Re-Excision Worries - PLEASE HELP ANSWER

[sable_lin]

Just had a lumpectomy three days ago.  Two out of six borders were positive for cancer.  I have DCIS grade three.  I am only 37 but I am not attached to my breasts by no means.  I don't want to continue surgery after surgery.  At what point will the durgeon suggest masectomy?  How many borders need to come back poritive before they do?  Anyhow, my main question is after having the biopsy and lumpectomy by cutting the duct (which is a round tube - ??? ) isn't the cancer now open to spreading?

[Norah_Za]

I had my second lumpectomy a month ago. I am 46 years old and I found out about my DCIS garde 3 in my left breast, 4 months ago. Mine one margin was less than 1 mm to the edge. I went to the second surgery just to make sure all the cancer cells are out. They say DCIS is the start of BC so they should make sure all the cells are out and would not grow back. I think after third surgery they may recomend you the masectomy if the size of infected area is large. You always have masectomy as an option. But do you want the breast reconstruction after masactomy. have you researced that? If you are up to it you can always have masectomy. They say DCIS is cureable with lumpectomy and radiation. In my case I want to keep my breast as long as I can. good luck.

[sable_lin]

Thanks for helping me out.  I was told that 80% of borders come back negative and a second surgery usually isn't needed.  I guess we are part of the 20% that need the second surgery.  How long after the first surgery was your second surgery?  My pathology report states the tumor size is 0.9 cm.  My report doesn't state TNM stage, Ki-67 level, or HER2 status, does yours?  Or anyone reading this?  Also is your excision in the same area as the first surgery?  Does yours go across or up and down?  Mine goes across and in a recent book published it shows that lumpectomy incisions should be  half rounded?  Just curious. It really doesn't matter as long as the cancer is gone.  So when do you start your radiation?  Were you ER or PR positive?  
Thanks for letting me talk about this - it feel's so good to know I am not the only one going through this.  I have a great husband, sister,  and wonderful six year old son but its not the same as someone else to talk to in the same situation.  

[Norah_Za]

I guess it depends on your doctor how to interpret the DCIS. Here is what my surgeon says. DCIS means the cancer is still inside the duct and has not gone outside of it so it is not invasive. It could be microscopic invasive. That the pathology report should show. Mine was not and I am so grateful to that. The do not do TNM or Ki-67 or HER2 test for DCIS because of the nature of this type of cancer. But they do ER and PR and unfortunately mine was negative. So talking Tamoxifen would not help me. My surgeon believes that all the borders or margins should be clean of cancer more than 2 mm to the edge. My infected area was 6x5.2x2 cm, pretty large. In one margin the cancer was less than of 1mm far from the edge. So I had second surgery. My surgeon opened up the old excision for the second surgery. I was going to have second lumpectomy 3 weeks after the first one but since I had a planned vacation she let me go on vacation so I did it 1.5 months later. Fist one came out nice and clean but after the second the scar looks ugly and I had hypodermic reaction. My breast was red and itchy so I had to wait another month that happened because my area was too big. But I have big breasts, D size, and now after two lumpectomy my left breast is smaller that right. My doctor had to cut behind my nipple so my nipple is gone inside. I am thinking if this bothers me later I may do a plastic surgery to fix it. See I am not married and don’t have a boyfriend at this moment either. I am starting the radiation tonight. I have to go there everyday for 33 times. As I see I was dying to talk to some one who was going through this. So ask me whatever you want. Norah

[Norah_Za]

I guess it depends on your doctor how to interpret the DCIS. Here is what my surgeon says. DCIS means the cancer is still inside the duct and has not gone outside of it so it is not invasive. It could be microscopic invasive. That the pathology report should show. Mine was not and I am so grateful to that. The do not do TNM or Ki-67 or HER2 test for DCIS because of the nature of this type of cancer. But they do ER and PR and unfortunately mine was negative. So talking Tamoxifen would not help me. My surgeon believes that all the borders or margins should be clean of cancer more than 2 mm to the edge. My infected area was 6x5.2x2 cm, pretty large. In one margin the cancer was less than of 1mm far from the edge. So I had second surgery. My surgeon opened up the old excision for the second surgery. I was going to have second lumpectomy 3 weeks after the first one but since I had a planned vacation she let me go on vacation so I did it 1.5 months later. Fist one came out nice and clean but after the second the scar looks ugly and I had hypodermic reaction. My breast was red and itchy so I had to wait another month that happened because my area was too big. But I have big breasts, D size, and now after two lumpectomy my left breast is smaller that right. My doctor had to cut behind my nipple so my nipple is gone inside. I am thinking if this bothers me later I may do a plastic surgery to fix it. See I am not married and don’t have a boyfriend at this moment either. I am starting the radiation tonight. I have to go there everyday for 33 times. As I see I was dying to talk to some one who was going through this. So ask me whatever you want. Norah

[Norah_Za]

I guess it depends on your doctor how to interpret the DCIS. Here is what my surgeon says. DCIS means the cancer is still inside the duct and has not gone outside of it so it is not invasive. It could be microscopic invasive. That the pathology report should show. Mine was not and I am so grateful to that. The do not do TNM or Ki-67 or HER2 test for DCIS because of the nature of this type of cancer. But they do ER and PR and unfortunately mine was negative. So talking Tamoxifen would not help me. My surgeon believes that all the borders or margins should be clean of cancer more than 2 mm to the edge. My infected area was 6x5.2x2 cm, pretty large. In one margin the cancer was less than of 1mm far from the edge. So I had second surgery. My surgeon opened up the old excision for the second surgery. I was going to have second lumpectomy 3 weeks after the first one but since I had a planned vacation she let me go on vacation so I did it 1.5 months later. Fist one came out nice and clean but after the second the scar looks ugly and I had hypodermic reaction. My breast was red and itchy so I had to wait another month that happened because my area was too big. But I have big breasts, D size, and now after two lumpectomy my left breast is smaller that right. My doctor had to cut behind my nipple so my nipple is gone inside. I am thinking if this bothers me later I may do a plastic surgery to fix it. See I am not married and don’t have a boyfriend at this moment either. I am starting the radiation tonight. I have to go there everyday for 33 times. As I see I was dying to talk to some one who was going through this. So ask me whatever you want. Norah

[Norah_Za]

I guess it depends on your doctor how to interpret the DCIS. Here is what my surgeon says. DCIS means the cancer is still inside the duct and has not gone outside of it so it is not invasive. It could be microscopic invasive. That the pathology report should show. Mine was not and I am so grateful to that. The do not do TNM or Ki-67 or HER2 test for DCIS because of the nature of this type of cancer. But they do ER and PR and unfortunately mine was negative. So talking Tamoxifen would not help me. My surgeon believes that all the borders or margins should be clean of cancer more than 2 mm to the edge. My infected area was 6x5.2x2 cm, pretty large. In one margin the cancer was less than of 1mm far from the edge. So I had second surgery. My surgeon opened up the old excision for the second surgery. I was going to have second lumpectomy 3 weeks after the first one but since I had a planned vacation she let me go on vacation so I did it 1.5 months later. Fist one came out nice and clean but after the second the scar looks ugly and I had hypodermic reaction. My breast