DCIS - Breast marker missed in initial surgery

Reggie3

Hello,

I was recently diagnosed with intermediate grade DCIS left breast presenting as a stellate lesion (1.4cm), apparently the usual presentation is calcifications. I had a wide local incision just before Christmas to have it removed. The surgery went well and I was very happy with the incision/surgery (done by a private breast cancer specialist). The scans I had before surgery were mammogram, ultrasound and an MRI. A breast marker was implanted at the time of the biopsy with Breast Screen.

I went back to see the specialist last week and the pathology was showing that there was no breast marker in the tissue removed and also no DCIS in the pathology sample. He sent me for another mammogram, that was very uncomfortable I must say on a breast that has just had surgery! 

Long story short the recent mammogram showed that the breast marker and DCIS wasn't removed at surgery it had been missed, I'm booked in for the exact same procedure all over again this Thursday.

I'm so upset that I have to go through another general and have the surgery all over again, plus I've been a mess just waiting for the results the first time around. That's been the worst part of this whole journey so far. I've spoken to the specialist about my concerns but I'm not really satisfied with his explanation.

Also this is my second time dealing with cancer 23 years ago I went through surgery/chemotherapy and had to have an emergency hysterectomy. Going through this journey all over again is bringing up a lot of bad memories.

Has anyone else been in this situation? I'm just feeling so deflated atm.

Dory65

Wow! You have every right to feel deflated, let alone seriously pissed off @Reggie3. I hope they are not charging you for the second procedure.

Afraser

Dear @Reggie3

I appreciate that the first thing you will want is to get the surgery successfully completed but I am wondering what your specialist said about what appears to be a major failure. How was the problem explained? I’d be pretty distressed too. Best wishes for Thursday.

Reggie3

He said that they are sometimes hard to locate and that he was about 1cm away from it. Apparently it does happen sometimes according to him! I actually think maybe that there is more to it.

I didn't want to ask to many questions as I really want it removed asap.

Thank you for your concern.

AllyJay

I reckon 1cm in relation to however large your breast is, would equate to an airline pilot flying from London to Sydney and landing in Brisbane. "Well I got close...considering I flew so many thousands of miles....at least I hit the right continent...the right side of the continent at that. Please fly XYZ Airlines next time you wish to travel...." Personally, I would get a second opinion. For goodness sake, he had a marker to aim for...more than just a... texta X... marks the spot.

Reggie3

Dear AllyJay 

Thank you for your understanding, I don't get it either - I had all the correct scans and it was still missed! I thought that's why they put the marker to help the surgeon find the correct area of the breast. I could understand if he got the correct spot but the margins weren't clear and he needed to go in again but this is not the case with me.

I'm going to contact my GP tomorrow and have a chat with him. I have a good relationship with my GP and hopefully he will tell me straight out if he thinks I should find another surgeon.

Reggie3

Dear Dory65

Yes you are correct I am more than pissed off!! I've been in tears for days since getting the news. I'm so glad that I have some other people on my side, I was wondering if I was being over dramatic about it but now I don't think so.

Cheers

noosa_blue150

Can understand why you’re feeling upset about the outcome. I recently had a lumpectomy and excision lymph nodes which was successful. I had a marker/clip put in at time of original biopsy six months ago . At this surgery , on day of surgery, (after months of chemo) I had to go to,imaging dept first and have dye injection (which you may not have needed?) and also have a fine wire inserted to localise the lump for the surgeon prior to surgery.  I did ask why a fine wire needed as well as clip and was told that clip can migrate and a wire is used to go through the lump and help,the surgeon localise his/her excision  and get clear margins. Normally fine wire done under u/s but they did have to revert to mammogram in the end as they had difficulty visualising the lump,well on u/s. Perhaps this may be relevant to your care as well? Ask the surgeon .

