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Pathways to Discovery: Fall 2011

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Young Mother Grateful for Innovative Breast Care at UChicago

The end result was amazing.
—Kim Jewett, breast cancer survivor

Kim Jewett was just 31 years old when she began to experience regular fatigue, frequent migraines, and a dull pain in her left breast. Cancer ran in her family. Her
grandmother had breast cancer, her mother had brain cancer, and her aunt had colon cancer.

Jewett, who had breast implants for nearly a decade, performed a self-exam and found a mass under her left armpit near her breast. She had to persuade her obstetrician/gynecologist to order a mammogram. “She was hesitant at first because I was so young. She thought it was just a fibroadenoma,” said Jewett.

Jewett finally had the mammogram, and the radiologist marked the lump as suspicious. She had an immediate ultrasound and then a biopsy.

This normally very energetic, west suburban mother of two received a telephone call on the Friday before Memorial Day in 2008. It was the general surgeon who performed her biopsy. Jewett was told she had breast cancer and that she should consider a double mastectomy.

“I was stunned. A double mastectomy seemed so aggressive,” explained Jewett. “Of course, I got right on the internet to do some research.”

Jewett said she was really impressed with The University of Chicago, not only because it is the #1 ranked cancer center in Illinois, but also because each physician’s biography, contact information, and photo were readily accessible online, along with video segments. She e-mailed Nora Jaskowiak, MD, because of her extensive experience in the surgical management of breast cancer, and David H. Song, MD, MBA, because of his international reputation in plastic and reconstructive surgery.

“Both doctors responded within minutes and said they would make time to see me Tuesday morning,” said Jewett. “It immediately eased my fears to know that after the holiday weekend was over, these prestigious doctors were going to review my situation with me.”

After performing additional diagnostic exams, Dr. Jaskowiak, associate professor of surgery and surgical director of the UChicago Breast Center, found a second cancerous nodule—this one in Jewett’s lymph nodes.

Dr. Jaskowiak said Jewett’s breast implants may have made it easier for her to feel that original lump. “Research shows that breast implants may make mammograms
less sensitive while making physical exams more sensitive because the implants provide a platform on which you can better feel the breast tissue,” she said.

UChicago’s multidisciplinary breast cancer team hosts weekly meetings to discuss individual cases. After hearing their treatment recommendation, Jewett chose to have a modified radical mastectomy with reconstruction followed by 5 months of chemotherapy. A year later, she had her other breast removed prophylactically.

The surgery was tricky because of the original implants, but both Drs. Jaskowiak and Song used innovative techniques to remove the cancer and then reconstruct her breasts. “We’ve led clinical trials on things like acellular dermal matrices, which are internal supporting structures for the implants,” explained Dr. Song, vice chair of surgery and chief of the Section of Plastic and Reconstructive Surgery. “When I performed Kim’s surgery, it was on the newer end of the spectrum. Now it is the standard of care.”

Jewett initially balked at the idea of reconstruction. “When a woman is diagnosed with breast cancer, her initial response is ‘Take it off and get rid of all of it,’” said Dr. Song. “Because we are catching cancer earlier than ever before, the chances are very high that a patient will one day resume a normal life. I think ahead for them when things like body image, sexuality, and clothing will be important again. It’s much easier to reconstruct the breast at the initial surgery than it would be 5 years or 10 years later.”

The Women’s Health and Cancer Rights Act of 1998 requires most group insurance plans that cover mastectomies to also cover breast reconstruction.

Jewett said she’s really glad she listened to Dr. Song’s advice. “The end result was amazing,” she said. “If I had not gone to The University of Chicago, I don’t know where I would be today.”

Nora Jaskowiak, Rita Nanda, David Song, breast cancer team

The multidisciplinary breast cancer team meets weekly to discuss individual cases. (from left) Nora Jaskowiak, MD, Rita Nanda, MD, and David Song, MD, MBA.

Kim Jewett breast cancer survivor