April 27, 2017
Using my voice during breast cancer treatment
BY Chitra Viswanathan, M.D.
Before I was diagnosed with breast cancer in 2011, I’d never had a mammogram. I was only 38 at the time, so I hadn’t started getting that annual test yet.
But that December, I found a lump in my right breast – a symptom of breast cancer. I was very apprehensive, and saw my gynecologist right away. He thought the lump could be benign, but recommended further testing. So I called Dr. Carisa Le-Petross in Breast Imaging and scheduled a mammogram at MD Anderson, where I work as a radiologist.
Accessibility proves no problem for wheelchair-using breast cancer patient
One of my biggest concerns before my breast cancer diagnosis was accessibility. In 1998, I sustained a spinal cord injury, which paralyzed me from the middle of my chest down. I’ve used a wheelchair to get around since then, so I worried about how I would navigate the diagnostic equipment effectively.
As it turns out, MD Anderson has both wheelchair-accessible mammography machines and wheelchair-accessible stretchers. And imaging technologists stand ready to assist patients with transfers whenever needed. I just rolled up to one of the mammography machines, and the technologists positioned my breast to get the views they needed. They were very kind and considerate, especially given the nature of the procedure.
More information, more flexibility in breast cancer treatment
As an MD Anderson radiologist myself, I know how to read imaging films. So when I saw the images from my own mammogram, I thought, “Oh, that looks worrisome.” An ultrasound and a core biopsy soon followed. A few days later, Dr. Le-Petross and Dr. Jennifer Litton gave me the news: it was stage I invasive ductal carcinoma – breast cancer.
Fortunately, we caught my cancer early. The tumor was still very small and relatively self-contained. Before I even started treatment, Dr. Litton used genetic testing to gauge the likelihood of its recurrence and whether I would benefit from chemotherapy. I was also tested for the BRCA1 and BRCA2 mutations, which make carriers significantly more likely to develop breast and ovarian cancers.
Luckily, the testing showed that my tumor had a low likelihood of recurrence, and I tested negative for both BRCA mutations. That gave us more treatment options for my breast cancer.
Customizing my breast cancer treatment
The flexibility provided by those test results would prove important, as we needed to consider my previous injury when deciding which type of surgery I should have.
The surgeons could not use my upper body muscle flaps for breast reconstruction because I depend on them to get around. They decided not to use my abdominal muscles for reconstruction, either, as doing so would require extra time for me to recover from surgery before starting chemotherapy — three months instead of the usual six weeks. I also had concerns about mobility. Based on my injury and the test results, I also opted to have a lumpectomy, rather than a mastectomy.
On Feb. 3, 2012, Dr. Kelly Hunt performed the surgery, removing the tumor and some adjacent lymph nodes. One of the nodes tested positive for cancer, bumping it up to stage II. But Dr. Hunt decided not to do a full axillary lymph node dissection to reduce the risk of lymphedema in my right arm.
My chemotherapy regimen began in March 2012: 12 cycles of Taxol and four cycles of FAC (5-fluorouracil, adriamycin, cytoxan) for six months. I then received radiation therapy five days a week for six weeks under Dr. Thomas Buchholz.
The good news is that the treatment worked. And thanks to the excellent care I received at MD Anderson, I’ve had no evidence of disease since November 2012.
Ask for what you need
Being a physician and working in a cancer center, I was probably a little more aggressive about asking questions and pushing for answers than most patients.
But every situation is different and you are your own best advocate, so I encourage other patients to speak up, too. Use your voice. Ask for what you need or want. That is the best way to get a positive outcome.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
TopicsHereditary Cancer Syndromes Symptoms Radiation Therapy Genetics Testing and Counseling Breast Reconstruction Treatment Breast Cancer Surgery Chemotherapy Prevention
Ask for what you need or want.
Chitra Viswanathan, M.D.
Physician & Survivor