Breast Surgery - Lumpectomy

Taking Care of Janice

When Janice Mason, 58, of Milford learned she had breast cancer, the diagnosis stunned her. Even though her grandmother had cancer, Janice never expected the whirlwind of events that followed her annual mammogram.

"Just hearing the word cancer, it really shocks you," recalls Janice, who dreaded sharing the news with her mother and 19-year-old daughter. "I did my crying. Then I said, everyone looks to me to take care of them and now it's time for me to take care of myself."

The Breast Center Team and patient Janice MasonTaking care of herself meant coordinating a treatment plan through Milford Regional's Breast Center, located in the Women’s Pavilion in the Hill Health Center. Opened in 2009, the Breast Center was one of the first in the state to receive national accreditation by the American College of Surgeons. The program now offers two board-certified breast surgeons, Drs. Salwa Fam and Ashling O’Connor.  In addition to breast cancer care, the Breast Center staff also treats patients experiencing discomfort from benign breast disease and will closely monitor those with a high genetic risk of breast cancer.

Janice appreciated The Breast Center's team approach, which includes the expertise of medical and radiation oncology specialists from Dana-Farber/Brigham and Women’s Cancer Center located conveniently on the Milford Regional campus. This impressive, multi-disciplinary team ensures a seamless continuum of care that helped Janice feel guided every step of the way.

Janice had a biopsy on February 3 and a lumpectomy one week later performed by Dr. O'Connor. Dr. Fam assisted with removing Janice's lymph nodes on February 28 and later put in the port for chemotherapy. "Dr. O'Connor made me feel very comfortable and told me not to worry, that everything was an easy fix, and I'd pull through this like it was nothing," says Janice. "I would say that this is the best place to go. It's like a big family over there."

Dr. Fam, medical director of the Breast Center, explains that one asset of the program is having a nurse navigator, Kimberly Maurer, RN, who works closely with patients to identify needs, ease concerns, and assist with scheduling. "Kimberly helps them through the process step-by-step," explains Dr. Fam. "It's having somebody whom you know is immediately available to answer the innumerable questions - a friend who will answer, clarify and advocate."

Kimberly follows all breast biopsies done in the hospital and ensures that patients receive follow-up.  Her other tasks include connecting patients with support groups and additional services, meeting with them to further discuss treatment, tending to drains and suture removal, and examining patients on a regular basis if they had a lymph node removal. "I try on my initial meeting to let them know I'm here in case they get confused," says Kimberly. "I like to think of myself as the person they can call. On the day of the surgery, I stay with them and make sure they're cognizant of what's happening. We're trying to make it as easy for the patients as we can."

Janice praises Kimberly for all her help throughout the process. "Kimberly came inside the room with me when I had the pre-op procedures and comforted me," Janice remembers. "She got everything all ready for me and scheduled all the appointments. She's a wonderful person who tries to keep you positive."

Most women with breast cancer undergo some form of surgery. Dr. Fam relates that the great majority of patients are treated with a lumpectomy, which removes only the tumor and a small area of normal tissue around it, while mastectomy is recommended for patients with more than one tumor. In a nipple-sparing mastectomy all of the breast tissue is removed, but the nipple is left alone. "We want to recommend the least amount of intervention," explains Dr. Fam.

Dr. Fam says that patients benefit tremendously from having medical and radiation oncology provided by Dana-Farber/Brigham and Women’s Cancer Center at Milford Regional, which includes access to the Dana-Farber breast cancer specialists and geneticist, as well as participation in clinical trials. Other services available to breast patients are physical therapy, reflexology, nutritional counseling, special programs, yoga and support groups. "The best thing for patients is continuity of care," she emphasizes. "We have an endless supply of support people who are eager to help, starting with physical therapy and nutrition."

Dr. O'Connor also acknowledges Milford Regional's team approach and values the twice-monthly breast tumor boards. Patient cases are reviewed by a panel of cancer experts including oncologists, radiation oncologists, surgeons, pathologists, radiologists, nurses, social workers and physical therapists. "It allows us a chance to discuss each patient so that we're all on the same page," says Dr. O'Connor. "It's an excellent way of managing patient care. Good communication between the medical oncologist and the surgeon is so important in choosing the best treatment."

Another powerful tool for patients is the new 3D mammography service, which became available over the summer.  3D mammography allows doctors to better pinpoint the locations of suspect cells and tumor masses. As a result an improved rate of detection, as well as a lower amount of false positives, can be realized. "In certain women who have very dense breasts, small tumors can be missed with conventional mammography so the 3D takes a number of images in two different directions," explains Dr. O'Connor. "The radiologist can scroll through the images almost like a CAT scan."

Dr. O'Connor emphasizes that not everybody with a breast lump has breast cancer. Many times lumps are caused by a breast cyst or a benign fibroadenoma."Sometimes we drain cysts if they're causing pain or discomfort, or if it is a larger fibroadenoma, we might recommend an excision for pain," says Dr. O'Connor.  "We also see people with strong family histories of breast cancer. It's our way of keeping a close eye on them and making sure that if they were to develop breast cancer, it would be picked up at a very early stage."

Janice says she feels grateful for the quality of care that she has received at both The Breast Center and Dana-Farber/Brigham and Women’s Cancer Center at Milford Regional. She started chemotherapy in late February and radiation in the spring, and also attended a couple physical therapy sessions after her lymph node removal.

"I love having everything right here and not having to do any traveling," says Janice. "They're very helpful; they take very good care of you, and give you the best care you could possibly imagine."

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