Thursday, July 29, 2010

Fran's Bilateral Mastectomy Experience

I was 47 years old when I found out I was BRCA1 positive. Two years prior to that my sister was diagnosed with breast cancer at age 56. Her doctor suggested genetic counseling, due to our family history, and she learned that she carried a BRCA1 mutation. I waited two years to consider genetic counseling because I didn't think that I would have the gene mutation. I am one of five siblings, two of us are positive for BRCA1 (the oldest and the youngest (myself)).

Our family history includes our paternal grandmother and two paternal aunts who died in their early forties from breast cancer. A paternal female cousin was diagnosed with breast cancer in her forties and is doing well. Another female paternal cousin had ovarian cancer and died at age 45. Our father died from lung cancer at age 74.

After learning that I was BRCA1 positive in 2006, I chose to pursue increased breast surveillance. This included my usual routine - mammography in the spring, ultrasound in the summer, MRI in the winter. An MRI in December 2009 detected a breast lesion at the 5o'clock position on my left breast. After finally getting an ultrasound guided biopsy I was diagnosed on January 13, 2010 with invasive ductal carcinoma, stage 1.

I decided to have a double mastectomy with reconstructive surgery. I have researched every possible surgery there was and the doctors that did them. In making my decision, I was concerned about insurance coverage and if I would still have a job after all the time needed for recovery. After searching doctors, I decided that Dr. Barbara Ward would be my breast surgeon and that Dr. David Greenspun would be my plastic surgeon. It was also good to know that these doctors have worked together numerous times and had the highest regard for each other. I decided on reconstruction with DIEP (deep inferior epigastric perforator). My prep for this operation was to stop smoking. I then had work-ups with pulmonology, cardiology, my general practitioner and more blood tests, chest x-rays, breathing tests, cat-scans and urine tests. I also had an MRA (magnetic resonance angiogram) to evaluate the blood vessel that they needed to move from abdomen to breast area in the reconstruction process.

My surgery date was on March 5, 2010. The day came. Surgeries went well. Dr.Ward removed the cancer and some sentinel nodes (had a dye injected into my breast area the day before in the Nuclear Medicine Dep’t at Greenwich Hospital). Dr. Greenspun removed everything from the breasts and replaced the breast area with blood vessels from my abdomen. Then transferred my own fat, tissue and skin from my stomach to my breasts. This took 11 hours. It is microsurgery. My recovery in the hospital was 3 days. While there, I received my final pathology. The results were not what I was hoping for. It revealed a progesterone negative, estrogen weakly positive, HER-2/Neu POSITIVE breast cancer. This meant I needed chemotherapy. I began chemo on April 14, 2010 and it will continue through July 2010. I will be on herceptin for 1 year, until next April.

The first 3-5 weeks were definitely rough. I was sore and unable to take a daily shower, dress myself or tend to my stitches independently. Thank God for my husband and daughter. I couldn’t lift my arms over my head with out feeling sore. I still have numbness in my underarm are on my right side (4 months later).I didn’t feel comfortable driving till a month later. I was dependent on others to take me to my weekly check-ups with Dr. Greenspun. It was hard for me to accept care giving from others, since I had always been the caregiver for friends and family. That was the emotional toll on me and still is today. I need to learn to just accept “gifts” of caring from others. After the 6 week mark I went back to work. I am a cook in the Ridgefield public school system. I needed to depend on my staff more to assist me in my daily duties (i.e. heavy lifting). They also were a Godsend. When chemo started I needed their help even more. I was able to adjust my schedule and come in later. I still cooked and did the managerial stuff, but at a slower pace. I would get tired during the day .And this frustrated me, since I always did my duties faster and without a lot of assistance (very independent and stubborn at times).

This is all a new and unchartered journey for me, my family, and my friends .Would I do it over again? Yes. Would I do the same thing? Yes. Dr. Ward and her staff are awesome. Dr. Greenspun and his staff are phenomenal. Would HIGHLY recommend both doctors to any one.

Best to all, Frances