Thursday, November 06, 2008 Cruzer asks

Q: grade one ductal infiltrating carcinoma with multiple margins

Received this diagnosis last week. The tumor was 7mm. The surgeon who did my biopsy said that I have to decide between lumpectomy and mastectomy. I want more info first, like I want to know what stage my cancer is....the lymph node status, etc. He said that first I have to decide lumpectomy plus radiation or mastectomy.

Is her correct? Do I have to decide now? If I have a mastectomy, I want to have it done at a University center where I can have immediate reconstruction and that takes a while to set up. Meanwhile, I don't know my node status and I still have cancer inside me.

What I want is lumpectomy & nodes cleared first, add up the info and decide about mastectomy. Is this something I really can't do? I honestly don't care one bit about having two surgeries instead of one to end up with the outcome I want.

Thanks for your help. This is all overwhelming. This is only day 4 of knowing I have cancer.

Answers (3)

Notify me when there are new answers

PJ Hamel

11/ 6/08 5:22pm

Cruzer, I'm with you. I had a lumpectomy first; THEN mastectomy and reconstruction, once it was discovered the lumpectomy couldn't handle all the small tumors, and I found out I had lymph node involvement. DO NOT let that surgeon badger you into something you don't want. Tell him you want a lumpectomy, and a sentinel node biopsy to determine your lymph node status. Then, when you have the complete pathology report, you can decide whether you want a mastectomy and reconstruction. Stick to your guns! This is a perfectly reasonable request, and certainly many women do it this way (including me). In the meantime, take a look at our IDC FAQS, OK? They might help you figure out what's going on. It's tough, I know, to absorb all of this so quickly, with all of this information coming at you, decisions to be made... Hang in there; and again, don't let them push you around. Be strong; you'll find you're stronger than you think. Please stay in touch here - PJH

Adria

11/ 6/08 11:38pm

You need some more information from your doctor regarding the pathology. Are you ER+ or -, are your margins clear? Did he/she recommend a sentinal node biopsy?

Do you have LCIS? What is your family history....

I just had a bilateral mastectomy because I had a 9mm tumor and in the sentinal node biopsy there was 1 of 3 nodes positive with a 3mm tumor. I had extensive LCIS in both breasts (this is a marker). If the sentinal nodes test postitive, you will have to have axillary nodes removed. I started reconstruction right away with expanders because I couldn't use my own tissue, and then will have an exchange later for permanent implants. You cannot always start reconstruction right away, depending on whether you have had radiation or have chemo first, etc. Talk to a plastic surgeon.

I had a lumpectomy 5 years ago, had LCIS and DCIS (non invasive tumor) and clear margins and had regular mammograms and sonograms. The invasive tumor was found serendipitously this time after finding calcifications which are markers but the tumor found was adjacent and they were not looking in that area.

It's a very personal decision to have a mastectomy. Weigh all the information you get.

Ask your doctor about Estrogen Inhibitors, e.g. Tamoxifen, etc.

Hope this helps.

APB

Special K

9/23/09 7:17pm

I just received the diagnosis of cancer last week. It's a grade 1 Infiltrating Ductal Carcinoma. I will be meeting with my surgeon this Friday. I too will have to decide whether a masectomy is warranted. I would prefer to have a lumectomy and have my nodes tested. My fear is that the cancer is right near the nipple and it has an easier time spreading. Does testing the nodes under my arm pit really give me an accurate enough reading of the situation? Maybe it has spread and hasn't reached my underarm nodes. I'm just so scared and confused. I also have breast cancer in the family.

PJ Hamel

9/23/09 8:24pm

Hi - First of all, unless your mother or sister had breast cancer, your family history wouldn't be significant; and even if it is significant, well... you've got cancer now, so it's a moot point. Please read our IDC FAQS, if you haven't seen them yet - I think they'll help explain your particular diagnosis. If you'd like to have a lumpectomy, ask the doctor if there's any reason not to do so - a lumpectomy + radiation provides just as much survival benefit as a mastectomy. The only thing that might hold you back would be if the cosmetic result wouldn't be satisfactory to you.

Testing the sentinel node in your armpit (the node closest to the tumor) is regarded as a pretty failsafe indication of whether the cancer has spread outside your breast - which is an important factor for the oncologist in deciding what kind of treatment you should have. So yes, I'd say it will give you an accurate reading of your situation.

Take heart - IDC is the most common type of breast cancer, and your medical team will have had plenty of experience in treating it. Millions of IDC survivors are out here living happy, healthy lives - you cn be one, too. Good luck - PJH

Nancy

1/31/11 12:22am

My cancer was found to come from my Father's side of the family. His Mother and sister had it. So, if you find that anyone in your family has had breast cancer, you need to have genetic testing to be sure you don't fall into the BRCA 1 or BRCA 2 categories. I was tested after they found a 4 cm lump and involvement in 2 of my first 3 lymphnodes. I have 3 sisters, 2 were found to have the genetic mutation and one didn't. One had a prophilactic mastecomy and oopherectomy and the other did increased surveillience. I just found out that my sister who was doing surveillience just found that she has it but much smaller - 1mm and 3mm tumors. If you have it in either side of your family, you shoud have genetic testing. It can affect your immediate family members and your future family - they will benefit from knowing!

PJ Hamel

1/31/11 8:37am

Nancy, since it's an expensive test, and most insurance companies won't cover it, and less than 1% of cancer-free women carry the gene mutation, I don't believe every woman with breast cancer on either side of her family needs genetic testing. Even for women with breast cancer, only about 2% carry the mutation; so chances are HUGE that you're not a carrier. Please read our post on BRCA testing for lots of specific guidelines about which women would do well to have genetic testing, and which don't really need it. Thanks for connecting here- PJH

Q: grade one ductal infiltrating carcinoma with multiple margins

Related Questions

Ask a Question