“Dr. Kohli, Dr. Greco and their team not only saved my life, but they also helped me preserve my identity so I can live a normal life after breast cancer.”
An innovative approach to breast cancer treatment enabled one young patient to move past her diagnosis and treatment quickly
When Shawna Dempsey lost her mother to cancer in 2015, she never imagined she’d be diagnosed with the disease just two years later. It was especially shocking because Shawna was only 31, active and a nonsmoker. “It was the scariest experience of my life,” she says. Fortunately, Shawna, who lives in Middletown and is manager of dining services at Rutgers University, had early stage breast cancer, and her prognosis was excellent. She had high-grade ductal carcinoma (the cancer was in the milk ducts) in her right breast.
Shawna was diagnosed at Monmouth Medical Center (MMC) and was told she was a good candidate for a nipples paring mastectomy, in which the breast tissue would be removed but the nipple would be saved. To ensure she was making an informed decision, Shawna got a second opinion at a well-known cancer center. She was told she was not a candidate for a nipple-sparing mastectomy and would need three surgeries (a mastectomy, implants and nipple reconstruction). “I was devastated,” she says. “The recovery would be twice as long as the nipple-sparing procedure.”
A better cosmetic result
Shawna returned to MMC, where she met with breast surgeon Manpreet Kohli, MD, FACS, Medical Director of Breast Surgery at the Jacqueline M. Wilentz Comprehensive Breast Center and a member of Barnabas Health Medical Group. “I felt an immediate connection with her,” says Shawna. “She put me and my family at ease. My gut told me to choose MMC for treatment because I’d be in the best hands there.”
Dr. Kohli recommended performing the nipple-sparing mastectomy using the Hidden Scar technique, in which the physician removes cancerous tissue through a single incision in an inconspicuous area, resulting in less visible scarring. She is a Hidden Scar-trained surgeon, and MMC is the first hospital in New Jersey to be certified as a Hidden Scar Center. “Treating the cancer is always the first priority, but we don’t always have to sacrifice appearance,” says Dr. Kohli, who uses the Hidden Scar technique in about 70 percent of the hundreds of breast cancer surgeries she performs each year.
“With the Hidden Scar approach to surgery, we are able to place the incision in a location that is difficult to see. As a result, the scar is not easily visible when the incision heals. This is important because scars have a significant impact on patients’ body image, intimacy, confidence and mental health.” Working with plastic and reconstructive surgeons at MMC, Dr. Kohli is able to preserve the skin covering the breast, maintaining its natural contour. Reconstruction using an implant or the patient’s own tissue can be done at the same time. “We’re committed to giving women access to transformative options in breast cancer surgery,” says Gregory Greco, DO, MMC’s Chief of Plastic and Reconstructive Surgery.
The Hidden Scar surgery can be performed whether a patient is having a mastectomy or a lumpectomy. To use the approach for a mastectomy, the patient must have a nipple-sparing procedure. The scar is located underneath the breast, says Dr. Kohli. With a lumpectomy, the surgeon removes the tumor and a small portion of healthy tissue but saves the remainder of the breast. The scar is located either underneath the breast or along the border of the areola (it blends in with the pigment), says Dr. Kohli.
Surgeons who use the Hidden Scar approach work in a small space to remove a tumor or breast tissue, so the area must be well-lit. The company that developed the Hidden Scar technique, Invuity Inc., pioneered a technology called Photonics, which illuminates the entire breast cavity and is integrated into surgical devices.
Moving past the diagnosis
Shawna had a double mastectomy using the Hidden Scar approach and was able to return to work in four weeks. “I have no visible reminder of the mastectomies or malignancy,” she says. “Psychologically and emotionally, this has helped me to move past my cancer diagnosis.” Shawna is comfortable knowing that she hasn’t sacrificed safety for the sake of appearance. Patients who undergo Hidden Scar surgery aren’t at higher risk of a recurrence than those who have traditional surgery, says Dr. Kohli.
Shawna is grateful to her physicians at MMC. “Dr. Kohli, Dr. Greco and their team not only saved my life, but they also helped me preserve my identity so I can live a normal life after breast cancer,” she says. Indeed, she and her fiancee are expecting their first child—a girl—this summer.
Best candidates
In order to undergo the Hidden Scar procedure, a breast cancer patient must be a good candidate for a nipple-sparing procedure. There are two key considerations, says Manpreet Kohli, MD, FACS, Medical Director of Breast Surgery at the Jacqueline M. Wilentz Comprehensive Breast Center and a member of Barnabas Health Medical Group:
• The patient’s nipple must be cancer-free.
• Ideally, the patient’s nipple is centrally located on her breast. In order for the nipple to “survive” surgery, it must receive blood supply from the surrounding tissue. With a large, heavier breast, the distance to the nipple is longer, and there’s a chance that surgery could disrupt the blood supply, says Dr. Kohli.
Visit the Jacqueline M. Wilentz Comprehensive Breast Center to learn more about their breast health services. Visit Hidden Scar to learn more about this breast cancer surgery. Early detection of breast cancer saves lives, request a mammography appointment at an RWJBarnabas Health facility near you.