Thanks for posting.
It’s understandable to feel confused and to want to know what the best way is to proceed. Sometimes it’s easier to talk this through on our Helpline.
It’s not possible for us to comment on your individual situation and say what your chances of recurrence are and how effective radiotherapy may be for you.
It can be difficult to know what to do when you have a close surgical margin and are given different options to consider. Your treatment team will be best placed to discuss the different options available to you as they know about your individual situation.
NICE guidance states that where DCIS is present within 2mm of the radial margin after breast conserving surgery, the benefits and risks of further surgery should be discussed. However, some hospitals have their own guidelines regarding the measurement for surgical margins following mastectomy as currently there is no consensus of opinion from experts regarding the optimal margin.
Radiotherapy may be offered following a mastectomy when surgical margins are involved. But again, this decision would be decided by your treatment team based on your individual situation.
You mention that the MDT has not been able to come to a consensus. It may be helpful to talk this through and discuss your concerns with your breast care nurse or treatment team.
It may also be helpful if you haven’t already done so to ask for an appointment with an oncologist to discuss whether radiotherapy may or may not be of benefit., They may be able to explain in more detail how much it may reduce your risk of recurrence.
Some people consider asking for a second opinion and doctors are used to patients asking about this. You can talk to your GP or treatment team if you feel this would be helpful for you and they can then arrange for you to have a second opinion. They can refer you to an NHS team or a particular doctor.
Having a second opinion doesn’t necessarily mean that the second treatment team will offer different treatment options or take over your care. If you decide you wish the doctor who has given the second opinion to treat you, this will need to be agreed by your GP and the hospital where you had your second opinion.
It can help to prepare for a second opinion by thinking about what you want to get out of the appointment, making a note of what you understand about your treatment plan and writing down the questions you want to ask.
Talking to someone who has had a similar experience can be helpful and our Someone Like Me service can arrange for one of our volunteers to talk to you by email or telephone. Our volunteers have had a personal experience of breast cancer and are trained to provide support.
You can ring the Someone Like Me team on 0345 077 1893 or email them at firstname.lastname@example.org,so they can then match you to your volunteer.
Do call our Helpline if you would like to talk this through or have any further questions. Your call will be confidential, and the number is free from UK landlines and all mobile networks.
The number is 0808 800 6000 (Text relay prefix 18001).
If you would like a nurse to call you do complete this form. Ticking the box agreeing to a call back.
Our opening hours are Monday to Friday 9am - 4pm and 9am -1pm on Saturday. Out of hours you can leave a message and we will call you back when we next open.
Breast Cancer Now Nurse
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Hi I was diagnosed with DCIS high grade in March 2021. There is no invasive cancer and no lymph node involvement. I am 42yrs old. I had a therapeutic mammoplasty in April and was due to have radiotherapy however, the margins were not clear and I had a mastectomy with immediate reconstruction with ADM and silicone implant 4 weeks ago. I received my results two days ago showing close margins less than 1mm in one small area (close to my skin)all other borders had 2mm clear margins. I am very confused how to move forward. I’ve been told I can either take it the border is clear and keep watch for any changes. Have radiotherapy but they don’t feel it is necessarily going to be helpful or my other option is to remove the implant and most of the skin leaving no ability to reconstruct thereafter as there would be no space for a further implant. Are these the usual options? Does radiotherapy not help in this situation? Are chances of recurrence in this situation high? The surgeon has said he concentrated making sure the area that showed close margin was as clear as possible but obviously he cannot guarantee no cells remain. The MDT have not been able to come to a consensus on the best option for me and have left me to decide on how I would like to proceed. Any help or similar experience would be greatly appreciated. Sorry for the long post!