The Keller Magazine

Road to Reconstruction

Six years ago, Kelly Persyn of Keller got the dreadful news no one wants to hear: she had breast cancer.

Sitting in her doctor’s office, she surveyed her biopsy scans that showed a speckling of white spots across one of her breasts. When the doctor walked out of the room for a few moments, she turned to her husband, Eric, now assistant athletic director for the Keller school district and said: “I’m going to have to have a mastectomy.”

Sure enough, when the doctor returned, he recommended a bilateral or double mastectomy because she was at risk that her Stage 1 cancer would invade her other breast.

Although she had some irregular mammograms and even a biopsy previously, Persyn was stunned by the diagnosis. As she struggled to take it in, the doctor asked whether she wanted to undergo breast reconstruction. If so, she was advised to decide quickly so the process could simultaneously begin with the mastectomy.

The plastic surgeon she chose laid out all the options and she opted for a procedure that involved removing muscle and tissue from her back and transplanting it to help reconstruct new breasts. She also chose to have implants as well.

“I knew I was going to be okay,” says the Florence Elementary School teacher. “I never would have gone for enhancement but here was my chance for perfect breasts.”

But what followed was an 11-hour surgery to remove her breasts by a breast surgeon and then installation of spacers in the chest wall to support the reconstruction. In the coming months, she suffered an infection from drains put in during the mastectomy followed by the ordeal of several more procedures. In the end, however, she says she was left with breasts that are very realistic-looking when she is dressed or wearing a swimsuit.

“I’m so lucky,” says Persyn, 48. “So many people get a different kind of talk from their doctors,” she says, describing the news of her cancer — found early and curable by surgery — as so much easier to deal with those people who hear very bad news: advanced stage cancer, or cancer which has spread to other parts of the body.

“Compared to that, this was really nothing,” she adds.

More women are diagnosed with breast cancer than any other cancer, with an estimated 252,710 women in the United States expected to be diagnosed with invasive cancer and 63,410 expected to be diagnosed with non-invasive cancer, according to 2017 statistics from the American Cancer Society.

Because of early detection and treatment advances, the average five-year survival rate for women with cancer in one breast is 99 percent. More than 60 percent of cases are diagnosed at this stage, according to the statistics. The 5-year survival rate is 85 percent for those whose cancer has spread to the lymph nodes and 26 percent for those whose cancer has spread to other organs.

About 3 million women in the U.S. are currently living with breast cancer, according to the data.

Breast reconstruction for survivors continues to grow in popularity with more than 109,256 procedures performed during 2016 or 1.9 percent of all restorative options, according to the American Society of Plastic Surgeons. The number of women choosing breast reconstruction has increased 39 percent since 2000.

Many women choose this option because a federal law, separate from the Affordable Care Act, requires insurers to pay for breast construction surgery in cases of mastectomy due to cancer, according to local experts.

“Breast cancer is scary,” says Dr. Jonathan Heistein, a plastic surgeon practicing in Southlake and Fort Worth. “It’s the silver lining in a bad situation. It goes a long way to helping women feel whole again.

“About 99 percent of the people who come to me to talk about it, end up doing it,” he says.

Because of the terrifying nature of a breast cancer diagnosis, some women prefer to postpone a decision on reconstruction until after treatment. Those with advanced stage cancer have to put radiation and/or chemotherapy treatment ahead of breast reconstruction and others are not good candidates because of underlying health issues, Heistein says.

Because breast reconstruction is considered elective surgery, women without insurance often don’t have the option of breast reconstruction.

Major breast cancer funders such as Susan G. Komen of Greater Fort Worth and the Careity Foundation put their money into paying for mammograms, lifesaving clinical services and research rather than reconstruction.

But Dallas-based non-profit Alliance in Reconstructing Surgery is trying to advocate for awareness of breast reconstruction options and raise funds to provide grants to women without insurance.

“The mastectomy is just part of the recovery process both psychologically and otherwise,” says Morgan Hare, co-founder and board member of The AiRS Foundation. “Breast reconstruction is integral to this process of healing.”

The organization also runs a patient advocacy program that helps patients navigate the healthcare system and provide support through the often complex breast reconstruction process, Hare says.

Because of advances in breast reconstruction technology, there are more options available than ever before, including the transplantation of fat and tissue from the abdomen (with the benefit of a de facto tummy tuck) or from the back to the chest wall. Implants with or without the tissue reconstruction are also options, Heistein says.

Nipples can be tattooed to closely recreate the look of a real breast, he says.

The process typically involves multiple procedures and can take months, or even more, if chemotherapy or radiation is also required, Heistein says.

Choosing a reconstruction option is usually a decision between a patient and doctor since each breast cancer case is different. Some women who forego reconstruction at the time of mastectomy can return later to have it done, Heinstein says.

Roxanne Martinez is one of those. She learned that she was pregnant just before being diagnosed with an invasive form of breast cancer that is most common in African-American and Hispanic women. Her treatment involved mastectomy and chemotherapy, which she underwent during her pregnancy.

Martinez’s plan was to get breast implants so she had spacers installed in her chest wall during the mastectomy. However, she developed an infection, which led to the removal her spacers. Further complicating her woes, she lost her job and health insurance. After her daughter was born, she and her husband adopted a newborn baby boy. With two infants and battling cancer, she decided to put off plans for the implants and use prosthetic breasts instead.

Now, seven years later, she is again considering the implants.

Tamara Whiddon of Fort Worth has undergone a mastectomy of one breast as well as radiation and chemotherapy. Crossing the five-year survival mark this month (October), she has undergone breast reconstruction through transplantation of fat and tissue from her abdomen. She has yet to have her nipple successfully reconstructed, likely because of radiation, but she is able to take that setback in stride.

“When you are first diagnosed, it’s hard to see then end,” says the 46-year-old mother and grandmother. “You go to support groups, meet all these people who are 20-, 15- and even one-year survivors and begin to understand there is life on the other side.

“I still have issues and only one nipple,” she says. “But I’m just so thankful to be here and have a life.”

Resources for Breast Cancer

patients and survivors:

 

Alliance in

Reconstructive Surgery

airsfoundation.org

Some grant money available for breast reconstruction surgery and patient advocacy program for patience assistance navigating the healthcare system.

 

Breast Friends

This support group for women fighting/surviving breast cancer meets the second Thursday of each month at 6:30 p.m. Email Tamara Whiddon at tamarawhiddon@aol.com

for more information.

 

The Careity Foundation

careity.org

Services include diagnostic procedures, biopsies, nurse navigator social workers, psychotherapy, Chaplain services, dietician services, nutrition supplements, medical massage therapy, patient gas cards and human hair wigs.

 

Simply the Breast

Support Network

www.team-roxy.com

The network meets quarterly at The Center for Cancer & Blood Disorders, 800 W Magnolia Ave. in Fort Worth. The next luncheon will be held Friday, October 13 at 11:30 a.m. For more information, email: roxannemartinez@gmail.com.

 

Susan G. Komen

of Greater Fort Worth

www.komengreaterfortworth.org

/breast-cancer/local-resources-

and-support

Resources include educational materials, where to find prosthetics, wigs and hair-coverings and services such as free rides for medical appointments. Also, links to learn about financial assistance for mammograms and medical services.

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