• How common is a 2nd surgery after a partial mastectomy?

    Asked by LuLux4 on Tuesday, April 23, 2013

    How common is a 2nd surgery after a partial mastectomy?

    I had a partial mastectomy last Friday. They checked my lymph nods and took out the lump with cancer in it. But apparently when the doctor got the results back today they did not get all the cancer and want to go in for a 2nd time. I got this news about 10 minutes ago and for a 2nd time I am thrown for a loop. I have put in a call to my oncologist and am waiting to hear from him to see if I have any other options.

    Right now I am so upset I don't know which way is up. Any suggestions?

    10 Answers from the Community

    10 answers
    • AlizaMLS's Avatar

      Dear LuLux4,

      Hi. I'm Aliza, a BC patient and the site's unofficial resident Medical Librarian. I offer advice (usually non medical [Librarians try to avoid giving med advice-it's against our Code of Ethics and is a bit illegal as it's practicing medicine sans license], but I do offer referrals to doctors, hospital, insitutions, agencies, books, media, etc. as well as research when requested or required. I am allowed to speak from my own experience as well as those of family and friends.

      I was very upset to read about your circumstances. I'm in NYC, one of the medical meccas of the country. Your mammography should have indicated quite clearly to your Breast Surgeon the kind of tumor(s) he/she was dealing with. It's most distressing to hear that you will have to have a second surgery.

      I am guessing since you had a partial mastectomy that you are currently home. I had a mastectomy and they let me go after one overnight.

      This is what I would recommend for you as radical as it may seem. I would not return to the same
      Breast Surgeon or Facility where you had your surgery performed. I would instead (I'm hoping that you have a caregiver or can draft one for what I'm about to suggest) contact MD Anderson in Houston, Texas or The Mayo Clinic in Rochester, Minnesota and have whatever Lincoln, NE facility treated you get their medical records department to get your records to one of these places (Breast Surgeon especially) asap!

      When you return, you can have their Breast Surgeon (whichever hospital you choose) there communicate with your Oncologist in Lincoln, NE, provided that you liked and respected his/her opinion. If not, it's time for a change. It's important, I think that you live near your oncologist because if you are to have chemotherapy, that could take some time.

      If you contact The American Cancer Society, you will find that they maintain a Hope Lodge (inexpensive or free lodging) near MD Anderson in Houston (just Google) as well as one in Rochester, MN (you can also Google). There are emergency low cost or free flights for cancer patients as well. I do not have that information, but will try to contact an acquaintance who does to provide that for you

      I know that this is all kind of a shock after finding out more bad news, that you now have to contemplate going a distance for competent medical care. Remember MD Anderson is ranked #1 in the country as far as Cancer care is concerned and I don't know what spot the Mayo Clinic holds, but it's an excellent hospital, so much so that the late King Hussein of Jordan was flown in there to be treated for his Cancer.

      I hope that you'll forgive me for perhaps taking you out of your "comfort zone" at what seems like a difficult time. I'm suggesting this because (if it were me and I weren't in NYC), I'd want the best shot at a good outcome. The outcome of your last surgery was lacking. We on the site all want you to have the best shot at getting rid of your Cancer, simple as that!

      If, aside from contacting my friend re the free flights, I can do anything else for you, please don't hesitate to ask me, I'm happy to help you. You can message me here or email me offsite.

      Hang in there-thiings wil get better! I know! Please keep us posted re your progress.

      Warmest Wishes,

      over 4 years ago
    • LuLux4's Avatar

      I have lots of questions that I want to talk to the oncologist about mostly what is the likely hood that they would not get it the 2nd time. Also I have been told from the beginning that this is very early stage one and that they have "caught" it at the very beginning. Again I am feeling very overwhelmed and not knowing which way is up again. The biggest question I want to put myself through the surgery again or just go with a full mastectomy?

      I will keep you posted. Thanks LuLux4

      over 4 years ago
    • gwendolyn's Avatar

      I don't blame you for being upset, but I do think a second lumpectomy is relatively common. I have met several women in treatment who experienced this. Tumors don't always have defined edges. The tissue around the tumor is always sent to the pathology lab to confirm that the margins are "clean" (cancer free.) If margins are not clean additional surgery will be recommended. I'm sorry you find yourself in this position. I agree your main dilemma is whether to choose to have another lumpectomy or get a mastectomy. Definitely talk to your surgeon about what was found and what is the likelihood of getting clean margins the next time. Best wishes.

      over 4 years ago
    • debsweb18's Avatar

      I wouldn't be to quick to blame the doctors. Mammograms and ultrasounds are not very accurate in measuring size of tumor. My mammo and US showed my tumor to be a little more than 1 CM. During my lumpectomy they found it to be 2 1/2 CM! They also had to take out a lot of scar tissue from a bioposy where multiple cysts were removed 30 years ago. By saying they did not get all of the cancer may really be that the margins weren't clear. They take "good" tissue around the tumor to make sure they get it all. If there are any stray cells near the margin-edge of tissue taken, they take more to make sure there isn't any more.

