Category: Evidence Based Research

The Intersection of Research and Decision for Breast Reconstruction

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One day your life is humming along as usual. Work, children, family, friends, school, house cleaning, errands, vacation, cooking, on and on. Then out of nowhere you hear the news that feels like a gut punch. “You have breast cancer.” Perhaps you get genetic test results back and you find out you have a genetic mutation putting you at high risk of getting breast cancer. You are thrust into a new role finding out all you can about your diagnosis. Will I be facing a mastectomy or choose a mastectomy for my treatment? When will the intersection of research and decision for breast reconstruction occur? The Research Process Why am I writing about this? I agonized over this part of my breast cancer diagnosis when I was told my best choice for my long-term survival was a double mastectomy. It was my second diagnosis and now in both breasts vs. Continue Reading →

Episode 7: Lobular Breast Cancer

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In episode 7 of the DiepCJourney podcast we are discussing lobular breast cancer, also known as invasive lobular carcinoma (ILC), with Leigh Pate. Lobular breast cancer is the second most commonly diagnosed type of invasive breast cancer. Often an understudied subtype of breast cancer I ask Leigh to join me on the podcast to help our followers understand more about it. Leigh founded the Lobular Breast Cancer Alliance (LBCA) in 2017 and continues to work as a research advocate in the breast cancer and ovarian/fallopian tube cancer community. Leigh and I both have had lobular breast cancer. I have tucked my diagnosis, both of them, away in files and don’t pull them out to often. This is my way of coping with two diagnosis of breast cancer. Connecting with Leigh, precipitated my need to talk about this. Our goal is to explain lobular breast cancer to patients who have it Continue Reading →

Can We Drive Change in Breast Sensation Through Webinar Attendance?

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We have become accustomed to attending online webinars. One I have watched from inception is the iBreastBook webinars. It was designed by oncoplastic breast surgeon Yazan Masannat. He is located in Aberdeen, Scotland. I continually learn from these webinars and appreciate the global presence of presenters and attendees. Yazan is driving change in breast surgery by exploring the latest surgical techniques in breast surgery in these online learning opportunities. The most recent one I attended I ask myself; can we drive change in breast sensation through webinar attendance?” Why is Driving Change in Breast Sensation Important to Me? The title of the webinar I am commenting on is, Mastectomy: What is New. The presenters were an impressive group of international surgeons in breast surgery. They are as follows: I am a patient who has experienced successful return of sensation to my breasts after DIEP flap breast reconstruction. It is equally Continue Reading →

How to Prepare for and Have a Shared Decision-Making Conversation

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Terri Coutee and Minas Chrysopoulo, MD FACS Shared decision-making occurs when your doctor (or any healthcare professional) collaborates with you to make the best healthcare decision. The optimal decision takes into account evidence-based information about the available treatment options, the clinicians’ knowledge and experience, and any factors you value in your decision-making. The patient brings their preferences, goals, lifestyle, support structure, …whatever they feel is important to them in making a decision. The physician brings evidence-based information and their expertise. Together, they find the “sweet spot” in the middle. Our aim is to offer recommendations for patient and healthcare professionals to prepare for and have a shared decision-making conversation. Most patients prefer this collaborative approach over deferring treatment decisions completely to their doctor. Unfortunately, in many cases patients may be reticent to initiate this type of conversation or simply don’t appreciate that they can. In reality, if the clinician doesn’t Continue Reading →

Creating Community to Promote Shared Decision-Making

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Throughout ancient history, we have gathered in communities to share stories. Stories change lives, change communities by connecting us with familiar human experiences. They can also elicit a call to action. Think back to a moment sitting around a family table, campfire, or standing on a neighborhood corner listening to someone’s story. Did it leave you with a lasting memory, provoke personal change, or inspire a call to action changing the trajectory of your purpose in life? How do we measure the value of creating community to promote shared decision-making? Authoring My Own Story Became My Call to Action My life changed by sharing my own story. I began writing a blog in early 2015 about my second breast cancer diagnosis that occurred in April of 2014. Seven months after a double mastectomy I had successful DIEP flap breast reconstruction using my own tissue. My surgery was performed by a Continue Reading →

