Hi. For ladies which were diagnosed with BC and had lumpectomy, did anybody have a second surgery in order to get clear margins? What does that mean, anyway? How far from the edges was the lump?
I noticed you hadn't had a reply yet so I just wanted to let you know your post has been read and hopefully some of our breast cancer members who had a second surgery in order to get clear margins will be along soon to share their experiences with you.
Do feel free to have a chat with our cancer nurses about this on 0808 800 4040 as well. Their phone lines are open Monday - Friday between 9a.m - 5p.m.
i didn’t have bc, but I understand that when removing a tumor the surgeon is aiming to also remove it with a margin of healthy tissue surrounding it. That means no cancer cancer cells in the margins. They also want the margins to be a minimum size, for my cancer (tongue) they wanted 5mm margins on every side. This reduces the chance of recurrence. One of my margins was only 3.5mm which they consider intermediate risk of recurrence, therefore I’m having post-operative radiotherapy to try to zap any stray cells they may have missed. I guess going back for a second surgery helps to achieve the same outcome.
I had margin clearance surgery as they wanted 4mm margin instead of the 1mm margin in one part of breast. I think the surgeon determines the size margin they want depending on each individual case.
Thanks for your replies Maggie and SW. It's pretty hard to understand the issue.
I read the NICE guidelines 2018 in relation to re surgery after lumpectomy for BC. Clinical evidence is not conclusive, however the committee agreed that margin >0mm is required for invasive disease and further surgery is needed where margins are involved (tumour on ink). Before these guidelines, clear margins were considered if >2mm, however, apparently there was no clear evidence that this width of radial margin had a conclusive impact on the local recurrence rate, therefore the new guidelines suggest a reduction of what the clear margin should be.
Back in 2014 when I had my lumpectomy, one margin was involved and another one was 0.7mm from excision. After doing my research and hearing what other patients say, I'm more convinced that a second surgery was needed in my case, but I wasn't offered. My point is, I did have a local recurrence because of it and required mastectomy and chemo treatment, which may have been avoided :-(
All the best for now. I hope you're both doing alright.
It is a difficult area, I think you’re right, I wouldn’t be happy with a margin <1mm. I guess your surgeon thought the radiotherapy would destroy any leftover cells?
Yes, I think so, too. The thing is he took the decision without consulting me. If I would have realised at that time, I wouldn't have accepted only radiotherapy. A bit late, now.
How are you keeping, Maggie? All is good with you, I hope.
page 19 relates to margins and states a margin of <1mm requires re-excision so I’m surprised your surgeon ignored clinical guidelines. Difficult to prove that the recurrence was due to margin but the fact the surgeon ignored guidelines is a serious matter.
im doing okay, getting back to normal life as best I can x
