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01-12-2015, 06:39 AM
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#1
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Senior Member
Join Date: Apr 2014
Posts: 206
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Is 0.1 margin clearance under tumor really Ok?
I had a 2.2cm IDC tumor in 6cm nuclear highgrade field DCIS. It was removed 1 year ago by mastectomy. The surgeon cut out an oval that went high above and low below the tumor to remove all the skin over the top of the tumor because it came relatively close to the surface.
My path results showed 0.1milimetres of clearance underneath it, ie chest wall.
That seems awfully close. Is it really a clear margin? Has anyone got any experience of such margins proving either fine or a problem?
I worry that it could have had micrometasases going through into the chest wall, that I may be at significantly at risk of chest wall recurrence. But I realise it could also be the thickness of a membrane that the tumor has not crossed over, a strong geographical boundary. Or not.
I have had no scans or xrays of that side of my chest since surgery or scheduled ahead. I would like to know how 0.1mm margins have worked out for others. Do you know of any true stories?
best wishes
Jessica
__________________
 1997-2004 many cysts, many MG & U/S: polycystic breasts.
Sept 2013 found lump,Cyst?? forgot lump.
Dec 2013 GP check, Referred for U/S, MG,FNA.
7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail."
Cancelled my psych clients for the week.
8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon.
Cancelled my psych clients for the month.
13 Jan 14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan,
16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done.
19 Jan 14 discharged home with 1 drain.
22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment.
26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans.
30 Jan 14 HER2+ high amplification, 13 gene copies per cell.
21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up.
Cancelled my psych clients for 6 months.
Feb 14 First MUGA test: 71%,
First C15.3 test: 20
7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and Claritin, reflux/indigestion helped by Somac.
July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily.
Sept 14 Second MUGA test: 69%
Cancelled my psych clients for 2014
Dec 14 Third MUGA test: 70%
Second C15.3 test : 20
Cognitive fatigue delays return to work.
March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring.
July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing
Aug 2015 Heart good, no evidence of cancer, just Fatigue.
May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets.
Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.
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01-12-2015, 10:07 AM
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#2
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Senior Member
Join Date: Feb 2006
Posts: 437
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Re: Is 0.1 margin clearance under tumor really Ok?
Hi Jessica. I never got " clean margins" after my mastectomy. I received Radiation tx and that cleaned me up.
__________________
Linda
Dxed Stage IIIC May 05, 12 pos nodes
er/pr -neg,Her -pos
LVI
Right partial mast & partial axillary dissection-June14,2005
Right modified mast-no clear margins- June 30, 2005
DD AC x4
Taxotere X4 with Herceptin
Rads x 35( 5 fields )
Left prophylactive mast( atypia & hyperplasia found ),
put on Tamoxifen x 1 yr; D/ced due to endometrial thickening
bilateral recon (saline implants)May 06
Nipple recon July 06
metformin 2010
removal of implants due to severe encapsulation, insertion of gummies 2013
Reclast Q yr
NED!!!
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01-12-2015, 11:51 AM
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#3
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Member
Join Date: Nov 2014
Posts: 8
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Re: Is 0.1 margin clearance under tumor really Ok?
I had surgery in December 2011, said the margins where clear, but they did not specify the margin. I had 29 chemo treatments plus an investigational agent called Neratinabib. I have been NED for 2 year since Herceptin. Your story is familiar to mine. So sorry its been a hard journey. Sandra
__________________
5/06/DX: Stage 3 B Her2 positive
7 cc tumor positive lymph nodes
6/24/11 12 weeks of Taxol and 12 weeks of neratinib clinical trial for late stage cancer
I spy clinical trial drug for 12 weeks
240 mg of neratinib q day
10/11/1011
8 weeks of A/C
12/06/11 Surgery # 2
double mastectomy both breasts
1/31/11
35 rounds of RAD
1/31/11
Herceptin 13 treatments
6/06/12
inserters Surgery # 3
05/26/13
Implants Surgery # 4
11/26/13
Removal of Right Implant
Surgery # 5
therapy, therapy, therapy
Depression from hell
Stopped working
11/04/2014
Reconstructive Surgery #6
seeing doctor today
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01-12-2015, 04:24 PM
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#4
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Senior Member
Join Date: Nov 2005
Location: Ireland
Posts: 3,463
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Re: Is 0.1 margin clearance under tumor really Ok?
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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01-12-2015, 06:10 PM
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#5
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Senior Member
Join Date: Apr 2014
Posts: 206
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Re: Is 0.1 margin clearance under tumor really Ok?
Trish, Sandra and Linda, thanks so much for your support and help. Sandra, I hope your doctor's visit goes well. It is a hard journey. Though so many others have had it so much worse than me, they still seem to manage hold onto hope and to keep the faith, not to have sleepless nights when they wind themselves up and start to focus more and more on the fear when they are tired. I had not expected there to be this change back to a deep fear of recurrences over the next 3 yrs. I thought I had it all sussed because I have been over this before several times, and I had got it into perspective so nicely. Now, with little cause, it fragments and falls in a heap again.
__________________
1997-2004 many cysts, many MG & U/S: polycystic breasts.
Sept 2013 found lump,Cyst?? forgot lump.
Dec 2013 GP check, Referred for U/S, MG,FNA.
7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail."
Cancelled my psych clients for the week.
8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon.
Cancelled my psych clients for the month.
13 Jan 14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan,
16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done.
19 Jan 14 discharged home with 1 drain.
22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment.
26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans.
30 Jan 14 HER2+ high amplification, 13 gene copies per cell.
21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up.
Cancelled my psych clients for 6 months.
Feb 14 First MUGA test: 71%,
First C15.3 test: 20
7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and Claritin, reflux/indigestion helped by Somac.
July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily.
Sept 14 Second MUGA test: 69%
Cancelled my psych clients for 2014
Dec 14 Third MUGA test: 70%
Second C15.3 test : 20
Cognitive fatigue delays return to work.
March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring.
July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing
Aug 2015 Heart good, no evidence of cancer, just Fatigue.
May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets.
Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.
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01-14-2015, 12:44 AM
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#6
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Senior Member
Join Date: May 2006
Posts: 144
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Re: Is 0.1 margin clearance under tumor really Ok?
Here's a study that recommends radiation when there is a close margin and you're under 50. I also had a 1mm clear margin after my mastectomy and didn't have radiation. On my last month of herceptin 2 tumors appeared on my mastectomy scar. I didn't see radiation in your treatment. Perhaps this is something to discuss with your doctor.
http://www.ncbi.nlm.nih.gov/pubmed/9635708
On the positive side, it's been 5+ years since my treatment and my oncologist no longer feels the need to follow me and I'm back to just my primary care doctor.
__________________
- Anna
Stage I - DX 9/2005 ER/PR-, HER2+, grade 3, DCIS, IDC multi-focal (1.05cm)
DD 4 A/C finished Jan 31, 2006
Herceptin weekly finished Jan 31, 2007
recurrence to chest wall on last month of Herceptin
Stage 3B - 3/15/07 - 2 carcinomas in dermal lymphatic
Rads finished 6/5/07
12x TH finished 9/10/07
12/07 - Clear scan!
3/08 - 4 month Melatonin trial
1/09 - osteoperosis - start Alendronate
2/09 - 4-month Simivastin trial
3/13 - take drug holiday after 5 years of Alendronate
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