Goldilocks surgery: Finding the perfect balance in breast cancer reconstruction
Kathleen Stewart was used to ready for check outcomes. She’d been known as again for extra mammogram photographs many instances and had already undergone two biopsies of suspicious areas in her breasts.
In March 2022, as she waited for a name about the outcomes of a breast biopsy, the resident of La Crosse, Wisconsin, felt she already knew what they might be.
“I had already had that internal conversation that if I was diagnosed, I knew what I would do,” Kathleen says.
Not-so-surprising prognosis
Kathleen’s expertise with breast cancer started lengthy earlier than that afternoon. She was raised in a close-knit household and witnessed 11 members of the family recognized with breast cancer firsthand. She remembers how every responded to chemotherapy, radiation and surgical procedure.
Kathleen contemplated having a prophylactic mastectomy attributable to her household historical past of breast cancer. This surgical procedure removes breast tissue to decrease the probabilities of getting breast cancer in the future.
While contemplating this selection, the then 52-year-old scheduled a routine mammogram. It got here again clear, however she wasn’t satisfied. At the urging of her sister, Kathleen mentioned her issues and household historical past with Steven Perkins, D.O., her major care doctor. Together they determined {that a} follow-up MRI scan could be essential to present her peace of thoughts.
Kathleen’s suspicions had been appropriate. The MRI confirmed a small lump and swollen lymph nodes, resulting in a sonogram and one other biopsy. Kathleen was at work when she obtained the cellphone name from surgeon M. Kathleen Christian, M.D., who defined the biopsy confirmed that she had early stage 1A breast cancer.
“When you get breast cancer, it’s hard to understand the complexity of it. Dr. Christian did a really good job explaining it to me,” says Kathleen. “I took a deep breath, but I already knew I was going to be as aggressive as I needed to be because I have kids.”
Kathleen discovered that she had a “well-behaved tumor,” however an invasive one, so therapy could be required.
“Thankfully, Kathleen had been diligent about regular breast cancer screenings. Due to her obtaining recommended breast imaging, the cancer was caught early,” says Dr. Christian. “She had several options on how to best treat her cancer based on her desires and risks related to her family history. She has an excellent prognosis, and that’s what we want for our patients.”
Taking an aggressive strategy
Dr. Christian defined completely different therapy approaches to Kathleen, together with a lumpectomy to surgically take away solely the regarding areas in her breast.
“We talked about a lumpectomy, but I knew that wouldn’t give me peace of mind,” says Kathleen. “I used to be a high threat, and I knew {that a} mastectomy was the means I wanted to go.
A bilateral mastectomy would take away the cancer and each of Kathleen’s breasts. She wasn’t in reconstruction with implants or a flap procedure however did not like the thought of being utterly flat-chested after surgical procedure. She says she feared a drastically modified profile could be a continuing cancer reminder for her and her household.
Goldilocks: Not too little or an excessive amount of
That’s why Kathleen was relieved when Dr. Christian defined she is perhaps an excellent candidate for a brand new choice: a Goldilocks process.
“Even with hearing and watching so many family members on their cancer journeys, I’d never heard of this option before,” Kathleen says.
The Goldilocks process is carried out after a mastectomy to take away unhealthy breast tissue. Then, the remaining fatty tissue and pores and skin are fashioned right into a breast mound that offers some form and definition to the breast. The operation is often used in sufferers with bigger and heavier breasts, however it may be used in some sufferers with smaller breasts.
It’s known as Goldilocks as a result of it represents a middle-of-the-road choice for sufferers, explains plastic surgeon Matthew Sherrill, M.D.
“It’s an option that isn’t too extreme one way or the other. It’s halfway between mastectomy with a flat-chest appearance and full reconstruction with implants, expanders or a flap procedure,” says Dr. Sherrill.
The process additionally is sweet for women who cannot have or aren’t in reconstruction instantly after mastectomy.
“This technique is often used in patients with other medical comorbidities who may not be good candidates for an immediate breast reconstruction because of the potential complications,” says Dr. Sherrill. “The Goldilocks operation is sometimes the only step in the process, or it can be a starting block for future reconstruction. Reshaping the breast skin at the time of the mastectomy with the Goldilocks operation gives patients a template or a canvas to undergo future breast reconstruction if they desire.”
Collaboration for higher outcomes
Drs. Christian and Sherrill clarify {that a} collaborative, multidisciplinary strategy to breast cancer surgical procedure and reconstruction results in higher affected person outcomes and experiences.
“The operation is most successful when done as a team involving the surgeons, physician assistants and nursing staff in educating the patient before the surgery, coordinating the operation and supporting the patient during recovery,” says Dr. Sherrill.
Dr. Christian applauds the work of the devoted breast cancer workforce at Mayo Clinic Health System in La Crosse.
“We work closely together and meet regularly at our breast tumor conferences to discuss the best options available for treatment,” she says. “We then individualize recommendations based on the patient’s staging, tumor characteristics and what they want for surgical outcomes.”
Surgery and past
In June 2022, Kathleen underwent a bilateral mastectomy to take away each breasts and her cancer. At the identical time, she underwent the Goldilocks process to kind breast mounds from her present tissue and pores and skin. The surgical procedure was successful, and shortly she was recovering at residence.
Kathleen returned to work half time three weeks after surgical procedure and shortly returned to the sidelines to cheer on her sons’ sports activities groups.
After the surgical procedure, her threat of future breast cancer was low, so no extra therapy was essential.
Recovery went effectively however wasn’t utterly clean. Over a vacation weekend, she developed hives and a rash attributable to a beforehand unknown allergy to adhesives and latex. Dr. Sherrill known as her that weekend to debate her signs and get her the therapy she wanted for allergy reduction. She hasn’t had every other allergy points.
Since then, Kathleen determined to have extra reconstruction procedures to present her breasts extra fullness and form with out implants or extra intensive flap surgical procedures.
About one 12 months after her surgical procedure, Kathleen says she feels effectively and assured that she made the proper therapy selections. She additionally feels safe along with her healthcare workforce.
“Nobody ever said, ‘You’ve got this.’ It was always a team approach, and everyone said, ‘We’ve got this,'” she says. “Cancer is a scary word, and nobody wants cancer. But I know that I had the best team through this journey.”
This article initially revealed on the Mayo Clinic Health System blog.
