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Doctor insights on: Clear Margins After Lumpectomy

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Dr. Regina Hampton
191 doctors shared insights

Lumpectomy (Definition)

A lumpectomy means removal of a breast lump. It frequently is used in relation to removal of breast cancer. However it can be generalized to removal of other lumps or imaging abnormalities also. Other terminology such as excision, wide excision or a partial mastectomy usually may mean the same thing. If it is done for breast cancer frequently it needs to be ...Read more


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Fluid accumlation in breast follwing breast CA and lumpectomy. Shows up on CXR 4 months after lumpectom. Size is 5 x 7 cm. Why?

Fluid accumlation in breast follwing breast CA and lumpectomy.  Shows up on CXR 4 months after lumpectom.  Size is 5 x 7 cm.  Why?

Possibly seroma: This is probably fluid collection or seroma in the resection cavity, especially if you also received radiation therapy. However, CXR is not the imaging modality of choice to diagnose this condition. I would suggest to see your breast surgeon, get an ultrasound to confirm the diagnosis and if there are symptoms or other indications an aspiration may be considered. ...Read more

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Leep shows hsil cin3 w/ endocervical gland involvement. Exocervical margins positive. Endocervical margins clear. Pap in 3 months or cone biopsy now?

Leep shows hsil cin3 w/ endocervical gland involvement. Exocervical margins positive.  Endocervical margins clear.  Pap in 3 months or cone biopsy now?

At least PAP, may: Require bone biopsy later. From the information you provided, you have residual abnormal cells in the cervix and at a minimum you need to monitor the process by pap. Three months is not likely to cause irreversible changes for the worse and you can wait to see the pap results to decide, in consultation with your doctor, if cone biopsy is needed. ...Read more

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Success rate for mastectomy retaining flap and nipple no sentinel node invasion stage 1b measures 8mm, margins good except anterior 1.5mm? Must chemo?

Tumor genetics: You could request a recurrence score which is a genomic evaluation of tumor cell gene s. 2 common tests in U.S. Are oncotype DX and mammaprint. ...Read more

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If margin is clear could cancer cells still be left behind after surgery?

Insightful question!: Some cancers shed, send their cells or even grow simutaneously far away. At an early phase and stage, tumor cells are detected in the blood and bone marrow. Clear margins are somewhat assuring that local recurrence in the area will not come back. In areas nearby, other foci might be hiding to grow later and cause local recurrence or even metastasize some place far away. Be specific, what cancer? ...Read more

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Is radiation therapy necessary when I have early stage of breast cancer with all clear margins?

Is radiation therapy necessary when I have early stage of breast cancer with all clear margins?

Yes!: There is nothing that makes a surgeon more uncomfortable after a lumpectomy than hearing the question: "did you get it all?" cancer is very humbling and it's growth is not completely predictable. While our margins may be "clear", we know many women will return with cancer at this lumpectomy site within 2-3 years unless radiation therapy is given. With rare exception, radiation rx is necessary. ...Read more

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Dr. Liawaty Ho Dr. Ho
3 doctors agreed:
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Stage iii-b crc removed surgically 2 weeks ago, 3 days ago surgery was performed to remove post op adhesion blocking the small intestines, suggested chemo is capeox. When should treatment begin?

Dr. Liawaty Ho Dr. Ho
3 doctors agreed:
Stage iii-b crc removed surgically 2 weeks ago, 3 days ago surgery was performed to remove post op adhesion blocking the small intestines, suggested chemo is capeox. When should treatment begin?

Adjuvant chemo: Adjuvant chemo for stage iii colorectal cancer would be combination of 5fu/oxaliplatin or capecitabine/oxaliplatin. Chemo can be started as soon as you are recovering well from your surgery. It can be started 4-6 weeks from surgery-providing that all surgical site is healed. Good luck. It is not a common thing to have a colon cancer at age of 30- thus a genetic counselling/testing is recommended. ...Read more

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Lump beneath lumpectomy area two weeks after chemotherapy?