WHIS Talks: Global Healthcare Thought Leaders Discuss Patient Empowerment and Shared Decisions

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Can we take concepts in healthcare and make them customary practice to improve patient care and outcomes by advancing patient empowerment and shared decisions? I invite you to consider this question yourself after watching the video and reading the summary from this session of WHIS Talks as global thought leaders discuss patient empowerment and shared decisions. Terri Coutee: Nonprofit Leadership and Shared Decisions I am a two-time breast cancer survivor who had successful DIEP flap breast reconstruction. As a trained ESL instructor turned nonprofit leader after my second breast cancer diagnosis, I appreciate the need for clear communication and understanding of language. In cancer care, patients must quickly absorb concepts and terms they have no knowledge of or intended to know about. Curating communities and discussion based on evidence-based medicine is an important aspect of cultivating the patient process helping them to understand the plethora of terms to use in Continue Reading →

Episode 15: Lymphedema Treatment and Surgery

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Lymphedema. It is not a disease. It is a condition breast cancer patients can experience. Skill, knowledge, expertise, experience, and compassionate care all matter when you are seeking any treatment for lymphedema. Our guest, Dr. Ramon Garza III, is well-qualified to discuss the topic of lymphedema treatment and surgery and possesses all of those characteristics. This is Episode 15 of the DiepCJourney podcast. Dr. Garza is a board certified plastic surgeon in San Antonio who practices at PRMA (Plastic Reconstructive Microsurgical Associates) and performs both surgical and non-surgical treatment for those affected by lymphedema. We discuss the value of finding a certified lymphedema therapist. You can search the LANA website for one in your area.  Understanding the Lymphatic System When Considering Treatment and Surgery The function of the lymphatic system is to move excess fluid out of our bodies. It works in unison with the immune system. It is the mismanagement of fluid that causes lymphedema. Continue Reading →

How Digital Health Can Enhance your Breast Reconstruction Decision

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Patients become unintended experts on a topic they likely had no intention of being an authority on. When you receive a diagnosis of breast cancer one of the biggest challenges is understanding the medical information you have to digest and make sense of for your own future health. How will these decisions affect your body, lifestyle, and long-term survival? If you are facing loss of breast due to a mastectomy, things can become a step more complex when digesting and understanding your options. Luckily, we live in an era where we have access to digital tools to assist with these decision processes. Digital health can improve your breast reconstruction decision. Defining Digital Health First let’s define what digital health is. It encompasses many platforms. Digital health can but is not limited to entities such as virtual consultations via your computer or phone and apps specific to a topic you need Continue Reading →

Episode 5: Abdominal Wall Reconstruction

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Dr. Ron Israeli of New York Breast Reconstruction and Aesthetic Plastic Surgery (NYBRA.com) and Dr. George DeNoto, Director of General Surgery and Hernia Institute, St. Francis, Hospital, East Hills New York, discuss the technique they have developed together in Episode 5, abdominal wall reconstruction, for the DiepCJourney Podcast. I hear from patients in the DiepCJourney Facebook group who requests information on various topics. This is one of those honored requests and I knew exactly who to turn to. I invited Dr. Israeli to do the podcast. To my pleasant surprise he asked if he could be joined by his colleague, Dr. George DeNoto. These two gentlemen have known each other for a while when they trained together in General Surgery. They refer to each other as “surgical brothers” leaning on each other as resource and eventually collaborating on a technique to repair hernia after TRAM flap surgery. Abdominal Wall Reconstruction Continue Reading →

Breast Reconstruction Truth: Headlines and Research

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Are you considering breast reconstruction? When I was faced with a second breast cancer diagnosis, had a double mastectomy, and began to do my own research about breast reconstruction, I was either oversaturated with information or wanted to shut down from information overload. When researching breast reconstruction, how do you distinguish the truth in headlines and research? The Moment of Truth The moment of truth begins when you are diagnosed or find you have a high risk of getting breast cancer due to a gene mutation. This moment is most often at the office of your healthcare provider. An oncologist, radiologist, breast surgeon, or genetic counselor are the most likely people to give you this news. You walk out the door with pamphlets and information. They might give you resources for online support, virtual meetings with other survivors, or websites to research. I hear so many individuals in this situation Continue Reading →