tumor not found

[SL951]

I recently had a lumpectomy for a small tumor. After the pathology report came in, the surgeon said he failed to get the tumor and has to do another lumpectomy to find it. He might have to remove a full quadrant. The surgeon said the radiologist who did the needle biopsy should have put in a clip to mark the tumor. Apparently this was discussed during the biopsy but they decided that it was not necessary and the surgeon should be able to find the tumor without a clip. I would appreciate any observations or advice, including whether to get a second opinion.

[SueYoung55]

Something doesn't sit right with that. I can't put my finger on it but I would ask for copies of all of my medical records and for sure get a second opinion.

And in my honest opinion, short of letting them section off your breast in small chunks I'd have a mastectomy and have reconstructive surgery at the same time, if you aren't going to need radiation and if that's what you would prefer. In the right plastic surgeon's hand, you could come out looking like you'd not had any surgery at all depending on where the lumpectomy was done originally. I wouldn't let any doctor come back and piece meal my breasts. I wouldn't go in to surgery without a real plan. That sounds frightening.  Best wishes :)

[SL951]

Here's what the surgeon just told me on the phone:

1. During the lumpectomy, he had sent a section to the lab and was told it contained cancer cells.The surgeon was skeptical because the section he removed did not include any scar tissue from the needle biopsy, but he went with the lab report at the time. Later examination showed it did not include tumor cells.

2. So what did happen was either the surgery missed the tumor or the needle biopsy had removed the entire tumor, which was 0.9mm.

(As I consider this now, I realize that something did show up on imaging the morning of the surgery. I wonder if this could have been scar tissue. However, if that was the case, why wasn't that removed during the lumpectomy, since they did locate something and placed a wire? )

3. What they plan to do next is to put me under completely (I hadn't realized I wasn't fully under last time, but the surgeon said it was a light enough anesthesia that I could have been awakened) and take small sections, send each to the lab, and look at the report, continuing with this process until they find the tumor. I told the surgeon that I do not want to go through another surgery after this, so even if they need to do a mastectomy to make sure the get the cancer, they should do so. The surgeon said that might be the outcome if they don't find the tumor.

I'm not happy about what I'm hearing, so I plan to ask for a second opinion, at least in terms of having someone review the file and the recommendation. Any further advice from you folks would be most welcome.

[SueYoung55]

I'd also get a second opinion.

Best wishes

[SL951]

Thanks for the information and concern. I'll post it when I hear back from the surgeon, at which point I'll have to decide whether to seek a second opinion, and your advice would be helpful to me and probably others with similar kinds of questions.

[japdip]

It isn't unusual that the entire tumor might not be removed ..... in other words, clean margins might not be obtained. For none of the suspicious area to be removed to me is quite rare and especially with the wire location procedure. Either the wire was misplaced or perhaps moved during your transport to surgery. I'm anxious to hear what answers you are given; please let me know either by post or by private message.   Thanks ....

[SL951]

Thanks for your reply It was me. I guess I felt I could be more objective about it if I said friend, but that doesn't work. They did put a wire in just before the surgery but obviously that didn't do the trick. I have a call in to the surgeon to ask for more information about why that did not work, but I was wondering how common this outcome is.

[japdip]

First I would like to clear up one fact .... was it YOU that had the surgery or YOUR FRIEND as you stated in your previous post ??  As a rule  a titanium chip if often placed at the time of biopsy OR a wire is placed immediately before surgery to define the location of the tumor. I can't say why neither of these was done in YOUR / YOUR FRIEND"S case. At any rate if the tumor was not removed it must be by another procedure.   Regards ....

[SL951]

apologies - this repeats a previous post - I thought this was a different forum