Margins not clear -excision or mastectomy?

[J73]

I had lumpectomy (2x7mm tumours to remove but 2 more found in op) but positive margins and dcsi so went for mastectomy to avoid another op of margins were still positive. Week in… have skin expander currently to try and avoid rejection of implant due to thin skin… feels a very slow process but glad all options being openly discussed. Just waiting for next set of results now for treatment..

lumpectomy left my breast really misshapen and out of balance anyway so felt full removal of all tissue would stop me worrying about what was left… need to balance everything anyway with surgery once done. All the best, just get as much info as you can so you can make an informed decision xxx

[Watcher72]

Yes it is like choosing the least shit option ... 🤔  shame because I'm actually quite happy with how my boob looks too right now. She did a good job.  Hoping it heals as well next time .....

[karzo]

Hello, 

I'm booked in for the op on April 5th. Yes, I too had margins and some new DCIS so I didn't really understand the difference. I just thought I'd give my boob a chance and I'm still comfortable with the decision now, although it's a bit like choosing the least shit option really! Yes, hoping we will all be in the 4 out of 5. 

Sending happy thoughts and clear margins to us all xxx

[Watcher72]

This thread has been really helpful.  I had my results yesterday and also have positive margins. To be honest I really didn't know what to ask when I was with the consultant as it took me by surprise. I have been booked in again for 4th April for excision - my original operation was a LICAP reconstruction. I will go with the excision as I don't feel ready for more large surgery and only had the drain out a couple of days ago after almost 3 weeks.  Fingers crossed we all get the results we need next time and become the 4 out of 5 

Sending you all love and hugs x

[karenNF]

Hi Karen,

I hope you’re doing okay. When is your next op?

I got my results yesterday and have positive margins too. Bit weird as new areas completely.  Discussed re-excision and mastectomy. MDT today and phone-call Friday. I’m also now struggling with what to do!

Keep “jumping forward” is my strength. 

Best wishes, Karen 

[karenNF]

Hi Karen,

Fingers crossed for your re-excision, my experience was it was nothing compared with first surgery. Do you have a date yet?

Still got to wait for Tuesday to know what next….

Best wishes, Karen 

[karzo]

Hi Karen,

Just wanted to say thanks for sharing your experience so far, and hoping your results were favourable. The waiting is terrible , I know.💓

I've decided on re-excision, so now getting ready for that. 

Sending all positive thoughts and wishes, Karen

[karenNF]

Hi Karen,

I hope you are getting there with your decision, and have a date for surgery.

I had re excision due to positive margins in left breast 8 years again followed by radiotherapy and all good so far. I have just had surgery on the right breast for larger area, and waiting for results.  Thanks for saying about the clips, I couldn’t understand why I had so many dots of glue! 

I’m trying to fill the week, as next Tuesday seems a long time to wait. 

Positive thoughts and best wishes,  Karen (there seems to a lot of us)

[Slightly Lopsided]

From one Karen to another!

I hope all goes well and you make a speedy recovery from the re-excision.Fingers and toes crossed for clear margins and I hope you can keep yourself busy while you wait for the  results . 

I only found out about the clips last summer when I went for my first  follow up mammogram  and the radiographer explained she had to make sure they were "in view"-I had never really thought about it before!

Take care,🤗

[karzo]

Thank you! Very helpful to hear your experience. I had been leaning towards mastectomy but have decided to go for an excision and hope to be in the four out of five.  My 'other' boob is an F cup and I know I don't want reconstruction, so the potential large imbalance was a factor for me too. 

When I spoke to the nurse last week, about to make the decision, she also told me that they put clips in during the mammoplasty so they know exactly where the margins etc are. I didn't know that until the last moment! I had been wondering 'how do they they know where it is?' and this also gave me more confidence in the re-excision. I can't believe they all forgot to mention that! So yes, more waiting on results, and radiotherapy, but I think I'll be happy that I tried to keep some boob. If it has to go, so be it. 

Thanks again and all the best to you 💖

Karen

[Slightly Lopsided]

Hello @karzo 

I'm sorry to hear of your dilemma.It can feel as if you're going round in perpetual circles or two steps backwards.I don't know what stage you are at in your treatment but  I understand that re-excision means more waiting for results, and delays before whatever comes next , such as radiotherapy. 

I was faced with much the same decision 2 years' ago.Everyone is different and I understand   some women decide at this stage that they want a mastectomy just to be sure that every trace of cancer is removed and to avoid further delays.It's hard to understand as the margins often seem to come down to a matter of millimetres, and sometimes it's actually only  one margin that isn't clear-it's maybe worth asking your team if they can give you more details as to where the problem was  .

One of the factors in reaching my decision and giving it another  go  was that I knew the re-excision was a relatively "minor" operation .It only took about half an hour, so less time under anaesthetic, and the existing  wound was reopened, so no further scars and as I did not need further lymph node surgery, there was no new underarm wound . I knew I had recovered quickly from the previous operation  and therefore  it meant I could be active  and less restricted in what I couldn't do fairly quickly and  I felt there would be less risk of complications and longer term side effects . (In my case, I already knew I was going to have to have radiotherapy whatever the outcome as I had a positive lymph node from my SLNB. ) I was obviously reluctantly  prepared for the fact it might not be successful  and I might  have to go down the mastectomy route.When you have been the 1 in 5 or whatever, you do start to think everything is going to happen to  you, as statistics mean is has to happen to someone!However, I did feel my team would not have offered me the chance if they did not think it had a good chance of being successful.The downside, obviously, was the sheer torture of waiting for still more  results and I can understand how difficult if feels-almost as if you're being asked to  toss a coin.

Good luck whatever you decide.

[karzo]

As you say, they may not clear it all. I hear it's one in five needs more surgery, but at least that is 4 in 5 that works. I guess at a certain point we have to trust they do their very best. I m leaning towards an excision at the moment.

[kmesinas]

I have an excision scheduled next Thursday.  i am terrified they won't clear i t all.  They are inserting guide wires the day prior, but you never know.

[karzo]

Margins were not clear and I've been offered another excision or a mastectomy. Excision plus radio gives same result as mastectomy. But one in five excisions still doesn't clear the margins, at which point mastectomy. I don't want more surgeries than necessary .... But is that enough reason to go straight to mastectomy? I just can't decide ... Anyone else been through similar? Maybe I should trust that the next excision will work. 

Thanks for any thoughts....