I am new to
this so I hope it’s OK. I was diagnosed with IDC (5cm tumour oestrogen + and
her2 + with spread to one lymph node) back in Oct 2011. I have had chemo which
worked really well and the tumour shrank right down. So far I have had ANC and
2 WLE. Second WLE still no clear margins and I have been offered a third excision to get clear margins or to opt for a mastectomy. I have quite large
breasts (36G) so there is still plenty to work on but I am struggling to decide
which option to take. The oncologist is quite keen to try again for clear
margins but I am not sure whether I want to go through the whole process of
surgery then waiting for the results etc. to find that it hasn’t worked. Just
wondered if anyone had been in same situation and how they decided. It seems
quite rare to get offered a third excision. I’m told I will still need
radiotherapy even with a mastectomy.
If it were me I would have another try at the WLE. It’s a very individual decision but I would fight tooth and nail to keep a breast or even part of a breast, rather than lose the whole thing, especially since you have a lot of tissue. A mastectomy is much more major surgery, with attendant risk of complications, and even if it goes well at some point you are likely to be faced with difficult decisions about more major surgery, or prostheses, or living without.
As I say, a very personal choice, but I would choose the WLE every time, until there was no choice left.
Damsel,
I was in your position and opted for the 3rd excision and have no regrets about that. I too had quite a lot of tissue to work with and I believed it was worth trying to preserve my breast as much as possible. I then went on to have chemo and radiotherapy, as it was quite a large tumour mass, but finished all treatment last November 2011. My WLE boob is quite mishappen compared to the other one but still looks fine in clothing and I have been offered surgery to even things up if I want it. I am probably not going to bother, even though it did shrink further after rads.
I’m absolutely fine with the end result, OH has no probs and indeed finds it rather special as its a ‘war wound’ !
Obviously everyone is different and you must make your own decision but I am certainly happy that I opted for the 3rd excision rather than the mx which like you was an option. I had decided in my own head tho, that if I hadn’t got clear margins after the 3rd go, I would go for an mx but I was always hoping for and as it turns out got ‘3rd time lucky’!!
All the best, with whatever you do.
Wandyxx
Hi Ladies
I’m in a similar position - had WLE to remove 6cm tumour and didn’t get clear margins in two placess, had a re-excision and they got one of the areas, but still no clear margin on other. I went to get my results thinking that if hadn’t got clear margins the 2nd time would be MX, but my surgeon said no, can excise up to 7 times !! I admit this really would be putting yourself through it and at some point you have to get sensible and go for MX.
For me, my surgeon has referred me for chemo next, to see if that kills the last bit of remaining cancer as its such a small area now, and then when the chemo has finished I’ll go for my 3rd re-excision in Nov and fingers crossed it will be gone this time. My surgeon is a bit of a star and like he says, the order of the treatment isn’t always fixed. No reason not to do the chemo first if it will give a better chance of success at the next re-excision. Have to say I’m glad not be facing a 3rd op in a row, so at least I get a break before my next surgery.
When they did my excisions (both) they did lipo-filling (lipo suction on the legs and inject the fat into the breast) at the same time, so my breast looks fab, no hollows of mis-shapen bits. So Wandy, there are other options to shape you up other than surgery.
Hope this finds you all well x