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“My pregnancy was totally normal until my 36th week—that’s when I learned I had breast cancer. I noticed a lump in my left breast and mentioned it to my OB/GYN, Dr. Danielle Holmes,” Gillian says. “Dr. Holmes arranged for me to have an ultrasound at Virginia Hospital Center Women's Imaging Center. They fit me in right away.”
“Because Gillian had very dense breast tissue and her breasts were swollen from pregnancy, the images from the sonogram were not definitive,” says Bonnie Ahn, MD, a radiologist specializing in breast imaging. “But I could see that the growth looked like it had tentacles—most benign tumors are smooth. I asked her to come back early the following morning for a biopsy.”
“I received a call from Dr. Ahn confirming I had cancer,” says Gillian.
“It’s frightening to be told you have breast cancer,” says Dr. Ahn. “I was surprised how strong and brave Gillian was. She said, ‘Tell me what I have to do.’”
Immediately a care team began to come together and worked with Gillian to develop a plan of action. “Dr. Ahn referred me to Claire Edwards, MD, breast surgeon,” says Gillian. “She also asked me to follow up with my OB/GYN and to come back to see her for imaging of the left lymph nodes and right breast. When I called to make those appointments, Dr. Ahn had already called ahead to share my information with Dr. Edwards and Dr. Holmes. That made me feel good.”
“Our approach to breast cancer treatment at Virginia Hospital Center is multidisciplinary and coordinated. For breast cancer, that’s a necessity,” says Dr. Edwards, who is part of The Reinsch Pierce Family Center for Breast Health, VHC Physician Group.
“We review complex cases at the tumor board, which involves input from all specialists. Everything that breast cancer patients need is available here on the Hospital campus—from surgery and radiation therapy, to chemotherapy, clinical trials, genetic testing and support services.”
One week after her diagnosis, Dr. Holmes delivered Gillian’s daughter, McCoy, via Cesarean delivery. “Every nurse and provider I encountered during my maternity stay were sensitive to my situation and made me feel really supported. I had the best birth experience for McCoy at Virginia Hospital Center, just as I had three years earlier with my daughter Ramsey,” says Gillian.
The team quickly scheduled Gillian for a CT scan and bone scan—tests she could not have while pregnant—to see if cancer had spread beyond her breast. “It was a very scary day,” recalls Gillian. “I had a 3-year-old and a newborn at home, and I was about to find out if I had metastatic breast cancer. By the time I left the Hospital, Dr. Edwards called to say there was no cancer anywhere else, but the genetic test showed I had the BRCA2 gene.”
“Prophylactic contralateral mastectomy is recommended for women with the BRCA2 gene,” says Dr. Edwards. “Alternatively, Gillian could have undergone intensive screenings more frequently or taken preventive medication prescribed by a medical oncologist, but neither are as effective as bilateral mastectomy, which reduces the risk of breast cancer in an unaffected breast close to 100%.”
Gillian decided to proceed with bilateral mastectomy and also opted to have preventive surgery to remove her ovaries because the BRCA2 gene put her at increased risk for ovarian cancer.
To determine whether chemotherapy should be done before or after her breast surgery, Dr. Edwards referred Gillian to Neelima Denduluri, MD, breast medical oncologist and Chair, Cancer Committee, Virginia Hospital Center. Because of the size and aggressiveness of the tumor, Dr. Denduluri recommended chemotherapy first.
“Chemotherapy would shrink the tumor, and Dr. Edwards felt that downsizing the cancer would facilitate nipple-sparing surgery and a better cosmetic outcome. And, if there were any rogue cells somewhere else in her body, chemo would potentially kill those cells,” says Dr. Denduluri.
“I told Dr. Denduluri I was ready to start now, the sooner the better,” says Gillian, who had chemotherapy over 16 weeks, with treatments every two weeks. “It made me feel tired, but not nauseous,” she says. “My husband and I received incredible support from our family and friends, who were always on hand to help with our daughters, especially on chemo days.”
Four weeks after her final chemotherapy treatment, Dr. Edwards performed a nipple-sparing bilateral mastectomy. At the same time, Marilyn Nguyen, MD, VHC Physician Group Plastic & Reconstructive Surgery, inserted tissue expanders, the first stage of breast reconstruction surgery.
“Gillian had a nipple-sparing mastectomy with prepectoral breast implant reconstruction. These two recent advances in breast reconstruction technique allow us to better preserve the natural shape and contour of the breast,” says Dr. Nguyen. Three months later, Dr. Nguyen performed the second surgery to remove the expanders and place the final implants.
Today, McCoy is eight months old and Gillian’s life is back to normal. She will continue to take hormone therapy for several years and be monitored carefully by her doctors.
“All of the doctors on my team were the biggest advocates for me and my health. I felt empowered. They turned what was a scary nightmare into a beast we could kill together. I am so grateful and thankful,” says Gillian.
“From the beginning, Gillian had the best attitude,” says Dr. Holmes. “Being treated within the Virginia Hospital Center community enabled our multidisciplinary team to provide excellent care. Everyone communicated with each other. Her care was seamless.”
The experts at Virginia Hospital Center are committed to providing the most advanced and dedicated care to patients with breast cancer. Click here to learn more about the Reinsch Pierce Family Center for Breast Health.