Show your support for Breast Cancer Awareness month! Get the latest news on mammogram screenings, treatment centers, and innovative reconstructive surgical practices
BY LIZ PETONIAK
As a child, Dr. Jim O’Toole grew up telling his parents he would become a plastic surgeon — even without really knowing what one did. Today, O’Toole is not only a plastic surgeon with his own practice, he’s also a reconstructive surgeon, redefining the way that both surgeons and patients view traditional breast cancer surgery methods.
“I became interested in reconstructive surgery after an interaction with a patient who had just undergone a bilateral mastectomy,” he says. “From a surgeon’s perspective, it was a victory, but when I went to see her in the clinic, she was crying. I asked her what was wrong. She looked down at her standard, conventional mastectomy scar, and she told me, ‘I look like a 14-year-old boy who was attacked by a lion.’ When you are involved with a surgery that left a woman feeling that way, what do you say? Afterward, I looked at all the photos of standard mastectomy incisions and saw that they hadn’t changed over a period of 10 years. In training, I was told that if you can recreate shape and form for the breast, then you’ve done your job. But, I realized that wasn’t enough. There are 20 to 30 different incision patterns for breast lift and reduction surgeries that are used to make the scars less visible. Why we didn’t use them for breast cancer patients made no sense to me.”
In 2005, O’Toole began applying cosmetic approaches and incision patterns to breast cancer procedures, and he said that he immediately noticed a significant positive effect on his patients. They no longer had to look down at themselves and see a huge scar reminding them of their experience. In order for patients to see the scar underneath the reconstructed breast, they would have to be standing in front of a mirror. Says O’Toole, “Patients tell me, ‘I didn’t expect to wake up [from the surgery] and look like myself,’ or ‘I never had to wear disguising clothing and feel self-conscious.’ When you operate on the female breast, you’re dealing with how a woman identifies her sexuality, sensuality, and femininity. To not take that into account is unacceptable in my opinion.”
However, O’Toole recognizes that there are times where the cosmetic approach is not possible. For example, smaller incisions may not effectively allow surgeons to eliminate cancer in patients with unknown tumor biologies or with tumors close to the skin in areas above the nipple. “That’s when the clinician needs to be smart and know when and when not to apply it,” he says.
Fortunately for Joan Lewis, the cosmetic approach was a viable option. She was referred to O’Toole after being diagnosed with stage one breast cancer at age 48. “After my husband and I had a consultation with Dr. O’Toole, he and I agreed that it was no-brainer since it eliminated a whole surgery,” she says. Ten days later, O’Toole and Dr. Raye Budway of St. Clair Hospital performed a double mastectomy on Lewis, using the cosmetic single-stage approach, and then reconstructed her breasts with implants. She only stayed one night in the hospital because she wanted to be home for her two children. “My goal each day was to be showered and up by the time my children arrived home in the afternoon,” says Lewis. “Every day, I would stay up a little longer, and after 10 days, it was a good recovery.”
O’Toole says, “The first two weeks of recovery are rough, but patients are back up to speed in six weeks. I tell patients that you want to give yourself time because there are two components: the physical recovery and the emotional recovery. Sometimes the emotional takes longer, but if this method can shorten it, that means a lot to the patient.”
For Lewis, she was back to a regular exercise routine in two months. “I’m a very positive person despite everything that happened,” she says. “Moving forward, I want to be strong so that if it does come back, I can fight it.”
And to O’Toole, his patients’ happiness and recovery means everything to him. “If you notice the way I interact with Joan, it’s because I’m close with my patients. I’m still a clinician, but I’m here to help them through everything,” he says. This desire to better the experience of battling breast cancer drives his need to educate other surgeons and to raise public awareness for the options available. In October, he will visit the Highmark Health System to discuss the requirements and benefits of these alternative methods in hopes of making them more available to Western Pennsylvania residents. Currently, O’Toole is the only surgeon in Pittsburgh using these cosmetic methods in breast cancer surgeries. “It seems so obvious, but for the longest time, there was such a stark distinction between what was deemed cosmetic surgery and necessary reconstructive surgery,” he says. “The reality is that there’s a lot of crossover between the two and that if you can borrow from the other, you should.”
O’Toole Plastic Surgery, 5200 Centre Ave., Suite 703, Shadyside. 412.345.1615.
ON JOAN: Makeup and manicure by Bonnie Kolba, La Pomponnée Salon and Spa. Hair by Jennie Williams, Sognatoré Salon. Jewelry provided by Orr’s Jewelers. Ippolita Wonderland Rainbow Collection sterling silver large teardrop ring, $595, and 40-inch necklace, $995. Ippolita sterling silver 33-inch clear quartz necklace, $795. Roberto Coin 18-karat white gold diamond and pink sapphire cluster pendant, $19,000. John Hardy Dot Collection sterling silver 36-inch necklace, $895.
