Breast-Conserving Cancer Surgery at Ingalls Best Option for Homewood Woman

At age 79, Donna Anfield assumed breast cancer was a health concern for younger women. As it turns out, the energetic grandmother of eight was mistaken. Age is one of the leading risk factors for developing breast cancer. In fact, women in their 70s and 80s comprise the fastestgrowing group of newly diagnosed breast cancers in the United States today.

But even the national mammogram screening guidelines don’t specifically address how often a woman over 70 should have a mammogram.

In Donna’s case, it had been three years.

“I thought at my age, it wasn’t really necessary,” she said. “I sloughed it off. I guess I take my health for granted. Other than a recent rotator cuff surgery, which was elective, I’ve never had any type of health problems.”

Luckily for Donna, the cancer — diagnosed last fall following a walk-in mammogram at Ingalls Family Care Center in Flossmoor — was caught very early. As a result, she was able to have breast-conserving surgery at Ingalls Memorial Hospital followed by radiation, instead of mastectomy.

“Under certain circumstances, women with breast cancer have the opportunity to choose between total removal of a breast (mastectomy) or breast-conserving surgery or lumpectomy, followed by radiation,” explains Gary Peplinski, M.D., boardcertified general surgeon, who specializes in oncologic surgery.

“Lumpectomy followed by radiation is equally as effective as mastectomy for a patient with only one site of cancer in the breast and a tumor under four centimeters.”

Clear margins — that is, no cancer cells in the tissue surrounding the tumor — are also a requirement. Donna, who met both criteria, said, “My daughter came with me to my initial consultation with Dr. Peplinski, and she asked him, ‘If it was your mom, what would you recommend?’”

“Lumpectomy,” he replied.

That was exactly what she wanted to hear. Before she underwent the minimally invasive procedure at Ingalls last November, cancer specialist Mark Kozloff, M.D., ordered a body scan to look for other possible sites of cancer. When the scan came back clean, Donna scheduled her breast cancer surgery.

“I had cancer for only 11 days,” she said with a smile, referring to her Nov. 8 diagnosis and Nov. 19 surgery.

“Everything fell into place like clockwork,” she said. “I left my house at 6 a.m. that day and was on my way back home by 4 p.m. The surgery was on time, and everything went smoothly. I couldn’t be happier.”

Breast-Conserving Surgery

During lumpectomy, the surgeon removes the cancerous tumor and some of the normal tissue around it. In Donna’s case, Dr. Peplinski also removed three lymph nodes, which all tested “clean.”

Until the mid-1980s, mastectomy was the standard of care for any stage of breast cancer, and research has shown that surgeons who trained before 1981 recommend mastectomy more often than lumpectomy.

However, in 1990, a National Institutes of Health consensus panel concluded that lumpectomy followed by radiation is as good as mastectomy for early-stage breast cancer.

“If you feel strongly about one option over the other, ask your surgeon how many mastectomies and lumpectomies he or she performs and why,” Dr. Peplinski added.

The main advantage of lumpectomy is that it preserves much of the appearance and sensation of the breast. And since it is less invasive, recovery time is shorter and easier.

“Experts agree that lumpectomy followed by radiation is the preferable treatment for most women with early-stage breast cancer,” he added. “And while breast-conserving surgery is more likely to be performed on younger women, the exception is women 80 years of age or older, among whom the frequency of breastconserving surgery is the highest.”

For Donna, who’d never had surgery before her rotator-cuff repair in early 2013, breast-conservation surgery was ideal. After she completed six weeks of radiation, Donna also enrolled in a clinical trial at Ingalls designed for post-menopausal women with estrogen-positive breast cancer. The trial uses the medication anastrozole (marketed under the trade name Arimidex) to inhibit the synthesis of estrogen, thereby preventing recurrence.

“While women my age don’t necessarily have to take such an aggressive approach to treating their cancer, the way I look at it, ‘It’s in there. I want it out, and I don’t want it growing back,’” she said. “My cancer is gone, and I want to keep it that way.” Donna will remain on the trial for five years.

“I had cancer for only 11 days,” she said with a smile, referring to her Nov. 8 diagnosis and Nov. 19 surgery. “Everything fell into place like clockwork...I left my house at 6 a.m. that day and was on my way back home by 4 p.m.”

Now that she’s fully recovered from surgery and radiation — and suffered no ill side effects from the clinical trial, Donna’s back to doing what she loves best — staying active.

“I golf, I bowl, I do water aerobics, yoga and Pilates,” she said. “I’ve always been athletic and enjoy physical activity. Last week, Dr. Kozloff gave me full clearance to do whatever I want to do — except lift 100-pound weights.”

Since her brush with breast cancer, Donna, who spent 11 years as the Ingalls Senior Life Travel coordinator and escort, has become a vocal advocate of the Cancer Support Center in Homewood, just minutes from her home. Not only does she take advantage of the center’s yoga and nutrition classes, she volunteers there too.

“It’s a wonderful place,” she adds. “I’ve learned a lot about how to eat healthier and take better care of myself. I would recommend it for anyone who’s been touched by cancer.”

As for what prompted her to get a mammogram in the first place, Donna said the “walk-in mammograms” banner in the lobby at Ingalls Family Care Center in Flossmoor caught her eye every time she went to the facility for physical therapy following her shoulder surgery.

“It sort of stared at me every time I was there,” she said. “I had kind of felt something in my breast and sensed something was there. I’m so glad I made the decision to have the mammogram right then and there, and I only had a 45-minute wait as a walk-in. I couldn’t be happier with the entire cancer team at Ingalls that took care of me; everyone was the best.”

For more information about breast cancer care at Ingalls, call 708.915.HOPE (4673).

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