Second Re-excision

I remember my surgeon explaining about my DCIS and my Invasive Ductal Carcinoma, saying that there is something that changes in the cancer that allows it to break through the membrane enclosing the duct, and that until they do actually break through, they lack certain characteristics that make them a lot less of a problem. The difficulty comes when there are microscopic areas called micrometastases that have managed to break through that membrane.

But Pathology should have completely assessed your tumor for these, and if they did not exist, then the cancer was contained within the duct membrane and that is like a country having a river or mountainrange forming it's boarders, a strong and reliable boundary.

He said this was why they worry far less about DCIS than about IDC. Then there is a second level of invasiveness which is demonstrated when the cancer cells manage to break through the  membranes containing the whole breast, which is a much more solid physical barrier again.

I had only 0.1ml margin under my tumor, but apparently this is the breast facia membrane, and so long as it was not pierced by micrometastases, I was told I could count on this to actually make a more solid barrier  to the cancer than the ordinary 1cm margin of tissue within the breast, where there is not a membrane of this type involved.

I find understanding how this works, and why  I should trust that 0.1mm is a clear margin in one situation but 0.5mm is not a clear margin in anothe situation, has helped me make sense of my surgeon's advice.