      Right after surgery they said they got it all and there was no lymph node involvement. But during the final pathology the next day they found the margins weren't clear after all and I had a very small tumor on 1 lymph node. Talk about being up and down! I understand the feeling.

      I ended going back and having a mastectomy. I would have been too lopsided and didn't want to go through it again (which is a possibility if you still don't have clear margins) They didn't find any more cancer. So again, it doesn't mean they didn't get it all, just that there's a chance and they want to make sure they get it all.

      This is not uncommon, so take a deep breath and take one day at a time.

      Talk to your doctors and see what they recommend.I agree with Gwendolyn on this one.

      over 4 years ago
    • laurie's Avatar

      A partial mastectomy is the same as a lumpectomy? I have read that if they don't get a wide enough margin around the tumor it is not uncommon for them to have to go back in and remove more tissue or the entire breast. I'm sure your oncologist will be able to explain everything to you. Lots of great people here that will post with more information I'm sure. So sorry you are going through this. The not knowing is the hardest part. (((Hugs)))

      over 4 years ago
    • Beannie's Avatar

      If your dr did not get clear margins, then you may have to have re-excision to be sure all is clear. Hang in there - it is not an easy thing to deal with. I had a re-excision and when dr told me, I really had a hard time even though I knew it was necessary. Just be sure you have confidence in your provider and in your decision regarding your treatment options.

      over 4 years ago
    • JennyMiller's Avatar

      Apparently they did not get the "clear margins" -- It has to be very discouraging for you. However, I am sure that you want to ensure that they get it all.
      My tumor did not show on the mammogram or ultra sound. They thought that my lymph node was a little "generous" so they biopsied it and found breast cancer cells. After an MRI and more biopsies, the tumor was located and it was 4.9! I made the choice to be aggressive against this evil and elusive enemy so I had a bilateral mastectomy, chemo, radiation and I am now on Arimidex for 5 years. I wanted the peace of mind knowing that I did all I could possibly do. Also, I wanted to avoid further surgeries, etc. Everyone is different and have to make the choice that is right for them -- after all, they are the one that has to live with that choice. I wish you the best - please keep us updated.

      over 4 years ago
    • DianaL's Avatar

      Hi, I went through what you did with a lumpectomy and sentinel node removal. Op findings looked great but when the final path came back not so good. I had two positive nodes and they found a second sneaky little cancer hiding behind the first. My surgical oncologist gave me the choice of a single mastectomy. I talked with my medical oncologist and his main question was did I want to go through this again--peace of mind is a wonderful thing. I was 65 at the time and we decided to go with a bilateral so that we never had to go through this again. I am being reconstructed now and quite happy with our decision. (My husband was a part of this from beginning to end and so supportive).

      over 4 years ago
    • grandmajean5's Avatar

      Dear Lulu4,

      I went through the same thing as you with the first lumpectomy not getting the whole tumor. The ultrasound showed it to be 1.2 cm and since the surgeon can't actually see the cancer cell, he/she has to go with the report. Even though my surgeon removed extra to try to get it all, when the report came back from the lab, the margins were not clear and it turned out the tumor was actually 3.2 cm. I opted for a 2nd lumpectomy, no chemo and 33 rounds of radiation. All went well, but I really wish I had gone with the bilateral mastectomy so that I wouldn't have to go through it again. My prayers will be with you. Good luck.

      over 4 years ago
    • Bug's Avatar

      Hi, LuLux4. I also had a second surgery. I had a lumpectomy on a Monday and on Friday the surgeon called and said that one of the margins was clear but very narrow - I believe she said it was 1 mm. Apparently, in some countries that is the norm and folks don't worry about it but she wanted to ask me if I wanted to go back for more tissue. I asked her what she would do if it was her. She sighed and said, "I don't know." (Later on I figured she probably didn't want to answer so as not to sway me. That isn't a criticism, by the way, just a thought.) Anyway, she said if I am the type to lay awake at night and worry about it that I'd probably want to do it for the peace of mind. If it doesn't bother me then skip it. Well, I am definitely a worrier so I had a re-excision about a week later. I have two sisters who had DCIS and they had lumpectomies and one of them had to go back to get clear margins. I know where you're coming from, LuLux4. I was thrown for a loop, too, when I got that call. Honestly, I just could *not* believe it. But, I did it. You can, too. Really. The best of luck to you.

      over 4 years ago

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