Topic: do surgical margins need to be clear?

Forum: Surgery - Before, During, and After — Surgical options and helpful tips for recovery and side effects.

Posted on: Feb 27, 2013 08:46AM

Posted on: Feb 27, 2013 08:46AM

sockarmom wrote:

Had lumpectomy, lymph nodes neg but surgeon called and said one edge of tumor didn't have clear margin so she wants me to go back in for re excision. I'm just now starting to feel good and my husband doesn't want me to go back in. Will radiation kill the cells if there are any or is it necessary to go back in for clear margins?

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Mar 7, 2013 05:16AM 007-Lynn wrote:

I just had a lumpectomy and when I went to see my surgeon, post-op,she told me that I had the option to go back to make the margins clear.   I did it as quickly as I could because I want to give myself every "edge" that I can.   I may not need radiation as  result of my action, but that will depend upon my oncologist.

You should really trust your sugeon.   

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Mar 7, 2013 06:13AM april485 wrote:

Having surgery again on Monday to get a larger margin. One of them was <1 mm so back I go. Clear margins are essential to start rads. Mine were clear and most were over a centimeter but one of them was too close. A small price to pay imho.

"Fear has been a huge dictator in my life - so I am trying to stage a coup!" ~ a friend Dx 1/30/2013, DCIS, <1cm, Stage 0, Grade 2, ER+/PR+ Surgery 2/20/2013 Lumpectomy: Left Surgery 3/10/2013 Lumpectomy: Left Radiation Therapy 4/21/2013 3DCRT: Breast Hormonal Therapy 6/19/2013 Aromasin (exemestane) Hormonal Therapy 1/1/2016 Femara (letrozole)
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Mar 7, 2013 08:06AM Bluegem wrote:

My diagnosis was early stage invasive ductal carcinoma and I had a wide local excision with sentinal lymph node biopsy end Jan.  At my followup appointment the surgeon said it was good news - lymph nodes were clear and they 'got it all' or something like that.  I have been happy and optimistic and feeling that the 3 weeks of radiotherapy is just belts and braces to prevent a reoccurance.  I had my first appt. with the registrar oncologist yesterday and she said that I would need 4 weeks of rads due to the fact that cancer cells were right to the edge of the margin.  I am now really worried that there are more cancer cells floating about in my breast as if they are on the edge of the margin, they could also be further afield.  I wish I had asked the Oncologist more but as usual you only think of these things after.  Does cancer cells at the edge of the margin mean not a clear margin?? And if so should I press to have more surgery or just have faith in the team looking after me. 

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Mar 27, 2013 09:13AM ironmagnolia wrote:

I had BMX with DIEP on 3/4/13 for bilateral invasive ductal CA. I was just told that the upper margin near the tumor in the left breast showed a cluster of microscopic cancer cells near the edge. My BS says this has only happened to her 2 times previously, and that it is a fine line taking enough tissue to eradicate the cancer while leaving enough under the skin for the PS to get a good cosmetic result.

Also, I discussed with her that I had read that this can be a result of how the pathologist prepares the specimen, slides, etc and she agreed with that. But, stated that we cannot take a chance and just do nothing based on speculation that this report may not be accurate.

She says radiation is out due to the DIEP recon, and although she did not recommend it, one option is to just take the oral drug and watch this area. No thank you. We both feel that going back in to re-excise this area is essential, so back I go to surgery within the next two weeks.

It sucks, but clean margins are important to make sure I've done everything I can to prevent a recurrence.

Dx 1/30/2013, IDC, <1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2- Dx 2/11/2013, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2- Surgery 3/3/2013 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 4/22/2013 Arimidex (anastrozole) Surgery 9/22/2013 Reconstruction (left): Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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Mar 29, 2013 08:42AM gramwe wrote:

Hi I'm a newbie, shaking in my shoes. DX with ILC 1/29/13. Bi-lateral mastectomy 3/12/13. JPs and 1/3 of my staples removed 3/19/13. Returned to surgeon 2 days ago, thinking all my staples would be out and I could go on to the next step of my journey, wrong! Margin wasn't clear, so another surgery will be done 4/2/13, to remove more tissue, a skin graft will be taken from my thigh to close this incision. Right now I feel like I'm the only person who's had to deal with this, Lol...Please someone tell me this happened to them too! I have no idea what treatment is next, I will see the oncologist for the first time on 4/9/13. Thanks for being here, I'm so glad I found this site.

Oncotype 16 Dx 1/29/2013, ILC, Stage II, Grade 1, 0/3 nodes, ER+/PR+, HER2- Surgery 3/11/2013 Mastectomy: Right; Prophylactic mastectomy: Left Dx 3/12/2013, DCIS Hormonal Therapy 5/27/2013 Femara (letrozole)
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Mar 29, 2013 11:16AM lolalee wrote:

Hi granwe, I am so sorry to hear you will need further surgery.  This did not happen to me but I am sure that once they have removed further tissue they will have a better idea what they are dealing with.  



I would assume that radiotherapy will be recommended along with chemo.  Hopefully someone who has experienced this situation will reply to you soon, meanwhile know that I am thinking of you and send best wishes for a good outcome.



Hugs Lola.



Dx February 12 Lumpectomy March 12 DCIS Stage 0 Grade 3 HR-/PR-
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Feb 16, 2016 07:52PM V1Teach wrote:

I was diagnosed just before Christmas. I had surgery on my left side above my breast in the tissue between the muscle and skin The 1st surgery was on January 13, 2016. There was < 1mm clearance so back to surgery I went and this time they found more microscopic sprinkles of cancer and so now I am scheduled for the 3rd surgery on February 26, 2016. I hate that there has been 2-3 weeks between each surgery.

I was just crying and freaking out, but now seeing these posts has calmed me a bit. This is my first time on this site. Thank you!

Dx 12/21/2015, Left, 1cm, 0/3 nodes, ER+ Surgery 1/12/2016 Lumpectomy; Lymph node removal: Sentinel Surgery 2/26/2016 Lumpectomy: Left Hormonal Therapy Radiation Therapy
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Feb 16, 2016 09:03PM hopeful82014 wrote:

V1Teach - just wanted to pop in and welcome you to the site. I am so sorry you are here but hope you will find support, camaraderie and a wealth of helpful info here. Good luck.
Dx IDC, HER2-
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Feb 17, 2016 12:20AM moderators wrote:

V1Teach-

Welcome to BCO! We know it can be scary and overwhelming, but you've come to the right place for support as you begin down this road. We wish you luck on your upcoming surgery and recovery!

The Mods

To send a PM to the Mods: community.breastcancer.org/my/...
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Feb 17, 2016 07:46PM hopeful82014 wrote:

V1Teach - Let's hope that third time is a charm, right? You must be sick of the way this is dragging out.

In the meantime, you may find additional support on the lumpectomy thread ("Lumpectomy Lounge") and, if you know your stage, there is a group for each stage that you'll find very welcoming.


Dx IDC, HER2-

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