mastectomy/lumpectomy/radiation

[sophieann]

Will mastectomy be enough?

I had a mastectomy on my left breast in 99. It was lobular cancer without lymph node involvement.
I have a new cancer on my right breast.
I just had a lumpectomy 8 days ago with Sentinel Node removed.  The Sentinel Node was negative.
The cancer was invasive and in situ ductal carcinoma Stage 1.
I was told that my surgeon had gotten clear margins.  

My concern and question arose when I got a copy of my report today.  Even though I was told that clean margins were gotten the report stated that  the deep posterior margin was only clear by 1mm. It stated all other margins were free by at least 5mm.  I know that 5mm is what is needed to state clean margins.  I have not been able to speak to the Surgeon but I spoke to her nurse and was informed that the posterior margin was short because it was right again the chest wall.  I think they call it fasha (spelling?).  I am very small in the breast area.

I am now have to make the decision of radiation or a mastectomy.  Now here is my question.
My surgeon told me before surgery my choices were lumpectomy with radiation or a mastectomy without radiation.  I am leaning toward a mastectomy for many reasons.  But I am concerned that since it was so close to my chest wall will the mastectomy be enough?
Sophieann

[BhumikaMD]

Hi,

You would need to talk and discuss this with your surgeon or oncologist.

Only once the exact spread and extent is known , can a comment be made on this. You should relax and talk to your doctors about this.

What they advise would be the best possible option in your individual case.

Do let us know about your progress and how you are doing.

Good luck and my regards.

[sophieann]

Please add this to the above question.
I forgot an important question.
Can't you scrape the chest wall area to get clear margins?
Sophieann

[BhumikaMD]

Hi,

You would need to discuss this in detail with your surgeon and oncologist. They would know what would be the best possible option in your case.

The current studies are more in favour of breast conservation surgery followed by radiotherpay rather than mastectomy.

You could read the following article in Annals of Oncology - Eurpoean Society for Medical Oncology by Verkooijen et al -

http://annonc.oxfordjournals.org/cgi/content/full/13/8/1236

This would definitely give you a clear perspective of the two management options that is - mastectomy versus breast conservation treatment with radiotherapy.

Do let us know if you have any more doubts.

Also let us know what your doctor advises.

Hope this helps.

Good luck.