I know the surgeon may not be taking questions, but just in case: I have found out that the last pathology report showed both estrogen and progestrone receptors negative. Is that on the remaining DCIS or all the cellular activity in the breast tissue that was removed? I'm still trying to decide between another re-excision or mastectomy.
Dear fooddiva: The medial margin is the side closest to the middle of your chest. We could not make a definate recommendation without reviewing the pathology ourselves and examining the breast tissue. Certainly, some additional intervention is required. Whether the physicians can believe that radiation therapy will adequately treat the remaining DCIS or whether additional surgery would be recommended is the critical question. If surgery is recommended the type of procedure will depend more on the cosmetic result between lumpectomy and mastectomy. Sometimes, mastectomy with reconstruction is preferred when a good cosmetic result after lumpectomy is not possible.
medial margin means the edge of the tissue that's most toward the center of your chest. It's not quite true that you don't have cancer: you have cancer, but in a form that has a cure rate of nearly 100% if treated adequately. If not, it has the potential to become invasive, meaning it can spread outside the breast. Curative treatment, based on the best studies, first requires removing all the known tumor; so at the present time, you are not quite there. Whether it makes sense to do more lumpectomy, or whether it's time to consider mastectomy depends in part on the anatomy of your breast; meaning, whether the surgeon thinks it's possible to take more tissue at that margin and still end up with a satisfactory appearance. It also would depend on other factors, such as whether the non-cancerous tissues have what are considered pre-cancerous changes, family history, and of course your own preference. There's still controversy about how much treatment of DCIS is enough, or too much. But when it's considered "high grade," it's pretty clear that thorough treatment is necessary and it's better to be too aggressive than not enough.