Lump beneath lumpectomy area two weeks after chemotherapy?

See your doctor: This could just be scarring from the lumpectomy, but you really must see your doctor to have them examine it. You might need to have an ultrasound or some other test to check it out. ...Read more

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What is the survival rate for sarcomatoid renal cell carcinoma after a partial nephrectomy. Encapsulated and clear margins ?

What is the survival rate for sarcomatoid renal cell carcinoma after a partial nephrectomy. Encapsulated and clear margins

?

Good: The survival rate for renal cell carcinoma is determined by several factors, including the stage and grade. Although sarcomatoid is a more aggressive variant of the disease, most predictive programs do not factor this into estimates of survival. For a small tumor (< 4 cm), well encapsulated and completely removed the 5 year survival should be > 90%. ...Read more

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Dermatology after laser procedure lesion on face not healing underwent biopsy dr reported very light pre cancer?

Dermatology
after laser procedure lesion on face not healing  underwent  biopsy  dr  reported
very  light  pre cancer?

Full excision : The lesion that is not healing may be actinic keratosis which is pre cancer or mild skin cancer. It may require other forms of treatment such as complete removal physically by excision, or local chemotherapy cream. Not to worry too much if you have a dermatologist taking care of you. ...Read more

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3 mm wide mole removed. Pathology dysplastic but no mention if margins were clear. Why wouldn't pathologist indicate clear or not? Re-biopsy required?

3 mm wide mole removed. Pathology dysplastic but no mention if margins were clear. Why wouldn't pathologist indicate clear or not? Re-biopsy required?

Margins on mole: Margins are typically reported on most moles. However, if the initial excision was a shave or a close biopsy, where primary goal was to see if it was dysplastic and limit the size of the defect, then margins may not matter on the report. Best to consult with your dermatologist since an additional excision may be required. ...Read more

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B breast ca, bilaterally multifocally recurrent, s/p salvage mastectomy, with no distant mets except back lesion which resolved on neoadj chemo. ?Rt?

B breast ca, bilaterally multifocally recurrent, s/p salvage mastectomy, with no distant mets except back lesion which resolved on neoadj chemo. ?Rt?

My view...protons...: In a similar case, i chose to use proton therapy. Why it is useful is that it can treat the axilla and chest wall, as well as the internal mammary nodes while sparing lung and heart. That spine/back lesion is a concern, but I have seen (it has been published) that bone met only patients if controlled can have very, very long survivals, so in my mind it is worth the work/travel. ...Read more

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Right breast cancer, no lymph node taken out. Had mastectomy, clear margins, 1.2 cm tumor, mitotic rate 1, grade 1, total score 5. Treatment recommend?

Right breast cancer, no lymph node taken out. Had mastectomy, clear margins, 1.2 cm tumor, mitotic rate 1, grade 1, total score 5. Treatment recommend?

Watch: If mastectomy performed, no RT needed. The chance of nodal involvement appearing later is a possibility. It seems when tumor spreads to lymph nodes, the disease remains in the lymph node chain and will not metastasize to other organs such as lung, liver, or bone. When nodes are left to expand, they extend to level 3 nodes, then eventually impinge on axillary vein, a reason for resection. ...Read more

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IDC BC-HER2,PR,ER&LN positive,local skin met-LVI found AFTER CHEMO completed. TAC,lump,rads&herceptin. Recur risk?Prognosis?Avg time 2 reoccur? [email protected]

IDC BC-HER2,PR,ER&LN positive,local skin met-LVI found AFTER CHEMO completed.
TAC,lump,rads&herceptin. 
Recur risk?Prognosis?Avg time 2 reoccur? Dx@39

Speak to oncologist: This is best answered by your oncology team. If you are not being treated at a designated breast center, then I highly recommend you find one. Recurrence and prognosis are individualized and only your doctors can give you the proper information. Good luck ...Read more