round from the re-excision she said it went so well and got such a good cosmetic result that she said she’d be happy to do another re-excision if necessary. I was lucky the second time so that wasn’t needed, but I think it would have been a difficult decision to make, whether to go in again or to go for a mastectomy.
It’s not uncommon for margins not to be clear, I was told around 20% of WLE needs further excision, but that’s not because of the surgeon but because of the nature of the disease. As you said, there is the possibility of very tiny areas of DCIS that can’t be seen by the naked eye and are only discovered under the microscope.
I asked my surgeon what if there were some other areas away from the tumour that remained in the breast, and she explained that that was what the radiotherapy was for, and that it would zap outright any cancer cells that remained in the breast stone dead. The stats for mastectomy versus WLE + rads are very comparable, and both have the same survival rates, so I was very reassured by the rads. (Not looking forward to them, but that for me was preferable to mastectomy, I rather like my boobs.)
Hope that helps. Ask a bit more about radiotherapy and what they do and how, I think they also take into consideration where in the breast the tumour is, how close it is to the chest wall etc, but I know there are some people who have a mastectomy and still have to have rads even then.
I think maybe a chat with the helpline could be helpful for you, they will be a very useful sounding board for the things you have to think about, so give them a ring in the morning and see if that helps.