Sonia Smith - Patient Story
"I am indebted to my team of Fox Chase doctors for being able to call myself a breast cancer survivor."
— Sonia Smith, Economic and Business Development Program Administrator for Bucks County
As the Economic and Business Development Program Administrator for Bucks County, PA, Sonia Smith is always on the go. However, after hearing the results of a routine mammography in January 2011, her world stood still. Further testing confirmed Sonia had stage 2 breast cancer in her left breast. “My son and daughter were in 7th and 9th grade, and I wasn’t sure how they would handle the news,” recalled Sonia. “I confided in my partner, Stephen, who lost his wife to a brain tumor. He and I agreed to keep this to ourselves until we had a plan in place.”
“I always thought I would die from a heart attack or skin cancer one day,” admitted Sonia, who was 47 at the time. “Breast cancer never crossed my mind.” Her mother is one of seven sisters and only one had breast cancer, which was likely a result of her taking DES during a pregnancy. Her gynecologist recommended additional tests, which were performed at her local hospital. When Sonia learned the cancer had spread to all four quadrants of her breast, she began to research her treatment options.
“I wasn’t ready to think about major reconstructive surgery at that point,” shared Sonia, who sought a second opinion. My gynecologist suggested I see Dr. Marcia Boraas, a surgeon at Fox Chase Cancer Center. “Dr. Boraas was really terrific and spent time explaining my options with regards to the mastectomy and reconstruction." Dr. Boraas recommended she make an appointment with one of Fox Chase’s medical oncologists who specializes in breast cancer, Dr. Paula Ryan.
“As soon as I met Dr. Ryan, I loved her.”
“I just cannot say enough good things about Dr. Ryan,” shared Sonia, who was impressed that Dr. Ryan is a researcher and clinician. “It was so easy to talk to her, and we even discussed her research.” Dr. Ryan understood that Sonia wanted to avoid major surgery, and started her on a 16-week course of chemotherapy designed to to shrink the tumor so that less invasive surgery might be an option.
With a plan in place, Sonia shared the news with her family and her co-workers. “Everyone was very supportive,” shared Sonia, who continued to work full-time through treatment, often with a baseball cap on her head. With his experience taking his late wife to countless doctor appointments, Stephen suggested that Sonia invite a different friend each week to accompany her to chemotherapy, which was a great distraction and even enjoyable at times. “Stephen brought me to my first and last appointment – and has been the best support person I could ask for. I am also so grateful to my friends and the business community that surprised me with homemade dinners, flowers, and sent notes of encouragement and funny get well cards.”
By July, the chemotherapy had done its job, and Sonia was ready for surgery. Dr. Boraas explained that a mastectomy would be effective in removing all of the cancer, and reconstruction could be performed at the same time. A less invasive procedure, called a lumpectomy, is performed when the tumor is more confined. But it is imperative to obtain clear margins – meaning no cancerous tissue is left behind. Per Sonia’s wishes, Dr. Boraas performed a lumpectomy on two separate occasions, but the margins were not clear. “I really appreciated Dr. Boraas’ willingness to work with me and honor my wishes.”
“The nurses were amazing and very responsive.”
Dr. Boraas referred Sonia to Dr. Neal Topham, chief of plastic and reconstructive surgery at Fox Chase, who explained her options for reconstruction, which were the free TRAM flap procedure or implants. Sonia chose the free TRAM flap option. In late September, Dr. Boraas and Dr. Topham teamed up to perform the single mastectomy and reconstruction. Sonia stayed in the hospital for a week. “The nurses were amazing and very responsive.” Although Dr. Topham recommended eight weeks for recovery, Sonia went back to work two weeks early, admitting she couldn’t sit still, and she continued to work from home during the time she was out. “I adored Dr. Topham, and the procedure was great because they used muscle, fat and skin from my abdomen to create a new breast – which was like getting a tummy tuck as a bonus! It looks perky, and it feels just like a real breast!”
Once she recovered from surgery, Sonia was on to the next step in her treatment – radiation therapy to ensure all the cancer was eradicated from the breast area. Fox Chase operates a satellite radiation facility in Buckingham, which is very close to her home. “Starting in December 2011, I went every day for five weeks. Ironically, my last day of radiation was January 10, 2012 – one year to the day that I received my diagnosis,” shared Sonia. “I absolutely loved Dr. Hayes – she is really nice and runs an efficient practice. I never had to wait for an appointment. And it’s cool to ring the bell when your treatments are completed.”
In May 2012, Sonia revisited Dr. Topham to have a breast uplift on her right breast, to have it look like her reconstructed left breast. Two months later, she had a nipple reconstruction, followed by an areola tattoo. “My goal is to look normal whether I’m at the beach or in the YMCA locker room,” she explained.
In addition to surgery, chemotherapy, radiation and a clinical trial, Sonia joined a support group at Fox Chase.
Sonia joined Fox Chase’s breast cancer support group that is run by the nursing and social work department. “Carolyn Weaver and Coleen Boyd did such a great job facilitating the group,” shared Sonia, who enjoyed meeting women at all stages of treatment. “We really supported each other.”
Through this experience, Sonia grew closer with her children. Her son participated in Relay for Life this year (an American Cancer Society benefit) through Central Bucks School District. And last year, during her treatments, her daughter and her friends participated in Relay for Life and organized a tag sale of clothing and books to benefit the American Cancer Society. “I was so proud of my children who did this in honor of me,” Sonia explained. “I can’t tell you how much that meant to me.”
Because family history of breast cancer can indicate high risk, Sonia met with a genetic counselor at Fox Chase and underwent testing for the BRCA1 and BRCA2 genes. Fortunately, she was negative for both genes.
For five years following active treatment, Sonia will take Tamoxifen, a drug which has been proven to reduce the risk of recurrence. She has also enrolled in a clinical trial for a drug called Metformin, which is used to treat stage 2 diabetes and may be effective in preventing breast cancer recurrence. She enjoys contributing to clinical research, knowing that she is doing her part on the road to a cure.
“I had always heard of Fox Chase, but never really knew where it was,” admitted Sonia. “Turns out Fox Chase is not far from where I live in Bucks County. I feel so fortunate to have a world-class cancer center like Fox Chase so close to me because when it comes to cancer, you want the best care you can get. And with a team like Dr. Hayes, Dr. Ryan, Dr. Topham and Dr. Boraas, you can’t go wrong! I am indebted to my team of Fox Chase doctors for being able to call myself a breast cancer survivor. I have lost weight and began a yoga/pilates exercise program at the YMCA. I feel great, and I am so happy with the way I look. I encourage all women to schedule an annual mammogram. My cancer was not a detected lump; only the mammogram was able to identify the distortion which led to the diagnosis.”