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addition to lumpectomy and mastectomy, “we almost always sample the auxiliary lymph nodes to see if there is any cancer there,” Cosgriff says. Every treatment option has drawbacks and benefits, and women should feel comfortable discussing different plans with their doctors. “There is not one operation that fits everyone,” says Dr. Scott Sullivan, co-founder of the Center for Restorative Breast Surgery. “If there is any level of discomfort with the plan, get a second opinion. Patients need to seek the best care for themselves.” Sullivan points out that more than 70 percent of women who have undergone mastectomies are not informed of options for breast reconstruction, according to a study by the American Society of Plastic Surgeons. “We try to help educate patients on what their options are,” he says. “It helps them handle a very adverse situation in a better way.” Once considered the “bastard child of plastic surgery,” Sullivan says reconstruction techniques have become more refined, with an increased focus on the aesthetic outcome. Performed at the time of the mastectomy, breast reconstruction is covered by insurance and takes one to one-and-a-half hours if implants are used, or three to four hours if the breast is reconstructed from the patient’s tissue via a microsurgical technique. “We can take fat from any part of the body and transfer it to the breasts,” Sullivan says. “The breast will be warm, soft, supple, and it moves naturally and changes its volume as (the woman’s) weight fluctuates, and it lasts their entire life.” This approach involves a longer hospital stay (three to four days versus an overnight stay) and recovery time than implants. But Implants carry a risk of capsular contraction and infection. “Some people have the misconception that (implants) will look like an augmentation,” Sullivan says. “That’s not true. You just have skin laying over the implant, so you see the imperfections in the implant, and the breast always feels cool.” He also addresses lymphedema, a side effect of lymph gland removal that results in chronic swelling of the arm. Very few women would choose to
SiSterS (left to right) Pam CrimminS, SuSie Stoulig and deedee King Share a Strong family hiStory of breaSt CanCer.
cast themselves as the heroine of a breast cancer story, but those who find themselves in this role can take comfort that frequently, it’s a story with a happy ending. “Eighty percent of women treated for breast cancer today will be cured of their disease,” Rugo says. Sisters Crimmins and Stoulig urge women to be proactive — to know their bodies, get tested for the BRAC1 and 2 genetic mutations if they have a family history of breast cancer, have regular mammograms and find doctors they trust. The support of family, friends and other women can be invaluable. “(Susie and I) did the surgery at almost the same time, and (our sister) Deedee took care of us,” Crimmins says. “It strengthened us. We were close before, but we are extremely tight now. We know we can live a long life laughing.” For information and resources, Rugo recommends the websites of the National Comprehensive Cancer Network (www.nccn.org) and Living Beyond Breast Cancer (www.lbbc.org ).