AllyJay

Whatever "technical confetti" this ....um specialist surgeon...might throw at you, there is no excuse in my opinion. He claims to be a professional, highly qualified person, and yet misses the whole shebang!!! Outrageous. I mean, if he is so enamoured with his own knife and fork skills, that he felt no need to at least check whatever it is that he removed for the all essential marker, then why have it in the first place? If a surgeon does their snippity snip thing, then fossicks around in the blob in the stainless steel bowl, and finds zero marker...what do they do? Do they say..."Oh well close enough is good enough...at least I took some shit out....and look...I sewed it up soooo nicely too.....What's that?....I missed it (a week later)...well never mind, put your hand in your wallet and I'll have another crack at it..." "Now now Reggie...no need for tears...just a little whoopsie there". Seriously...speak to your GP and get another referral. I'd also ask the "surgeon" for a written "Pauline Hanson"....please explain... and drop the words..."for my attorney"..into the sentence and watch him flinch.

Reggie3

So you did make me smile AllJay :-) thanks for the advice about getting a 'please explain' ha ha. And also for your supporting words nice to know that I'm not alone on this one.

I have an appointment tomorrow with my GP let's see what happens. 

Reggie3

Dear noosa_blue150

No I didn’t need to have the
dye injection (sorry you did I’ve heard they aren’t that nice), I did ask at
the initial consult if he would be using the fine wire to locate the lump and
he said that he used other methods u/s. When he told me that I needed surgery
again because the clip and lesion where missed I did ask again if he would this
time be using the fine needle to locate and he said no it wasn’t necessary!
Like OMG you missed it the first time! My DCIS is presenting as a 1cm mass so I
don’t know why it was missed. Anyway I will be asking those questions tomorrow
when I visit my GP.

I’m feeling that I should
change surgeons but I’m already $2,500 out of pocket, he isn’t charging for
anything for my scheduled surgery on Thursday but that’s not much consolation,
two generals anesthetics in three weeks is not great.

Cheers

Caz1

Hello @Reggie3
I’m so so sorry you have to go through this again.  Not good enough.
Good luck at the GP tomorrow. I will be thinking of you this week. 
Sending love and thoughts your way
Caz xx

ps I had a clip inserted too, and my surgeon had an ultrasound during the operation - did your surgeon even do that? What is the point of putting a clip in if you aren’t using it to guide you??!!

AllyJay

Insist on a refund. If I took my cat to the vet to have a hairball surgically removed, and found that they had cleaned her teeth instead, there is no way in hell I'd pay for it. You paid him good money to remove your DCIS. He didn't. He removed perfectly healthy breast tissue instead and left the diseased area behind. He didn't complete his portion of your mutual contract. Tell him a coffin costs more.

AllyJay

By the way, by offering a "freebie" second time around....he's admitting fault. If he genuinely was of the opinion that he had done no wrong, I can assure you, he wouldn't be doing this. If someone reverses into your car, and then unprompted by the courts, offers to pay for the damage, that person is ipso facto admitting fault. Dickhead!!!

FLClover

Oh @Reggie3 🤦🏼‍♀️🤦🏼‍♀️.
You poor, poor thing. Believe me, you are so not alone in thinking this is wrong, and if anything you are being under dramatic. I would also ask for a refund, and immediately seek a second opinion. This is just not good enough. And you’re right, because of him now you need to be exposed to GA again so soon. Not fair and not ok!!! You paid for a service, didn’t get it, didn’t get a proper explanation in writing as to why you didn’t get it...I’d be suing this guy. 

Btw, where do you live? It might be a good idea to leave him a nice little review to prevent more poor women going through the same thing. Just completely unacceptable. And second time round too. 

So sorry darl, really. Hope your app with your GP goes well today and it sorts out quickly. Just remember your rights ♥️♥️

Emma17

@Reggie3 You have the right to receive a copy of your medical records.  This includes correspondence between doctors.

When you see your GP today, ask for a copy of all documents from your surgeon to the GP.  This will include the surgeon's letters documenting your pre-op and post-op appointments.  Likewise contact your surgeon's office and request a copy of your full record including your signed consent forms.  Understandably the records from your surgeon will include some duplicates of documents you obtain from your GP.

Very importantly, you must get a copy of your Operation Report.  This is the surgeon's description of the operation.  It will be in your surgeon's records and he will have lodged a copy with the hospital.  If your GP did not receive a copy and it is not included with your surgeon's documents, it can be obtained from your hospital.  You have the right to receive this document.

Your surgeon's post-op explanations are fanciful and his abject failure and the impact on you is a travesty.  My opinion is if you do not return to him, you should not be be out-of-pocket for his failed operation and he should issue a refund.  You paid $2,500 for, literally, nothing.