Raising the Standard
This October marks the one-year anniversary of the new Breast Care Center at St. Clair Hospital, a unique facility in Mt. Lebanon. Since it opened, the center has consistently provided patients with personalized care in a convenient location using state-of-the-art equipment, such as 3D mammography, which resident breast surgeon Dr. Raye Budway says will eventually become the standard for mammography screening. “The center is so convenient for those in the suburbs because they don’t have to go into the city to receive the best detection and diagnostic services,” she says. “We have everything patients need and they can park for free.” Aside from the convenient location, patients appreciate the relaxing, spa-like space that St. Clair created to address the stress that accompanies breast cancer screening. Additionally, patients can feel less anxious knowing that it’s easy to schedule an appointment at the St. Clair Breast Care Center on short notice and that the center provides quick results. Says Budway, “We can provide patients with fast results and diagnostics here, which is key when dealing with breast cancer. The sooner you can detect a problem and know your options, the better.”
St. Clair Hospital Breast Care Center, 1000 Bower Hill Road, Mt. Lebanon. 412.942.3177. stclair.org.
Susan G. Komen Pittsburgh recently expanded to include 30 to 34 counties in Western and Central Pennsylvania, extending its reach to increase awareness and fundraise for breast cancer research and services, such as providing mammogram vouchers for those without health insurance. The local branch of the largest nonprofit funder of breast cancer research in the U.S. has raised more than $33.5 million. The Komen Race for a Cure is held every Mother’s Day, but Komen Pittsburgh offers opportunities to help the cause year-round, especially during Breast Cancer Awareness month. On October 6, Susan G. Komen Pittsburgh will host its fifth annual Paws for the Cure dog walk at Hartwood Acres and will sponsor a number of other events throughout the month. “Creating your own event is great, too!” says Kathy Purcell, chief executive officer of Susan G. Komen Pittsburgh. “You can host a dinner and instead of each guest bringing a bottle of wine, have them bring a donation.” Purcell also stresses the importance of being educated and learning the facts, both for your own health and to help spread awareness in the community. “Sometimes, knowing and acting are two different things, but we need to change behavior. Women think that if you don’t have a family history, you don’t need an annual mammogram, and that’s just not true. People often forget that men get breast cancer, too. One more person educated helps.”
Susan G. Komen Pittsburgh, komenpittsburgh.org.
Prevention is Key
Breast thermography is a medical imaging tool that has been FDA-approved as an adjunct to other diagnostic tests since the early ‘80s. Locally, HE@T Health Enhancing Thermography, owned and operated by Certified Clinical Thermographic Technician Bethany Narey and staff, offers radiation-free, painless screening. It takes only 15 minutes and can detect disease by way of detecting thermal abnormalities and patterns present in the body, as well as subtle physiologic changes that accompany breast pathology, whether it is cancer, fibrocystic disease, an infection, or a vascular disease. Thermography breast screening is suitable for all women, but is especially appropriate for women from ages 23 to 55, whose denser breast tissue can make effective mammography difficult. Breast thermography is also a great option for women who are fibrocystic, have had a mastectomy, are unable to undergo routine mammographies, or have implants. When thermography and mammography are completed together, the best possible evaluation can be made.
HE@T Health Enhancing Thermography, 110 Fort Couch Road, Bethel Park. heat-images.com.
Healthcare professionals recommend that women have annual screening mammograms from the age of 40 and up. But, in special cases, women may need to start earlier. According to UPCI’s Dr. Nancy Davidson, women who belong to families with a history of hereditary breast cancer should have their first screening mammogram five years before the first diagnosis was made in their family. So, if a high-risk woman’s mother was diagnosed at 35, she should begin screenings at age 30. Women of any age who have breast symptoms may be advised to have a diagnostic mammogram.
Breast Cancer Awareness Month Event Guide
Make a difference by attending local events to support research for breast and other cancers!
Hot Pink Pittsburgh, August Wilson Center for African American Culture, adagiohealth.org
Breast Cancer Awareness Pink Luncheon, Le Grande Room, 724.483.5063
American Cancer Society’s Coaches vs. Cancer, Heinz Field, 412.919.1042
Philip Pelusi Pink Runway Fashion Show, WHIM Station Square, philippelusi.com
Mario Lemieux Foundation and Pittsburgh Penguin Foundation’s Pittsburgh Penguins 6.6k Road Race, CONSOL Energy Center, mariolemieux.org
Susan G. Komen 5th Annual Pittsburgh Paws for the Cure, Hartwood Acres, komenpittsburgh.org
American Cancer Society’s Making Strides Against Breast Cancer Walk, 100 Art Rooney Ave., North Shore, makingstrideswalk.org
Chris4Life Colon Cancer Foundation Scope It Out 5K, North Shore Drive, scopeitout5k.com
8th Annual Pink Ribbon Round-Up Western Gala, Four Points by Sheraton Pittsburgh North, pinkribbonroundup.org
Hillman Cancer Center Gala — Living Courageously: A Future Without Cancer, CONSOL Energy Center, hillmangala.org
Susan G. Komen Tickled Pink Survivor Brunch, Omni William Penn Hotel, komenpittsburgh.org