• I had a lumpectomy and a subsequent excision. The last biopsy says that there is more microscopic insutu cancer around the top borders.

    Asked by katya on Sunday, December 30, 2012

    I had a lumpectomy and a subsequent excision. The last biopsy says that there is more microscopic insutu cancer around the top borders.

    The doctor want to remove my breast now as she said too much breast will be excised with another surgery.. Would radiation be a better idea than removal my breast? Chemo will follow the removal of my breast. Do I need another opinion? From whom?

    9 Answers from the Community

    9 answers
    • cllinda's Avatar

      Have your doctor recommend a doctor for a second opinion. My doctor would have helped me find a second opinion if I had needed to get one. Sometimes, they recommend going to either a University Hospital or another good hospital and doctors in another area to get the 2nd opinion. This way, you would get another idea on how your care should go. Find the doctor that suits your needs. Good luck!

      almost 5 years ago
    • nancyjac's Avatar

      Radiation is typically not an alternative to surgery but an adjuvant treatment after surgery. Since your cancer is non-invasive, any and all treatments you elect are for preventative reasons, not curative reasons. So any treatment comes down to benefits to reduce the risk of future invasive cancer. Whether or not you need another opinion and from whom is entirely up to you. Ultimately regardless of the number of opinions, the decision is yours. Since the issue here is follow up treatment based on a pathology report from your lumpectomy, a second opinion would consist of your doctor providing the pathology report (and any other relevant medical history that his recommendation was based on) to another doctor. Oncologists often do this on their own where a panel of doctors (oncologist, surgeon, radiology oncologist, pathologist, etc.) review test results and provide treatment opinions/options based on their individual areas of expertise. I would recommend you ask you doctor if this has already been done and whether his recommendation is based on the consensus of that board.

      almost 5 years ago
    • JennyMiller's Avatar

      I feel that a second opinion is valuable as it can confirm the first and give you the peace of mind that you need to go forward with your decision. When I was diagnosed, before I even had my first visit with the surgeon, I had made up my mind to have a bilateral mastectomy -- I wanted to be aggressive in my battle against this evil and elusive enemy. Following surgery, I had chemo and then radiation -- and I am now on Arimidex for 5 years. Everyone is different and has to make their own decision. I know I made the right decision for me -- I just would not want to go through it all again for a cancer diagnosis in the second breast. In fact, I recently heard of a lady who made a last minute decision to go for the bilateral -- and -- lo and behold -- the pathology report showed cancer in the second breast that was not detected beforehand. However, I would imagine her case was quite rare. Based on your type of cancer and with a second opinion, I am sure that you will make the best decision for you. I wish you the best. Keep us updated.

      almost 5 years ago
    • Momofivedcisbc's Avatar

      Dear Katya, I am so sorry that the first biopsy, lumpectomy and subsequent excision did not remove all the dcis. I like you had high hopes that they would get it all during these procedures. I did decide to get a double mastectomy and there was dcis in 7 of the 33 remaining segments. I would ask more questions? Like are my breasts dense? will it be hard to detect in the future? What type of dcis do I have? Mine had high grade comedo necrosis which had a greater chance of reoccurrence. I had a second and third opinion and I went with their recommendations of double mastectomy because I was so young at 45. I did not want to go through this again. I wanted all dcis out before further treatment ie radiation etc. I hope that you find peace in your decision making. Thanks for sharing. Good luck. We are here for you. Keep asking questions.

      almost 5 years ago
    • Harry's Avatar

      Getting a second opinion is fairly standard procedure. As the others have said, you can get some peace of mind from a second opinion that confirms the first. Also, there may be treatment alternatives that your first oncologist hasn't considered. As to where? It's hard to beat the Mayo down in Rochester. That's just one of the very best cancer hospitals anywhere and is not too far from Minneapolis.

      almost 5 years ago
    • DianaL's Avatar

      Hi Katya, I also started with the lumpectomy and sentinel node biopsy. I had microscopic cancer cells in two of the three nodes. You did not say if they found any cancer there. They also found a second cancer behind my primary (infiltrating lobular carcinoma). My second cancer was Insitsu ductal carcinoma. My surgeon is a surgical oncologist and his recommendation was to remove that breast and additional nodes. He recommended that I talk with my medical oncologist (who is also a friend). The one thing I remembered him saying to me was "a mastectomy is not a bad thing." It was up to me and my husband if it would give me peace of mind that was the most important thing to remember. Either way one breast had to go! Since I am 65, my husband and I decided that we did not want to ever go through this uncertainty again. I went back to my surgeon and told him to do a bilateral mastectomy. The irony is that he had got it all with the lumpectomy and of the 13 node he took they were all clear! But I have this wonderful feeling of peace. I will start my reconstruction on February 15, 2013. It will be almost a year since my original diagnosis when we start reconstruction. It is your decision, but I thought you might like to hear from someone who has walked in your shoes. Good luck with whatever you choose to do!

      almost 5 years ago
    • Mom2's Avatar

      Hi Katya, Two years ago I had a lumpectomy that turned into 3 lumpectomies ( 2 weeks apart) because they couldn't get clean margins all the way around. The margins were clean after the third excision. Since the microscopic insitu cancer was localized and had not spread to my lymph nodes, I had radiation following the lumpectomy (ies).
      Two years later almost to the day, the same DCIS showed up again in the same place on mammogram. I had a mastectomy and sentinel node biopsy 3 weeks ago. Again, nodes are clean and the cancer is non-invasive. I would recommend a second opinion if you feel you need it.
      Radiation does not replace surgically removing the cancerous cells. Having the mastectomy now instead of waiting in fear for your cancer to return is my advice. Also, they can start reconstruction during the same surgery as the mastectomy if you choose to go that route.
      Good Luck with your decision and recovery!!

      almost 5 years ago
    • Ardy53's Avatar

      first I want to say, I am so sorry. I too am a newbie to this cancer thing as well, however I have been an OB/GYN nurse for about 40 years. I had a mastectomy Dec 5, 12 for invasive ductal CA. Although I was told that I only had one tumor and they wanted to do a lumpectomy I opted for mastectomy because I have seen more found so often at the time of surgery, and low and behold that's what happened to me. Like everyone else here I would suggest you get at least one other opinion. I am headed back for a second mastectomy to get rid of the other possible cancer maker....but even so I will have to have Chemo since I went from stage 1 before surg to stage II or III after the pathology report came back. It is very shocking, and I think that all or most of us are like deer in the headlight for quite a while after diagnosis. Get a good second opinion and think long term...I will be thinking about you. Hugs.

      almost 5 years ago
    • KimG's Avatar

      The only advise I would give is if there is a second occurrence or a third the best thing to do is mastectomy and possible implant so u don't have to worry anymore. kimg09

      almost 5 years ago

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