At 53 years old, Karen has always been vigilant about having her annual mammogram. Living on Long Island - where breast cancer rates are higher than national averages - as well as working in the medical field, have made her especially conscious of the importance of early detection. However, in 2007, her parents' health became a priority for Karen, causing her to neglect her mammogram. Still, with no family history of breast cancer and no symptoms, she was shocked when her next routine mammogram detected abnormalities in June of 2008.
A Time for Decisive Action
Diagnosed with Stage II breast cancer in her left breast, and ductal carcinoma in situ (DCIS) in her right breast, Karen was faced with a decision. She knew she needed to have her left breast removed, but since DCIS is considered non-invasive, or pre-invasive, she had the option of keeping her right breast. She didn't waste time weighing her options. "I immediately decided to have a bilateral mastectomy," Karen recalls. She did not want to risk the DCIS turning into invasive breast cancer, and she was eager to get her treatment underway.
She also knew that breast reconstruction on Long Island would be part of her treatment and recovery. Karen had a good friend who had undergone direct-to-implant reconstruction with Dr. James Romanelli. She called Dr. Romanelli's office, and was seen within a week of her breast cancer diagnosis.
Gathering Information, Making Choices
In addition to scheduling her consultation right away, the staff at Dr. Romanelli's office made it clear to Karen that they were available and accessible for any help she might need. On the day of her consultation, Karen felt a little nervous at first. "You're talking about things that are very personal and somewhat traumatic," explains Karen. Dr. Romanelli took the time to answer all of Karen's questions and explain all of her options for breast reconstruction.
Karen had the option of using her own tissue for a flap reconstruction procedure, but she only had enough extra tissue to re-build one breast. Since she wanted both of her breasts to look and feel the same, she opted for breast reconstruction on Long Island using breast implants. When Dr. Romanelli told her that he could perform a skin-sparing direct-to-implant reconstruction at the time of her mastectomy, she knew that this was the right option for her. "Having everything done at once, with no subsequent surgeries - that's what I wanted."
Surgery, Recovery, and Getting Healthy
Karen underwent her breast surgery on Long Island less than three weeks after her cancer diagnosis. For her reconstruction, she chose silicone breast implants because, as she explains, "they look and feel more like natural breasts, and I feel that concerns about their safety have been resolved." She admits to being slightly apprehensive about undergoing major surgery, but says that any fear that she felt was minimal, thanks to the confidence she had in her surgical team.
When she awoke from surgery, she felt very swollen, and thought to herself, "'Oh my gosh! My breasts are huge!'" But she knew that swelling would be temporary. "As the swelling subsides, you do become aware that the implants are heavier than your natural breasts," says Karen, "but you get used to it." She spent only one night in the hospital, then returned home to recuperate.
Although Karen took prescription pain medication, she says that the pain was "not as bad as I was expecting." She was able to care for her post-surgical drains without help until they were removed after approximately 10 days. Karen opted to take 8 weeks off from her job as a CT scan technologist, mainly due to the physical nature of her work. "If I worked at a typical office job, I would have gone back quite a bit sooner," she explains. According to Karen, her new breasts looked and felt good after about 3 or 4 weeks.
Since Karen underwent direct-to-implant breast reconstruction on Long Island, she has required no subsequent surgeries or secondary procedures. With this approach, there is no tissue expander or temporary implant that needs to be replaced, and she was fortunate to have her own nipples preserved during the surgery.
She was also fortunate that her sentinel nodes tested negative for cancer, so her therapy was preventive. She responded well to her 18 weeks of chemotherapy, and will continue with her Herceptin treatments for a full year. Despite losing her hair, Karen maintains a positive outlook, and her prognosis is good. Her doctors estimate that there is a 90 to 95% chance that Karen's breast cancer will not return.
Back to a Normal Life
Karen says she never questioned whether or not she would have breast reconstruction. "I definitely knew I wanted reconstruction, probably due to personal vanity," she candidly admits. "Plus, I had seen my friend's results, and I knew how great she looked and felt. And working in the medical field, I know how far breast reconstruction techniques have come." By choosing direct-to-implant reconstruction, she says "I was able to get back to my life very quickly."