Margins

Hi @MaryAnnie, yep I had radiotherapy with 5 days boost to the area. 

@AA Will you be having radiation? Close margin doesn’t matter as long as you are having radiation and they normally give a boost to the area.

@Rubylulu Aw, so sorry to hear about your situation. It is really frustrating when they didn’t detect the DCIS in earlier scans. I hope it works out for you.

For me, I have no choice but hope they got it all.  There is no more appreciable breast tissue to take out and my breast surgeon said if he takes more under the skin, it may result in flap necrosis. He did say if I insisted (against his advice), he could cut out a skin eclipse at the area of the margin and it will result in a big scar and they will probably not find anything.

It sucks that we go through mastectomy to be in the clear, but still have to monitor for residual disease. 

Thanks @kmakm

Oh @Rubylulu that sucks big time, I'm so sorry. I suffered from the dreaded occult cells as well. One lot was discovered in the pathology of my re-excision, the other in my bilateral mastectomy. Neither had ever shown up in any of the scans and ultrasounds. It's infuriating and scary. The technology is just not perfect.

@AA My breast surgeon said 2mm when I asked him this question. He also said that in the US they don't worry about it as much, that a margin is a margin no matter the width.

Hi,

I am 11 days post bilateral mastectomy with a direct to implant reconstruction.  On around day 8 my BCN called me to say all my pathology was clear including my removed nodes.  All good I'm thinking. But....when I see my surgeon on day 10 he tells me the nurse didn't read the report properly and there is an 8mm area of DCIS right under my nipple (I had nipple sparing reconstruction).  With a clear margin of only 0.4mm from the "inked" area.  AAAAhhhhhhhh!  He basically told me he's not sure what the right option is here and he will think about it - I see him again in 3 weeks.  He did say you could take off the nipple, but it could come back positive or negative.  If it came back negative it would all be for nothing.  You could have radiation, but this would probably destroy my implant.  You can take a watch and see approach.  I'm so annoyed, after all the scans and MRI's I've had this never showed up.  The whole reason for having the nipple sparing surgery was because my original  DCIS was 4cm away from nipple - so they said I was a good candidate.  I've had 3 surgeries in 8 weeks and just thought I could put all this behind me.  Apologies for the rant!  

I was also concerned as mine was only 2mm margin on the chest wall side (lumpectomy), my surgeon said it is all good as it is clear. Does anyone know the minimum acceptable size for negative margin?

Hi Cecily. I just wanted to update that since I last posted, I had an ultrasound and MRI done. I was not comfortable with my close/positive margin and wanted to see if they could find any residual cancer or any residual breast tissue.
 
Well, the reports say no sign of residual malignancy. And no appreciable residual breast tissue. This really put my mind at ease. If they did find residual breast tissue, I was prepared to  request my breast surgeon to re-excise.

Hi MaryAnnie. It sounds like you and are are in the same position - positive margins after a mastectomy. I saw my surgeon again last week and again we spoke about the positive margins. He says it’s just a “technical” thing. The pathologists have to report it that way if there is no more breast tissue left adjacent to the mastectomy surgical margin. He reassured me again that it’s all ok and he’s not worried. Between the 2 of us we’ve seen 4 surgeons and they all say the same thing. I’m assuming that they’re all right and I’m going to stop worrying about it.
xx