Making Her Whole Again

Overcoming Scars with Reconstructive Surgery

Janet Fowler went 12 years without a mammogram. She was busy keeping a roof over her family’s heads and being a caregiver for others, including her boy-friend who had liver cancer. But she knew she was taking a chance with her health. “I could feel a lump and see changes in my breast. But I didn’t have health insurance,” she shares. “It was a lame excuse.”

So, when Janet finally did get insurance in November 2011, one of the first things she did was to make an appointment for a mammogram. The results revealed cancer in her left breast, and inconclusive areas in her right. The diagnosis, unfortunately, came within days of her boyfriend’s passing.

“His last coherent words to me: ‘Do whatever you can to get rid of the cancer.'” So, less than two weeks later, Janet underwent a double mastectomy.

“I didn’t have a lot of time to prepare; I just went with it. I guess I was numb.” Following surgery, she had six months of chemotherapy and radiation treatments. Throughout this difficult period, Janet was buoyed by her faith, financial and emotional support of her family, her best friend and her church family, and by the staff at NorthBay Cancer Center. “I am so grateful I was sent there for treatment,” she says.

“Learn everything you can about the procedure so you know what to expect, and reach out to others who may have had a similar experience. Then you’ll be prepared.”

—Janet Fowler

Before Janet’s mastectomy surgery, the topic of breast reconstruction came up with her oncologist, J.D. Lopez, M.D. “I was told that it was every woman’s right to be made whole again, but I just wasn’t sure what I wanted to do at that point.”

After surgery and treatments, Janet opted for prosthetics. She gave them a try, but found them uncomfortable, and they made her feel self-conscious.

“I felt self-conscious in a crowd,” she says. “I took to wearing sports bras and tank tops over my prosthetics, just to feel more comfortable.”

After many prayers, a heart-to-heart conversation with her mother, and several consultations with Jason Marengo, M.D., oncoplastic surgeon, