I am 64 years old. I have a grade 3 agresive tumour I had a lumpectomy and a sentenil node biopsy ten days ago. went back for results today and was told the margin was not clear and I had to have a second opp with lymph node clearance next week. So I’m a bit concerned.
Hi Di Di,
Almost a year ago I was dx with breast cancer I had a WLE, and lymph node involvement. Although I didn’t have to have a second op, there are many women who have had to.I’m sure one wil be along soon to help you. You will feel better once you have a treatment plan.
Take Care
Dotty2 xx
I had to have op twice,many ladies do…Xsarahx
My margins were not clear either. I have been told I could have another operation to try and get clear ones or go straight for the mastectomy, but this could keep going and the consultant has said that a mastectomy is more or less probably going to be the final outcome anyway, so thats probably the way I am going infact I am pretty certain I am going to have a bilateral as want the whole chance of this damn disease coming back erased. Going back for more surgery is quite common as its hard to see the margins.
Hi Di
I had that too. When I went for my WLE I was told that around 20% of people don’t get clear margins the first time. It’s not a reflection on the skills of the surgeon, more on the nature of cancer.
The most common form of BC is Invasive Ductal Carcinoma (IDC) which is often started from areas of DCIS (Ductal carcinoma in situ, a “pre-cancer” which has not developed the ability to spread but could turn into IDC if not removed). The problem arises because tumours aren’t neat and tidy marbles with really obvious edges, they are often surrounded by areas that contain DCIS which cannot be seen with the eye but shows up under the microscope when the path lab carefully examines what’s been removed. Surgeons like there to be a clear rim of normal tissue around what they have removed, so if there is DCIS within a certain distance of the edge of what they removed, they like to go back in and take another sliver, just to be certain. (Of course there is the risk that things are still not clear after a re-excision, but that’s not something to be concerned about at this stage.)
It’s not brilliant because you have another op, and another period in “The Waiting Room” while you hang around waiting for results, and a couple of weeks of delay to the start of your treatment, but it’s not something to worry about more than we all worry. The waiting for results is really horrible as if you’re anything like me you imagine the worst, but the delay to the rest of your treatment is not something to give concern, as it WILL start within the required guidelines, so do ask them about it.
When I had it done, the surgeon opened up the same incision she’d used for the WLE, and four months later the scar is looking really good. Unless you’ve been told so, they won’t be doing anything to the node incision which means the whole thing is a lot less traumatic and a lot less painful, it’s a much shorter operation and you get less anaesthetic in your system so it’s quicker to recover from. They generally give prophylactic antibiotics as there’s a slightly increased risk of post-operative infection, but they are a preventative measure and something to feel reassured about rather than worried.
I hope that’s put your mind at ease a little, but I really sympathise with the worrying.
After my re-excision the surgeon told me that it went so well that even if she didn’t get clear margins the second time she would be happy to “have another go” if necessary. So I was looking at three possible outcomes following the re-excision: 1) clear margins, move on to next step; 2) margins not clear again, have another re-excision, and still no certainty of clear margins even then; 3) mastectomy (TBD whether straight away or after chemo).
Fortunately, I got option 1 and am currently in the middle of 6 x FEC, with Herceptin, rads and hormone therapy to follow.
Hi, I had to have a re-excision because I didn’t have clear margins but it was clear the second time. I was told that it would have been possible to have a second re-excision and know people who have done that and got clear margins. I know its not what anyone wants to hear but it does happen to quite a lot of people and it can be sorted out with a second short op xx
Hello there, I had two ops, but in a different order to you - had lumpectomy WITH lymph clearance first and then mastectomy (bit of a shock since they had ommited to warm me this was a possibility!!) So the two op crowd is a big and diverse one - lots of us have two ops for a range of reasons.
The lymph node clearance was actually the challenging part of my ops to recover from just cos the armpit area stiff and sore for a couple of weeks and then just stiff. Its really good to do the exercises as instructed - I’m not really good at routine so it was a bit challenging but, you know what, over a year later I am swimming backstroke so it was all worth it!! Do you know if your surgeon uses drains for lymph node clearance ops? Some do and some don’t. My drain was no bother and came out really easily -and I got a great little turquoise bag from the hosp to carry drain around in - but check with your hospital cos I know from on here that some hospitals don’t give you a bag - a small robust paper one with flat bottom and string type handle worked a treat.
very best of luck, Nicola
DiDi,
As you can see a number of us have been where you are now. I actually had 3 go’s!! WLE and SNB and no clear margins, a 2nd attempt and no clear margins, a 3rd attempt and finally clear margins although some DCIS left but as Choccie said it is difficult to see until in the path lab and as long as the main tumour sites have gone its then left to the chemo, rads and hormone therapy to do the rest!
It is a hideous time waiting and waiting for the next bit but as you can see its not unusual and again as CM said its not anything to do with your surgeons’ perceived lack of skill its just a very difficult thing to get the measure of in one go.
I opted to go a 3rd time because I was a big enough girl to cope with that, but at all times everything was discussed thoroughly with my surgeon and he would have been prepared to go for a mx after the 2nd time if that had been my wish but I was going for 3rd time lucky!
And I was! You WILL get there and hopefully it will be 2nd time lucky for you.Good luck, you will find loads of support here.
Wandyx
Thanks for the support feeling a bit better now. Onwards and upwards.