• I had a lumpectomy and lymph node dissection 3 weeks ago and got clean margins. Radiation oncologist told me my clean margins are only 1mm big and he suggests that I should got back for more surgery to get a bigger, cleaner margin just to be on the safe s

    Asked by jojo12 on Wednesday, December 7, 2011

    I had a lumpectomy and lymph node dissection 3 weeks ago and got clean margins. Radiation oncologist told me my clean margins are only 1mm big and he suggests that I should got back for more surgery to get a bigger, cleaner margin just to be on the safe s

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    6 Answers from the Community

    6 answers
    • attypatty's Avatar
      attypatty

      Dear jojo12:
      I had the exact situation - all margins were clean after the lumpectomy but one margin was only 1mm. The other margins were all over 1cm. I also had clean lymph nodes. But because of the size of the tumor, I am Stage 2. I had extensive discussions with both my surgeon and my oncologist. They both agreed that a clean margin is a clean margin. Also because the narrow margin was right under the nipple, the surgeon could not be sure that if she "scooped out" some more tissue that she could save the nipple. Interestingly enough, when I was talking to her on the phone, she was at a national breast cancer conference where the latest thinking was that a clean margin of any size, even 1mm, is sufficient. She told me that they used to think they needed a margin of 2cm, then 1cm, now 2mm - so the thinking around this issue has changed.
      I would advise you talk more to your surgeon and oncologist together, see if they have discussed this together, and consider all the other factors in your case. In my case, I opted NOT to have more surgery because: I was early stage, I had nothing in my lymphs, I had no metastases, I was going to have chemotherapy any way, I did not want to risk losing my nipple, the narrow margin was very near the skin so any recurrence would show right away and I could have surgery later to take out more.
      All these factors are important, not just the width of the margin.
      Good luck to you and keep us informed on your progress toward cancer free life!!
      attypatty

      about 5 years ago
    • jojo12's Avatar
      jojo12

      Thanks ladies for your advice. After talking to my surgeon and oncologist, I have decided to go for the extra surgery. I'm not a small chested girl so I have plenty of tissue to spare ;) I don't really care if the girls are "even" right now, that's the last of my worries. I mainly decided to go ahead with this because I did have two positive lymph nodes and if nothing else, then this is just an extra "security" step for me. On the bright side, I do get to enjoy the rest of the holiday season at home now :)

      about 5 years ago
    • attypatty's Avatar
      attypatty

      Sounds like youare making the right decision. Good luck and please let us know how the second surgery turns out. Enjoy your holidays!
      Attypatty

      about 5 years ago
    • bonjour's Avatar
      bonjour

      Glad to hear you've made a decision and are doing well! My breast surgeon recommended doing a second re-excision to get clean margins. I trust him. No problems with either surgery, and I am a small-breasted gal. I told him I would look like a car with one headlight shining in the sky. He said, "I'll try to keep it on the road." Gotta laugh. Have a wonderful holiday.

      about 5 years ago
    • jojo12's Avatar
      jojo12

      My second surgery went well. Feels easier than the first but that's probably because there were no lymph nodes involved this time. I'm still feeling pretty sore. My surgeon said he got everything out that he wanted and there were no complications. I have my follow up appt next week.

      about 5 years ago
    • susie81610's Avatar
      susie81610

      Thats great to hear Jojo hope you heal fast and can enjoy the Holidays keep up the good work sounds like you made the right decision. Warm fuzzies sent your way=====Glad all is well.
      Susie

      about 5 years ago

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