“Both my mother and my grandmother had breast cancer,” said Andrea Fisher. “So my whole life, since probably I was 30 and started getting mammograms, I always felt that this was going to happen to me at some point.”
In 2013, following a routine mammogram, Andrea was diagnosed with ductal carcinoma in situ (DCIS), which is essentially stage 0 cancer, in the right breast and lobular carcinoma in situ (LCIS), an indicator for an additional risk of breast cancer, in the left breast. Her initial surgeon recommended a lumpectomy, but Andrea was worried about a recurrence of cancer and sought a second opinion from Lauren Cassell, MD, at the New York Center for the Advancement of Breast Reconstruction at New York Eye and Ear Infirmary of Mount Sinai.
“I'm married with three children, and I didn't want my family to have to worry about me,” said Andrea. “So I made the decision to have a double mastectomy and autologous breast reconstruction.” With Dr. Cassell performing the bilateral mastectomy, Andrea chose Joshua Levine, MD, and Robert Allen, MD, to perform the breast reconstruction surgery.
Why did you choose to have natural breast tissue reconstruction surgery?
I opted for a technique called Deep Inferior Epigastric Artery Perforator (DIEP) flap, in which the abdominal muscle is preserved, and skin, tissue, and blood vessels are taken from the abdomen and used to reconstruct the breast. Autologous breast reconstruction was appealing to me for a couple of reasons. First of all, the fact that I would be using my own body tissue to reconstruct my breast seemed like a no brainer. What else belongs in your body than your body? I never liked the concept of implants. I've known too many stories of women who have had trouble with implants; either they've burst, or become infected, and they look really unnatural. After surgery, I really wanted to look as close to what I looked like before surgery, and I knew that autologous would get me to that point. The other benefit was that after having three children and three c-sections, I've always dreamt of having a tummy tuck, and I got that with my surgery. That was my silver lining.
How was your experience with the DIEP flap surgery and your recovery?
I was lucky because I was able to have the double mastectomy and the reconstruction done at one time. It was a long surgery, I think it was about eight hours, but right after the surgery, I knew I made the right choice—because when I looked down at my breasts, they looked exactly like they did the morning that I went in for surgery. My scars are on the underpart of my breast and so, unless I'm standing in a mirror and I lift my arms up, I can't really see them. And, of course over time those scars begin to fade, so the physical reminders disappear. That gives me such comfort, to look in the mirror and look the same.
Of course, I won’t minimize it; the recovery from the surgery itself is really tough. I was in the hospital for five days, and the hardest part was the abdominal surgery. It takes a tremendous amount out of you physically, so you need to rest, and I spent a lot of time in bed. But I also rented a recliner chair, which was easier to get in and out of than a bed. That was a lifesaver. Two or three weeks after surgery, I went out for a walk to my favorite coffee place, which is a block away from my apartment, and I was shocked at how long it took me to get there. But after about six weeks, I was given the go-ahead to do some exercise with a physical therapist, and I started to feel significantly better.
How is your life different now, after the natural breast tissue reconstruction surgery?
I feel more empowered, having made a decision that really allowed me to move ahead with my life. I still work full time as an attorney, and my children are now 14, 16, and 19. I just never wanted them to worry about me. That goal was met.
Did your insurance cover the surgery?
Yes. My insurance company said they weren't going to pay for my procedure, and I went to the attorney general for the state of New York and I fought them. I got my procedure paid 100 percent. You have to be a fighter, you have to fight for what’s right for you and your body. Don't let insurance get in the way of what you want.
What advice can you offer to other women who may be newly diagnosed with breast cancer?
It’s important to become your own best advocate and an information junkie. Go on the Internet, ask friends who have gone through this, demand more of your doctor. If your doctor explains something to you and you don't understand it, stop them and say explain it to me in a way that I understand. Make a list of questions. Don't stop asking questions until you are 100 percent comfortable with the explanation. You really have to push your doctors to understand who you are, and to understand what's important to you in terms of your lifestyle.
When I raised the issue of double mastectomy to my first doctor, she actually told me it was over treatment. But knowing now what I know about the type of aggressive cancer I had, I have never ever regretted having made the decision to have a double mastectomy and autologous reconstruction.
This is your body, and no one should ever be able to tell you what's best for your body. Just as you would advocate for anything else that you believed in, you have to go out there and find the information, advocate for yourself, and do everything possible to get to a doctor who can do for you what you want for your body.