Just one day

'Just one day' — a patient’s first day at Roswell Park

When Karen K. first walked through the doors of Roswell Park in September 2020, she was scared. But by the end of her first day at Roswell Park, she says, “I walked out of those doors knowing that I was in good hands, and that there was a plan for me. I felt like everyone I met there that day had wrapped their arms around me in a hug. For the first time since having an abnormal mammogram at another facility a month before, I finally felt safe.”

Karen’s cancer story began with a routine mammogram in August 2020. “I’m 67, and I’ve had annual mammograms at the same facility for years, with no irregular findings.” This year, however, was different. Because of COVID, many facilities — including Roswell Park — did not have mammography patients stay at the office to learn their imaging results, but called them later. “The radiologist called me the next day and told me he saw some suspicious findings and he needed to get additional images,” Karen recalls.

And so began “a long horrible month of screening, testing and waiting.” It took two weeks before Karen was able to get another mammogram and an ultrasound, and another 10 days before she could be scheduled for a biopsy. A week and a half after getting a biopsy, Karen had an MRI, and then a few days later, she received a phone call from a technician who told her, “You have breast cancer.”

A week later, Karen met with a surgeon from her radiation facility, and surgery to remove one of her breasts was scheduled for the following month. “Something — I can’t define exactly what it was — nagged at me,” she says. “The surgeon’s bedside manner didn’t exactly make me jump for joy. He told me about the surgery, but I still had so many unanswered questions.”

“So I decided to get a second opinion at Roswell Park. It was one of the best decisions I’ve ever made.” 

Comprehensive and caring

Within a week of calling Roswell Park, Karen and her husband met with Kazuaki Takabe, MD, Chief of Breast Surgery, and Robert Lohman, MD, a surgeon in the Department of Plastic & Reconstructive Surgery. “The first thing that impressed me was that they were organized and worked as a team. Their bedside manner put me at ease almost immediately. They had already reviewed all of my images and records before I arrived. Both doctors clearly explained my situation and a recommended treatment plan for me, and Dr. Takabe even made me laugh,” Karen says.

Proving Karen’s point, Dr. Takabe explains that “the patients we see are not just walking breasts. They are people who may be afraid and have a lot of questions. At Roswell Park, we are not only a treatment facility but also a research and academic facility, and part of our mission is to help patients understand cancer and their treatment options. When the patient understands these things and has a voice in the treatment decisions, the physicians and the patients can fight cancer together.”

“When Karen came to us, she didn’t have a clear or completely accurate explanation of her type of tumors, and exactly how they would be treated beyond the initial surgery,” says Dr. Takabe. Indeed, after reading Karen’s original mammogram, Ermelinda Bonaccio, MD, Roswell Park’s Chair of Diagnostic Radiology, agreed with the finding of a 10 mm stage 1A tumor at one location in Karen’s breast, but determined that what had originally had been interpreted as a group of small calcifications in another location in the breast were, in fact, extensive high-grade stage 0 ductal carcinomas in situ (DCIS) that were twice as large as originally estimated. 

“A DCIS is a tumor that is so ‘wimpy’ that it can’t get out of the milk ducts, but it can still be dangerous, because it can expand by growing spindly legs,” Dr. Takabe says. Because the DCIS occupied close to half of Karen’s breast, he recommended mastectomy — removal of the affected breast.

A treatment plan she understood

“I was totally on board with the option of a mastectomy. I wanted all of the cancer gone,” Karen says. “Dr. Takabe explained that if I chose to work with Roswell Park, my surgery would be performed within a few weeks — the medically recommended standard of care for timely treatment.”

Then Dr. Lohman explained Karen’s options regarding breast reconstruction after a mastectomy, and how it is done. “I made the decision right there that this was where I wanted to be treated. These doctors and the entire Roswell staff were all so kind and thorough, and I knew I was in the right place,” Karen says.

Before she left Roswell Park that day, Karen’s surgery had been scheduled and all her necessary preoperative tests and clearances were completed. “No more extra trips and appointments — everything was taken care of at Roswell Park that first day, and it was such a relief,” Karen recalls.

Karen’s surgery went well. “After the surgery, pathologist Boulis Beshai, MD, found an unanticipated DCIS in the nipple that had grown from Karen’s first DCIS, but because we had already explained the nature of DCIS spindles, Karen was not alarmed,” Dr. Takabe says. “This also confirmed that we made the right decision to perform a mastectomy instead of a lumpectomy, which would have missed the DCIS in the nipple.” Dr. Lohman then fitted Karen with a temporary tissue expander to prepare for her reconstruction surgery.

Once Karen’s tumors had been analyzed and genetically profiled using the state-of-the-art OmniSeq molecular test (developed at Roswell Park), Karen met with Ellis Levine, MD, Chief of Breast Medicine. “Dr. Levine explained that because my tumors were early-stage and estrogen-positive, I could be treated with an estrogen-blocking drug instead of chemotherapy,” Karen says.

The next major step in Karen’s treatment will take place in May, when Dr. Lohman will perform her breast reconstruction.

Looking back on her experience, Karen advises, “When it comes to cancer, don’t just settle for partial explanations. Go to a facility where the staff treats you with respect and dignity and takes the time to explain things to you and answer your questions. I just can't say enough great things about the treatment and care I received at Roswell Park.”

Editor’s Note: Cancer patient outcomes and experiences may vary, even for those with the same type of cancer. An individual patient’s story should not be used as a prediction of how another patient will respond to treatment. Roswell Park is transparent about the survival rates of our patients as compared to national standards, and provides this information, when available, within the cancer type sections of this website.

Fonte: Roswell Park

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