Linda Gottlieb - Patient Story

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

— Linda Gottlieb, Breast Patient

Linda Gottlieb has always been vigilant about getting her annual mammogram. Even though breast cancer does not run in her family, she knows the importance of screening. However, she typically does not perform a breast self-exam. In November 2008, she learned her routine mammogram was normal. Just five months later, she was getting out of the shower, and as she wrapped her towel around herself, Linda felt a small lump in her breast.

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

Linda went to a local hospital for a biopsy. She recalled 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," shared Linda, who was looking forward to participating in her oldest granddaughter's Bat Mitzvah later that year. "I went 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]."

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

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

"I was so thankful to be under Dr. Bleicher's watchful eye. He is terrific," Linda shared. She scheduled her first lumpectomy for May 11, 2009. Dr. Bleicher removed the tumor and based on the sentinel node biopsy, she 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. Linda scheduled her 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," Linda noted, who underwent her 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 Linda to consider a mastectomy and reconstruction and recommended the plastic and reconstructive surgeons at Fox Chase, who specialize in breast surgery.

Linda landed on the Fox Chase website and started to read the breast cancer patient testimonials. She wanted to gather as much information as she could. "I read all of Dr. Topham's testimonials and it made me feel more comfortable going into surgery."

When Linda met Dr. Neal Topham for the first time, he explained her options for reconstruction. Linda opted for the LD (Latissimus Dorsi) flap procedure, which uses muscle and skin from the upper back. "Dr. Topham was very kind and considerate," Linda added. "He made me feel like I was his only patient. He is truly concerned about his patients."

On August 3, Linda checked into the hospital for what she hoped will be the last time. Her team of surgeons, Dr. Bleicher and Dr. Topham, performed a mastectomy and reconstruction all at once. It was important to Linda to enter surgery with both of her 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. Linda commented that her 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."

Linda spent the following month recovering and slowly returned to work as a travel agent. By eight weeks, she was back to her old self. Her circle of friends provided Linda and Mark the support they needed to get through the couple's second bout with cancer.

She consulted with a radiation oncologist at Fox Chase and a medical oncologist, Dr. Lori Goldstein. "The doctors were spectacular and kind. They made me feel so comfortable," Linda thought. After evaluating Linda, the team decided she would not benefit from radiation, so chemotherapy was a consideration.

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

Linda concluded that, "All in all, considering my diagnosis, the time that I spent at Fox Chase was as good as it could be under the circumstances. Dr. Topham's physician assistant, Matt Wetherhold, and the doctor in the hospital, Dr. Carlos Medina, were terrific.

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

Connect with Fox Chase