Margaret N

Taking Action: Breast Cancer Surgery And Back

In February 2015, Margaret N. (last name omitted) had a routine mammogram at the Seattle Breast Center at Northwest Hospital. As a breast cancer survivor, mammograms made her nervous, so she asked to review the results with the radiologist.

She knew it was breast cancer the moment she saw the scans. “I saw something right away,” said the 64-year-old.

Breast radiologist Dr. Craig Hanson explained that Margaret needed a breast ultrasound, followed by a biopsy to remove some tissue and test it for cancer.

Being a woman of action, Margaret didn’t hesitate. “I talked them into giving me the ultrasound and biopsy that same afternoon.” she said.

Two days later at her follow-up appointment, the pathology report confirmed she had cancer. Margaret was determined. She felt a few days’ head start could give her more time to get things accomplished.

She left the Breast Center and went immediately to the hospital’s Surgical Services & Hernia Center. The clinic booked an appointment the next day with general surgeon Dr. Alison Lytle Perrin, who specializes in breast surgery, including cancer and benign breast disease.

Margaret had the head start she wanted.

Surgery is the primary treatment for breast cancer. Women have many surgical options: breast conservation, which includes lumpectomy or partial mastectomy to remove just the affected tissue; or mastectomy, which removes the whole breast and lymph nodes. The lymphatic system helps the body fight infections, but many types of cancer spread using the lymph nodes.

Twenty years ago, when Margaret was diagnosed with breast cancer for the first time, she wasn’t aware of her family history of breast cancer. She chose a lumpectomy and radiation instead of a mastectomy.

“The decision I made then was the best I could make without knowing I had a family history. I don’t have any regrets,” she said.

At her appointment with Dr. Perrin, Margaret learned she had a type of cancer that often spreads rapidly.

“I knew right then I was going to have chemotherapy. And I had decided years ago that if I ever had breast cancer again, I was going to have a mastectomy and reconstructive surgery,” she said.

After discussing her surgical options with Dr. Perrin, Margaret crossed the hospital campus to plastic surgeon Dr. Dan Downey’s office, where he was able to fit her in for a consultation on breast reconstruction.

“In less than 72 hours, I had a mammogram, an ultrasound, a breast biopsy, and saw my surgeon and plastic surgeon,” she said. “Having all these services on the same campus made it so easy.”

“We treat our patients like members of our own family,” said Dr. Perrin, “which means getting them in quickly and being there emotionally when they need it.”

“When I joined Northwest Hospital 18 years ago,” she said, “I became part of a multidisciplinary team that discusses all cancer cases, from diagnosis to surgery to treatment. The hospital is small enough that we know all our colleagues, but big enough to have great expertise and the latest treatments available.”

Margaret’s surgery was scheduled for a month later. Dr. Perrin would perform a double mastectomy, a sentinel lymph node biopsy (to determine if cancer cells were present in the lymph nodes) and insert a chest port (also called a port-a-cath) to help with Margaret’s chemotherapy. If there were no complications, Dr. Downey would also insert tissue expanders, the first step in Margaret’s breast reconstruction process. A tissue expander is a breast implant that is filled with saline over time, slowly expanding the muscles and skin to reach the desired size.

As a voracious reader, Margaret’s love of learning helped her prepare and make decisions about her care. “The more you prepare for the little things, the less likely they are to throw you off,” she said.

Despite her preparation, she was still nervous on surgery day. “I couldn’t quite believe it was happening, since I felt the healthiest I’d felt in years,” she said. “I dreaded the surgery, but also knew it was the right thing to do.”

The surgical staff helped calm her nerves by providing simple comforts like a warm blanket while she was waiting.

“They are amazing. I can’t say enough nice things,” she said. “Northwest Hospital hasn’t changed in all the years I’ve been going here. I’ve had both my babies here and even my gallbladder out here when I was 27.”

The surgery went well. The biopsy, done during surgery, showed her lymph nodes were clear, so Dr. Downey was able to insert the tissue expanders, saving Margaret from another procedure later on.

Although she lives in Marysville, she appreciates getting all her care in one place, and continues to make the trip down for appointments with oncologist Dr. Kinsey McCormick and chemotherapy at the Seattle Cancer Care Alliance oncology clinic
on the Northwest Hospital campus.

She also has a new hobby thanks to Northwest Hospital Casting Call. The program teaches cancer patients to fly fish and was created by an oncologist at the hospital who thought the motion of casting a fishing rod could help with lymphedema.

Lymphedema is a swelling in the arms and legs caused by excess fluid buildup in the lymphatic system, and is common in mastectomy patients. “Casting Call is great for cancer rehabilitation because it gets the arms moving and reduces the swelling and tension of lymphedema,” said Dr. Perrin.

For Margaret, fly fishing was a healing experience that provided some normalcy during her treatment. She enjoyed it so much she plans to take her daughter and husband.

“That’s one thing I’ve discovered about cancer – go try new stuff. Do it,” she said. “Sure, have a bucket list, but don’t concentrate so hard on it that you ignore what’s happening in the moment. You might pass up opportunities you might not expect.”

Throughout Margaret’s surgery, recovery and ongoing chemotherapy, she has remained positive, and is grateful to have gained new perspective.

“You may lose the innocence of not knowing your own mortality, but you gain a better appreciation for today and the moment,” she said.

For more information on breast cancer surgery and treatment at Northwest Hospital, visit brokenlink.com. For information on Northwest Hospital Casting Call, email MaryAnne.ChurchTrettenero@nwhsea.org or call 206.668.1838.

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