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Topic: no clear margins after mastectomy?

Forum: DCIS (Ductal Carcinoma In Situ) — Just diagnosed, in treatment, or finished treatment for DCIS.

Posted on: Jul 23, 2019 04:57PM

Magnolia4117 wrote:

Hello everyone. I was just wondering if any of you diagnosed with DCIS did NOT get clear margins after DMX and what your options were.. Thank you!

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Jul 23, 2019 05:37PM Beesie wrote:

I had a 1mm margin by the skin after my MX for widespread, high grade DCIS (plus I had a microinvasion of IDC). Radiation was not recommended but I had implant reconstruction, and when I had the exchange surgery, I asked the PS to remove a bit of extra skin at the scar line, since that's where the close margin appeared to be.

Some of those who've had close margins at the chest wall have opted for rads. Here are some older threads on this topic:

https://community.breastcancer.org/forum/68/topics/856402?page=1#post_5111070

https://community.breastcancer.org/forum/68/topics/856075?page=1#post_4986002

https://community.breastcancer.org/forum/68/topics/849320?page=1#post_4832588

https://community.breastcancer.org/forum/68/topics/847670?page=1#post_4809129

https://community.breastcancer.org/forum/68/topics/844927?page=1#post_4731204

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Jul 23, 2019 09:54PM TB90 wrote:

Magnolia4117: Sorry you find yourself here. I did too. As you can see from my stats, I opted for radiation. But I do not suggest that is the right or best decision. Factors that matter include, extent of positive margins. The larger the extent of positive margin, the higher the risk for recurrence. Grade of DCIS. The higher the grade, the higher the incidence once again. Reconstruction? Radiation may complicate future surgeries. I continue to review the studies and it ranges pretty much 50/50 as to what to do. Good news, your prognosis is excellent regardless of your choice about radiation. Hormonals were not seen as protective against recurrence. So it comes down to preference and tolerance for risk. Radiation reduces chance of recurrence by 50%. So from approximately 13% to 6.5%. But does NOT affect mortality at all. And if you do not do radiation, should you have a recurrence, that tool remains an option. And radiation presents it’s own risks, albeit minimal. Many surgeons will not even consider a second surgery following a mx, even with positive margins. This is crazy making. I so get it. Discuss options and recommendations from a medical team you trust. Decide what is important to you and your risk tolerance. I have never regretted my choices, but until I die of something besides bc, will never argue that my choice was s the right one, even for me. Never mind for someone else. Take your time. You will overwhelmingly likely be just fine regardless of your dec

Dx 11/28/2013, DCIS, Grade 2 Surgery 12/18/2013 Mastectomy: Left Radiation Therapy 2/20/2014 Breast

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