Targeting Cancer: Doctors collaborate on behalf of breast cancer patients
By Kelli Warner
Artist Mindy Bench has a passion for making jewelry. That outlet served as a therapeutic distraction for her after she was diagnosed with breast cancer earlier this year.
“I was shopping for bras at a department store when I found a small lump in my breast,” she says. “It was really scary, but I didn’t tell anyone at the time because I didn’t want anyone in my family to be worried if it turned out to be nothing. Unfortunately, it wasn’t nothing.”
An ultrasound and a biopsy revealed Mindy had stage 2 breast cancer. She met with surgeon Dr. Nichole Ingalls at Northwest Surgical Specialists to discuss her treatment options.
“That first visit is designed to give the patient a good perspective of what they’re dealing with and what their next steps are going to be,” says Dr. Ingalls.
Mindy chose to have a mastectomy with breast reconstruction. She explains, “When I made that decision, it wasn’t for the people who would be looking at me. It was for me to feel comfortable. I didn’t want to wear a prosthesis every day. I just wanted to feel like myself.”
There are three options when it comes to breast reconstruction:
- No reconstruction
- Immediate reconstruction
- Delayed reconstruction
“For most patients, immediate reconstruction is the most attractive option,” says Dr. Garth Meldrum, Mindy’s plastic surgeon. “But sometimes a cancer diagnosis can be so overwhelming that the patient wants to treat the cancer first and deal with the reconstruction later. A delayed reconstruction makes sense in those situations.”
Not all women are candidates for immediate reconstruction, but there are benefits for patients who are candidates.
“We work with the oncologic surgeons and basically do two surgeries in one—the mastectomy or lumpectomy plus the reconstruction—so, we combine the healing time for the patient,” Dr. Meldrum says. “We can also preserve the skin envelope of the breast, and that is important in the overall aesthetic result.”
There is much to be discussed between the breast cancer surgeon and the reconstructive surgeon before a patient’s surgery.
“Based on what the reconstructive surgeon recommends, we have to decide: ‘Does the cancer allow us to do that?'” says Dr. Ingalls. “There are factors that need to be discussed with the plastic surgeon in order to make the best plan both from an oncologic surgery perspective and from a reconstructive surgery aspect.”
Collaborative patient care
Dr. Ingalls and Dr. Meldrum are members of the Oregon Cancer Alliance, a network of physician groups that work together to care for patients. They meet regularly in what’s called tumor board to review cases, provide expertise and recommend treatment options—essentially assuring that all of the specialists a patient will see are on the same page.
“The breast surgeon is involved, the plastic surgeon is part of the team, the medical and radiation oncologists are there, as well,” says Dr. Ingalls. “Think of it almost like a football team—everyone has a very specific, key role—that if that player wasn’t there, the whole game wouldn’t go the way that it should.”
Physicians discuss the timing of a patient’s surgery, whether the patient will need other treatments before or after surgery, such as chemotherapy and radiation, and how that will affect their body and their ability to heal.
“I think our collaboration leads to better care,” Dr. Meldrum says. “The more the team communicates together, the better we will do in making sure that timing is optimal. I think it also improves the outcomes for patients, as well.”
Focusing on health and healing
After Mindy’s initial surgery to remove her breast and add her implant, the pathology showed her margins weren’t clear. As a precaution, Mindy underwent a second surgery to remove additional breast tissue. This time, she was not only focused on her own health, but she was supporting her mother who was battling stage 4 lung cancer.
“I had so much support from my family and friends to help me get through it. You get through it because you have to,” she says.
Knowing that all of her doctors were working together on her behalf was comforting to Mindy and made her feel that she was in good hands.
“I just can’t tell you how wonderful it is. It’s a wonderful team. All 5-stars in my opinion. I’m just very thankful.”