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Linda Gottlieb: Four Breast Cancer Surgeries

"I was so thankful to be under Dr. Bleicher's watchful eye."

— Linda Gottlieb

I have always been vigilant about getting my annual mammogram. Even though breast cancer does not run in my family, I know the importance of screening. However, I typically do not perform a breast self-exam. In November 2008, I learned my routine mammogram was normal. Just five months later, I was getting out of the shower, and as I wrapped my towel around myself, I felt a small lump in my breast.

The lump bothered me for a couple of weeks, so I asked my family doctor to check it. My doctor was concerned and recommended I go straight to a breast surgeon for a biopsy. Looking back, I credit my doctor with saving my life. Without her opinion, I may have waited until my next mammogram, at which point the tumor could have turned invasive.

Receiving Diagnosis

I went to a local hospital for a biopsy. I remember that one Friday afternoon when the surgeon called. She told me she wasn't sure if she should ruin my weekend or not, but my biopsy came back malignant. At the time I was looking forward to participating in my oldest granddaughter's Bat Mitzvah later that year. I fell to pieces. It was the only time I cried during this whole ordeal. I didn't know what the future would hold, but I knew that I wanted to be there for our family's Simcha [celebration].

My husband, Mark, was treated at Fox Chase for ureteral cancer five years earlier. We credit Dr. Robert Uzzo and Fox Chase Cancer Center with saving his life. Mark's Story.

My first appointment was with Dr. Richard Bleicher, a breast surgeon at Fox Chase. I had another mammogram and ultrasound, but the tumor did not show up. Dr. Bleicher and his team got together and suggested I get an MRI. That's when they saw it. The tumor was larger than they expected. It was originally estimated to be two centimeters but turned out to be almost four. Due to the size, my diagnosis was stage 2 breast cancer.

Three Lumpectomies

I was so thankful to be under Dr. Bleicher's watchful eye. He is terrific. I scheduled my first lumpectomy for May 11, 2009. Dr. Bleicher removed the tumor and based on the sentinel node biopsy, I learned there was no node involvement. However, the surgeon could not get clear margins.

During a lumpectomy, the surgeon removes the tumor and a border of healthy tissue surrounding the mass, leaving behind as much healthy breast tissue as possible. The breast is essentially left intact, without the need for reconstruction (as with a mastectomy). A pathologist examines the tissue that is removed to check for cancer cells in the border. A report of "clear margins" means there is no cancer in the outer tissue. As a result, there is a lower risk of recurrence. If there are no clear margins, the surgery may need to be performed again. I scheduled my second lumpectomy for June 4. Again, surgeons could not get clear margins.

I really wanted to save my breast, so I decided to try surgery one more time. I underwent my third procedure on June 22. Again, there were no clear margins. Dr. Bleicher said it was close, but he was not comfortable. I could tell he was truly sorry to tell me this news. He asked if I wanted to consider a mastectomy and reconstruction and recommended the plastic and reconstructive surgeons at Fox Chase, who specialize in breast surgery.

Final Surgery

I landed on the Fox Chase website and started to read the breast cancer patient testimonials. I wanted to gather as much information as I could. I read all of the plastic and reconstructive suregons' testimonials and it made me feel more comfortable going into surgery.

When I met the chief of the Divison of Plastic and Reconstructive Surgery for the first time, he explained my options for reconstruction. I opted for the LD (Latissimus Dorsi) flap procedure, which uses muscle and skin from the upper back. The surgeon was very kind and considerate. He made me feel like I was his only patient. He is truly concerned about his patients.

On August 3, I checked into the hospital for what I hoped was the last time. My team of surgeons performed a mastectomy and reconstruction all at once. It was important to me that I enter surgery with both of my breasts and come out with both breasts intact.

After the surgery, Dr. Bleicher reported that they were finally able to remove all the diseased tissue. Honestly, my 2-day stay in the hospital was amazing. The nurses were one of the reasons I chose Fox Chase - they are fabulous. I remember the way they cared for my husband when he had surgery. You don't see that type of compassion very often at hospitals. Everyone you meet is so kind. I was never afraid.

Post Surgery Treatment

I spent the following month recovering and slowly returned to work as a travel agent. By eight weeks, I was back to my old self. My circle of friends provided Mark and me with the support we needed to get through our second bout with cancer.

I consulted with a radiation oncologist at Fox Chase and a medical oncologist. The doctors were spectacular and kind. They made me feel so comfortable. After evaluating me, the team decided I would not benefit from radiation, so chemotherapy was a consideration.

Women who meet certain medical criteria, like me, have access to a relatively new test that predicts whether women will benefit from chemotherapy. I had decided that if the results were borderline, I would get the chemotherapy. Fortunately, my results were clear - my low score indicated chemotherapy would do more harm than good. My chances of recurrence are relatively low. I started a 5-year dose of a drug called Femara, which will help maintain my low risk of recurrence. Femara is an oral non-steroidal aromatase inhibitor that is given to women following treatment of hormonally-responsive breast cancer.

Preventions 

All in all, considering my diagnosis, the time that I spent at Fox Chase was as good as it could be under the circumstances. My plastic and reconstructive surgeon's physician assistant, Matt Wetherhold, was terrific.

After my experience with breast cancer, I encourage other women to perform breast self-exams, in addition to annual screening. And although I had no family history of the disease, I plan to undergo genetic testing so I can share the results with my daughters. You never know. My mother died of uterine cancer. Maybe there is something we can learn from my experience.

Learn more about breast cancer treatment at Fox Chase Cancer Center.

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