Part of the team
UF Health Breast Center – Jacksonville puts patient at the center of the huddle
By Tiffany Wilson
Debbie Galvin stepped out of the shower in a hurry to begin Easter Sunday festivities when her wrist brushed against her breast.
“I felt something different that I hadn’t felt before,” she said. “It was a lump.”
The next day she was in her OB/GYN’s office, and the day after that she had a diagnostic mammogram. She heard the words she dreaded: breast cancer.
Doctors recommended a double mastectomy. They scheduled the surgery for a few days later. But something didn’t seem right.
“It all happened so quickly and it seemed so radical. There was no conversation and it almost seemed mechanical. Like, this is the walk that every patient walks,” Galvin said. “I thought, ‘No, this is about me.’”
Everything changed when Galvin met with experts from the UF Health Breast Center – Jacksonville.
One of just two fellowship-trained breast surgeons in the region, Laila Samiian, M.D., marked where the lump was on Galvin’s breast. Then she pulled out a sheet of paper and started drawing how Galvin’s breasts could be reshaped depending on the size of the lump.
“It was almost as if they were in the operating room discussing what the plan was. I thought wow, this is teamwork,” Galvin said.
Galvin and her husband, Tim, discussed all the options with the team, and together they decided a lumpectomy and breast reduction would be the best course.
“A lot of people are encouraged to have double mastectomies, but she was good to get a second opinion,” Samiian said. “We planned it so carefully to make sure the chance of success was more than 90 percent. A double mastectomy wouldn’t have given her any better odds.”
Galvin’s lumpectomy was extremely precise, thanks to a relatively new technique called radioactive seed localization aided by 3-D mammography. The UF Health Breast Center – Jacksonville is the only facility in Northeast Florida capable of this 3-D digital imaging, called tomosynthesis.
“The technology today is just amazing,” said Martha Wasserman, M.D., chief of women’s imaging at UF Health Jacksonville.
Galvin’s breast tissue was immediately examined by pathologist Anwer Siddiqi, M.D. While Galvin was under anesthesia, she also had a sentinel node biopsy, something Samiian said all patients with invasive breast cancer should have. Sentinel nodes are the first lymph nodes in which breast cancer spreads. Siddiqi found that all three of Galvin’s sentinel nodes were cancerous, so Samiian removed the 30 remaining accessible lymph nodes. Six of those nodes also tested positive for cancer.
Samiian said having the pathologist, radiologist and plastic surgeon working with her during the surgery was crucial to the operation’s success.
“It takes extra effort to do something like this. If you’re not in a multidisciplinary group like we are, it would be so hard to coordinate everything,” she said.
Once the team confirmed the lump was completely removed, John Murray, M.D., an assistant professor of plastic surgery, reshaped Galvin’s breasts.
Now, Galvin is receiving chemotherapy and preparing for radiation, which she hopes to under go at the UF Proton Therapy Institute. During proton therapy, patients receive targeted doses of radiation that cause less damage to healthy tissue. Researchers believe it could counter the prevalence of heart disease in women who have traditional radiation on their left breast, which is right above the heart.
As she continues to undergo chemotherapy, Galvin said she feels like she can take on anything now.
“I’ve had the biggest scare of my life. I don’t think anything else can scare me,” she said. “I realize now anything is possible.”