So, went for my follow up appt today after a wle and snb nearly 3 weeks ago. The doctor was very positive, said my lymph nodes were clear which is excellent, but he did say there was a very small margin around the lump which showed some nasty microscopic cells that if not dealt with would cause trouble. I need to have another op to see if he can get clear margins and then as i’m only 47yrs and it’s grade 3 invasive ductal cancer he wants me to have chemo, rads and hormone tablets.
I understand the logic behind it and he is looking at full recovery but it all sounds a bit daunting at the moment.
Has anyone else had to go under the knife again? Consultant did ellude to the fact that if margins were not clear second time round we may have to think Mx, but i’m not going there yet.
Jane
that was mostly me althouth i’m TN so no future pills etc…
After my WLE on follow up appointment, i was told that the were micro blaa blaa and that i need more out, but as i only had small boobies to start with i was told it was best to go for MX there and then… so i did, with node clearance. Follow up to that i was told that there had ben no cancer in what was taken out second time. But atleast that means there is no breast for evil to come back in !
Good luck x
I needed a second op; due to unclear margins on 2 sides.
First op was wire-guided. I had low grade DCIS dx after first so knew I wasn’t facing Chemo or HT. I did have 3 weeks RT following second op.
I was concerned for 2nd op as the surgeon advised re-open original scar which had healed really well. But rest assured scar healed just as well second time around. Good thing no second scar.
Per the stats there is a 20% (I think) risk of needing the second op. I was warned if no clear margins would only do a third if good cosmetic result & clear margins could be obtained.
Thankfully at second op I had really good clear margins (over 1cm); apparently the surgeon not only took an additional area of suspected abnormal cells but in effect carried out 10 spot biopsys all round the area which confirmed no invasive & no more DCIS. What a relief. Due to size/age I did have RT as well.
More bruised & sore after the second & needed 2 weeks off work only needed one with the first op.
Take care; I was looked after really well at both ops. Now onto monitoring for 5 years as RT completed in March. You will get there.
Sounds almost exactly what I had. After the core biopsy I was told it was Grade 2 so just (did I really say “just”?) rads and Tamoxifen, but after the WLE I got a free upgrade to Grade 3 and HER2+, so got the added benefit of chemo and Herceptin on top of rads and Tamoxifen.
Not getting clear margins isn’t rare. I was told by my surgeon that because they’re usually talking about extra bits of DCIS that can’t necessarily be seen by eye, just under the microscope, around 20% of her ladies have to have a re-excision to get clear margins. I was one of those as around my IDC tumour there was some DCIS and a bit of LCIS, so she went in and had another go at dicing and slicing. She used the same incision so I didn’t get any extra scars, but the second go wasn’t quite as neat so where the scar had been flat it’s now indented. But that’s ok, at least I got to keep my boob.
She said when I came round from the second op that if it turned out I still didn’t have clear margins she’d be happy to go in a third time as it went so well, but fortunately she didn’t have to. If that had turned out to be necessary I’m not sure whether I would have had another re-excision or just opted for mastectomy, but that was something I spent the time in The Waiting Room trying to get my head round.
No node involvement is absolutely fantastic. You can ask for a copy of the path report, and BCC do a very good leaflet about how to read it and what the various things on it mean. I found it very reassuring to look at it and pick out the good bits, when I was having a wobble.
Hi All,
Was reading through the posts and I am in a similar situation.
Recently new to the site and also to having breast cancer.
8 weeks ago found lump, have biopsy showed cancer 12mm grade 2. Had WLE / SNB (6 removed) on Tamoxifen.
Got results today and have 3 margins showing cancer so advised to have either another WLE or MX.
Opted for WLE again. Found 1st WLE bearable just the injections for days after did my head in!
Having the 2nd WLE mid August.
Anyone else in a similar situation or a little further ahead on this path?
I feel that I am not alone having read the posts in this dicussion thread.
Thanks
Wendy x
Janeruth, I had to have second WLE as well as there were no clear margins first time around. Despite a breast MRI I had three separate tumours adjacent to the primary. I spoke to my surgeon about a mastectomy but we agreed one more go and I’m happy to say he got clear margins second time around. I found the recovery time was quick as the worst part of surgery for me was the lymph node clearance xx
Wendels, it’s the node bit that’s the really ouchy stuff, because they mess around with nerves and stuff. The re-ex was a much smaller op, and because it was so much shorter there was a lot less anaesthetic to recover from too.
I was told that around 20% of WLE’s have to have a second go, but that’s not because of any lack of skill from the surgeon, but the nature of cancer. It’s not a neat and tidy little thing, often a main tumour has bits of DCIS in it and around it, and DCIS can’t be seen with the naked eye, just under the microscope.
I also found out yesterday that I need a re-ex. It was a bit disappointing but I am over the disappointment now and happy to read the comments here. It is reassuring to know that they are so careful with their decisions and recommendations.May now need rads which weren’t part of the original treatment plan.
Hi -I also had 2 WLE (The first was April 7th and the second on April 21st)I agree with ChoccieMuffin that the first one is the worst (had 7 nodes removed but thankfully all clear)and also had invasive lobular and ductal grade 3b (attached to skin).I am now due my thirsd lot of FEC on Monday and will then be boosted and blasted with Rads and 5 yrs of Tamoxifen after that.The scar was much bigger the second time around as the nipple had to be removed but once I got my head around it all it is a small price to pay for getting rid of (hopefully) it all and at least when I am wearing a bra no one would know.
Janeruth-if you need someone to get you through please pm me - I am only a year younger than you and we seem to have a similar diagnosis
love and hugs
Marie x
Janeruth - I had the same diagnosis as you, had WLE followed by a second op to improve margins. A year on, the scar has healed really well and is still fading and I’ve had chemo and rads, now on Herceptin and Tamoxifen. It is very daunting looking ahead to all that treatment, but you WILL get through it and we are all here to offer you support as and when you need it along the way.
Hugs
Lilac x
hi janeruth , i had a wire guided WLE, for dcis, and sentinal node + 3 lymph glands may last year, thankfully no node involvement, but un clear margin,s on one area, upgraded to invasive grade 2.with dcis my origional scar was just healing and looked good, surgeon re-opened the origional scar but still looks good a tad bigger cut and now have an indentation , but healed and fading already, had 15 rads and 2 boosters and am now on aromasin for 5 years, origionally tamoxifen but side effects were bad, its very common to have another op to obtain good margins , angie xx