As a physician, a wife and a mother, Diane has plenty of people counting on her. Despite her busy schedule, she has always been aware of the importance of keeping tabs on her breast health, particularly since her mother died of breast cancer when Diane was just 17. Vigilant monitoring and self-checks had always been a part of Diane’s healthy lifestyle, but upon the birth of her children, she sought more reassurance.
Due to her family history, in 1997 Diane chose to have genetic testing for the BRCA1 and BRCA2 gene mutations. These are harmful mutations in the two breast cancer susceptibility genes, and only about 1% of individuals have them. Her test results came back positive for the BRCA1 gene mutation, which meant that she was at a significantly higher risk for breast, ovarian, and other cancers. She underwent surgery to remove her ovaries right away, a decision she calls a "no brainer." However, she chose not to have a mastectomy at that time, instead opting for aggressive breast cancer screening.
Staying One Step Ahead of Breast Cancer
For more than 10 years, Diane went through the rigors of this stepped-up screening protocol. That meant she had either an ultrasound, MRI, or mammogram every 6 months. She describes the process as "Very stressful. You’re always thinking that the next test is going to show something; you’re always worried about finding a lump. Then there’s the hassle of getting approval from the insurance company." Finally, in 2009, she decided to put an end to all of the anxiety and undergo a prophylactic mastectomy.
Diane was well aware of Dr. Romanelli’s reputation as a top surgeon for breast reconstruction in the Long Island medical community. She knew that he would be the one to perform her surgery. At her consultation, Dr. Romanelli answered all of her questions and discussed each of her surgical options. Ultimately, the two of them decided on direct-to-implant breast reconstruction on Long Island with silicone breast implants and Alloderm® regenerative tissue matrix for added reinforcement.
Diane was pleased that she would be able to avoid the extra step of tissue expanders. She had been seen at a major metropolitan cancer center in New York, and they wanted to do a staged reconstruction. She recalls "They are very set in there ways there, and slower to adopt newer approaches. I knew I wanted to go with Dr. Romanelli and the direct-to-implant reconstruction."
Setbacks and Successes
At about the same time, Diane’s sister, also BRCA1-positive, underwent a prophylactic mastectomy in a different part of the country. She had a very difficult time, and Diane became apprehensive. She ultimately canceled her scheduled breast surgery. After about a year, she decided that she was ready, and re-scheduled with Dr. Romanelli. "I have friends who had had breast cancer, and they told me I was crazy NOT to get the mastectomy. That helped to put things in perspective," says Diane.
With renewed courage and resolve, Diane underwent her bilateral mastectomy in January of 2010. Diane’s breast surgeon was able to remove all of the breast tissue and preserve her nipples. Dr. Romanelli used silicone implants at the time of mastectomy to bring Diane to a C cup. He used Alloderm®, a regenerative tissue matrix, to provide added coverage and support for the implants.
To her surprise, the surgery and recovery were not as difficult as she had anticipated. She had a pain pump after her surgery, which helped with the discomfort. She also took prescription pain medication for a few days after surgery, but says "I felt fine. It wasn’t an incredible amount of pain. The worst part for me was having to lie on my back instead of my stomach. Other than that, it really wasn’t a bad experience."
Within only a few days, Diane was driving and running errands. Her drains were removed after 5 days, and she was back on the treadmill within a week. Dr. Romanelli attributed her smooth recovery to Diane’s dedication to health and fitness. Diane agrees, but adds that Dr. Romanelli deserves some of that credit "He’s really good at what he does," she states simply.
After only 3 weeks, Diane was back to work and back to living her life. Looking back on this experience, she says she would do it over again, perhaps even earlier. "I would do the bilateral mastectomy with immediate reconstruction in a heartbeat," she says. "Even if only one breast had cancer, I’d choose bilateral just for the peace of mind."