Reconstruction Is the Road Not Taken after Mastectomy

When Candace Anderson's screening mammogram at age 49 showed a lump in her right breast, the Petersham resident stayed calm and followed up with the recommended ultrasound and biopsy. Results came back as invasive ductal carcinoma. What she remembers from that difficult day in April 1999 was that she did not panic.

Within a day, Candace received a telephone call from the Comprehensive Breast Center at UMass Memorial Medical Center to set a time for her husband, Tom, and her to come to the multidisciplinary clinic for consultations. The clinic team includes radiologists, oncologists, surgeons, nurses and other health care providers. At that meeting, the couple was brought to an examining room where they were served tea. One by one, members of the team came in to speak with the couple about Candace's disease and what could be offered. This team approach provided comprehensive medical perspectives without the stress and strain of multiple appointments with various specialists. Later in the day, the entire team met to discuss specifics of Candace's case, including treatment options.

"Cancer was not new to us," said Candace. "Tom was living with prostate cancer and my father was dying from bladder cancer." She faced her cancer head on, partly because of Tom's spirited attitude on living with cancer: "Live life with joy," he would say. "Treat your cancer like it's only background noise!"

After much discussion with her cancer team, Candace chose mastectomy instead of a lumpectomy. Secure in a marriage of many years, this was the choice she and Tom had made. Radiation would not be needed with this option. Heavy on her mind, though, were how their two children, Barrett, a high school student, and Emily, out on her own, would react now that both their parents had cancer. Beyond that, Candace, an artist and a teacher, also worried about how "inconvenient" cancer would be to her demanding schedule. With time, both concerns lifted.

Candace had surgery the following month at UMass Memorial. Kathryn Edmiston, MD, the associate director of the Comprehensive Breast Center, was Candace's medical oncologist, someone who came highly recommended by her primary care physician, Michael Ennis, MD. Candace's breast was removed, along with two sentinel nodes, the first nodes that are reached by lymph fluid from the site of the cancer. Sentinel node removal is less surgically invasive than the traditional axillary node removal. Pathology results from the node were negative, something that averted further treatment with chemotherapy. While many women might have chosen reconstructive surgery, Candace considered it unnatural and invasive. She thought as an artist, she would feel very positive about her body if there could be some art at the mastectomy site.

Two years after her mastectomy, Candace designed a motif featuring an ancient Roman symbol of renewed life, a peacock. She drew her peacock with a sweeping tail perched on a blossoming tree branch. She collaborated with a friend, a tattoo artist, to finalize the design and then the friend etched the peacock onto her chest, at the mastectomy site. "My husband loves it. I love it, and it's very empowering to have a design with such symbolism."

Candace has high regard for the care she received from the oncology team and the compassionate way she was treated. "I was surrounded by supportive people and this made the whole experience manageable."

Since her surgery, Candace is doing well and is taking Evista. Today her mobility permits her to work as a painter, and she likes creating naturescapes. Her appreciation for nature has deepened since her cancer. She finds beauty, as well as lessons, in simple things that nature offers.