I had a lumpectomy, I felt no pain, and the nurses were positive and reassuring.
In the fall of 2019, Nancy Stevens, 78, was surprised when a routine mammogram revealed a suspicious area in her left breast.
“There was no cancer in my family,” says the antique dealer in Smithville. “I didn't know what to do. I had heard that RWJBarnabas Health had good breast care, so I called and was referred to Dr. Schulman.”
Nancy saw breast surgeon William Schulman, MD, at Monmouth Medical Center Southern Campus (MMCSC) in November.
“I liked him immediately,” she says. “He is soft-spoken, and he made me feel comfortable.”
Dr. Schulman recommended a core biopsy guided by ultrasound. Nancy had the procedure in early December, and it showed that she had invasive ductal carcinoma in her left breast. The tumor was only 8 millimeters and was considered Stage I (early cancer).
Personalizing Treatment
When formulating a treatment plan for Nancy, Dr. Schulman took into account the fact that she has a serious lung condition called bronchiectasis, in which the airways are scarred. As a result, she’s vulnerable to lung infections.
Dr. Schulman advised that Nancy have a lumpectomy, in which the tumor is removed. Her lymph nodes didn't need to be biopsied, and she wouldn’t need radiation therapy after surgery.
“We tailored the treatment to Nancy so that it protected her from the side effects that can be associated with aggressive treatment,” says Dr. Schulman. “With more aggressive surgery, she would be exposed to anesthesia for a longer period of time. Also, radiation therapy can have an impact on the lungs. Clinical studies show that the approach we took is highly effective in women in Nancy’s age group.”
Nancy had the lumpectomy the day after Christmas.
“I had no pain,” she recalls. “The nurses were positive and reassuring. I went home the same day, and life went on.”
Nancy had no complications or postoperative problems, says Dr. Schulman. He sent her to a radiation oncologist to confirm that she didn’t need radiation therapy, and the doctor agreed that it wasn’t necessary. He also referred her to Seth Cohen, MD, Regional Director of Oncology Services for the RWJBarnabas Health Southern Region and a medical oncologist.
Since Nancy’s tumor was hormonally sensitive, Dr. Cohen prescribed an estrogen-blocking therapy, which she will take for five years to reduce the risk of a recurrence.
Minimizing Side Effects
In previous years, a patient with Nancy’s type of tumor might have undergone lymph node biopsies and radiation therapy in addition to the lumpectomy and hormone therapy.
“We’ve learned through landmark studies that evaluation of lymph nodes and postoperative radiation therapy may not have an impact on well-being and survival in patients like Nancy,” says Dr. Schulman. “Sometimes, more treatment isn’t necessarily better for a patient. By treating Nancy’s cancer in a less aggressive way, she experienced a few side effects, and her chances of survival are excellent.”
With the type of tumor Nancy had, her 10-year survival rate is 90 percent, says Dr. Schulman. She was able to avoid the possible side effects of radiation therapy, which include thickening of the breast skin, shrinkage of the breast, and chronic pain.
Removing lymph nodes can lead to chronic pain and swelling in the arms, says Dr. Schulman.
“As long as a patient is willing to take hormone therapy, he or she won't jeopardize survival,” he adds.
Today, Nancy is cancer-free and happy the experience is behind her. She will see Dr. Schulman three to four times per year for the first two years after her treatment, and then once every six months in the third through fifth years. After that, she’ll see him once a year.
“I’m relieved this is over,” she says. “I didn’t think breast cancer could happen to me. I felt comfortable and secure at Monmouth Medical Center Southern Campus. It was great that I didn’t have to go to New York or Philadelphia to get top-notch treatment.”
Learn more about breast cancer care at Monmouth Medical Center Southern Campus or call (844) 226-2376 to make an appointment.