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Clear Margins Question...

Fay A.

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I received this as a private message, but thought the information might be of use to others:

"Fay, could you please tell me the difference between spiculated margins and clear margins? When I had my nodule it was "spiculated".. Is there any difference in the cancer returning whether or not it is spiculated or clear? Thank you for your information.. "

First off please remember that I am not a Physician. And you would probably receive a much better answer from our Ask The Experts. But I will try my best to explain this term, using what I've read from reputable sources, and what I've been told by what I feel to be reputable individuals.

When I was referring to clear margins I was referring to the tumor being removed with excess non malignant tissue surrounding the lesion. Think of a drop of coffee on a white tablecloth. The term "clear margins" as I used it would mean cutting the fabric in such a way that the removed swatch would have a border of white fabric surrounding the coffee stain.

This is a dictionary that I use to help me understand the terms with which I am unfamiliar :

http://cancerweb.ncl.ac.uk/cgi-bin/omd? ... Search+OMD

click on the first letter of the word you want to look up and scroll down until you find it.

I was told that my largest tumor (right lung, lower lobe) that was removed in the very first Thoracotomy was a "...spiculated, cavitary mass...". I was told that the little fleshy bits protruding from it were indicative of an invasive process. I was told it meant a higher risk for spread of the disease. So here I sit, with recurrences but still very much alive, almost six years later.

The one thing I am absolutely certain of is that there are no absolutes. I really do think you should post your question to the Ask The Experts Forum, though.

PS to this added at 9:17 AM / After the first surgery I was told that the "spiculated" edges were part of a "Lepedic" growth pattern along existing alveoli. The clear margins came into play by cutting around the tumor through lung tissue that had no evidence of malignancy.

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Not a doctor either, but I think you're comparing two different things here. Clear margins is exactly right--it's removing a clean, disease free rim of tissue along with the tumor. You want to have clear margins following surgery to insure there is no malignant tissue left behind. That's a huge deal in breast cancer surgery, and the lack of clear margins in my surgical biopsy caused me to have to have surgery again, which was not a mistake on the surgeon's part, just kind of a didn't get lucky situation for me.

Spiculated is just a descriptive term for a mass where spiky protrusions are present, instead of a smooth edge. That's all that is, and it's still the goal to get clear margins if you're removing a tumor with spiculated features.

Clear margins is a goal of surgical removal of a tumor. Spiculation is just descriptive terms for a nodule.

Again, I am not an expert or a doctor or anything like that, just a person with some experience.


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