How soon do I need another surgery after lumpectomy with positive margin

[pinkywave]

Stage 2 breast cancer (T2, N0, MX), grade 1. Had lumpectomy 04/21/20, negative lymph node but got positive margin. Considering getting mastectomy, hopefully skin-sparing mastectomy, but my surgeon says he only performs total mastectomy and if I want skin-sparing, he will need to refer me to someone else and that might take time (If I’m ok with total mastectomy, I can have surgery by him in 10 days). So my question is; how long is too long to wait to have repeat surgery after lumpectomy when you got positive margin? I certainly don’t want my remaining cancer to spread but I’d like to explore my options if possible. My primary tumor is called mutinous carcinoma (grade 1), but I also have DCIS (grade1-2)Thank you!

[msnbthomas]

Had double mastectomy May 1st.  Had a lumptectomy and radiation 16 years ago and then it returned.  They did a biopsy first and I decided to go ahead with the mastectomy because I didn't want another return.  When they did the mastectomy they discovered that the biopsy actually got all of the cancer and there were no lymph nodes involved.  If I had know that, would I have had the mastectomy?  Maybe/maybe not.  But I am glad there is no cancer now and very unlikely to return.  Have you been to an oncologist?  They might determine to do some treatment first that might slow any growth so you can get second opinions.  Have you talked to a plastic surgeon about your reconstruction options?  You want to be very confident in your plastic surgeon because they spend more time with you after the initial surgery then your surgeon will.

[Sara_MHModerator]

We just wanted to check back in and see how you are doing.  We hope you've been able to come to a decision about the best course of treatment for yourself and hope that it is going well.  We're here to support you any way you need.  Best to you.

[Sara_MHModerator]

We're sorry you have gotten this diagnosis. Please continue to work with your doctors and let us know any updates.

Here's information on positive margins and what that means.  https://www.breastcancer.org/symptoms/diagnosis/margins

More surgery is almost always needed with a positive margin which means cancer cells come right out to the edge of removed tissue and need to be removed. However, there are differences from practitioner to practitioner as to how far out they check to be 'clear'.  

That's a clarifying point for your doctor as to what parameters they used. Women with DCIS do have a likelihood of developing invasive cancer such as mucinous carcinoma.  

Here is a read on mucinous carcinoma.  https://www.healthline.com/health/mucinous-carcinoma

I would imagine that with your situation they will be aggressive with their treatment recommendations and obviously, sooner is better to getting started if your doctor is suggesting that.  However, getting a second opinion can certainly give peace of mind which is important in making these decisions.

It has been a few days since you've posted this and any update on the situation would be appreciated. We wish you the very best and are here to help you as best we can or just to talk along the way.