Clear margins

[rockchalk76]

I'm not understanding why a surgeon cannot always get "clear margins" when removing the lump.  Some kinds of cancers take up certain stains, where with others, the cancer does not stain, like with Iodine, and normal tissue takes the stain.  I have not yet found anything about this in any of my reading.  I have seen some cancers in animals that are really a defined shape and others that looked like an octopus.  If the surgeon takes quite a bit of tissue on a lumpectomy, will they be able to get a clear margin?  I'm not really wanting to have a mastectomy right now, but don't really care if my breast is not perfect, if they can get the clear margins for pathology, that seem so important in the research I have done.  I was going to ask this question in the section where a doctor answers, but got the message that it has taken all the questions it can for one day.  Thanks, Kay

[japdip]

I realize what you were asking ..... if this were possible then it would certainly be done on an everyday basis. Breast surgery would be vastly different, wouldn't it ? If there were a way to prevent re-excisions I'm sure it would be used.

[rockchalk76]

Thanks for your explanation, but what I was asking about is whether there is a stain that can be used in vivo, during the surgery to remove the lump.  Surgeons can use acetic acid as a way to "stain" cervical cancer cells.  I don't remember if the cancer cells turn brownish or are colorless. They use that difference in coloration to guide them on what to remove during surgery. What I wondered is if breast cancer cells lend themselves to that kind of staining during the surgery so the surgeon could get a clear margin.  Thirty years ago I was studying to get a Master's in Veterinary Pathology.  I didn't finish the degree; I married a veterinarian instead.  So I guess you could say that I have enough knowledge to be dangerous.  I ran a lab for a group of 5 OB-GYNs for a while, so I'm more familiar with things like cervical cancer in humans.  

[madgeOwens]

hahahah maybe I took stupid pills today instead of my heart pills ........thanks that cleared things up a bit for me .

[japdip]

That's what it means .... was there something in my answer that led you to believe differently ??? If so, I apologize ....

[madgeOwens]

I thought clear margins referred to gettinga border of tissue that is cancer free.........I guess thats wrong.........hmmmmm...back to the books..I am cornfused

[japdip]

It's not possible to obtain clean margins on occasion is because one cannot see with the naked eye how much of the tissue beyond the actual lump has been invaded by cancer cells. The staining is done on the tissue samples when slides are made of the specimen in the Pathology Lab. Also it depends on the location of the tumor ... how much actual tissue surrounds it; how close it might be to the chest wall, etc. Often a second surgery (not a mastectomy but a re-excision) is necessary to obtain clean margins. Hope this helps to clear it up somewhat for you.   Regards ..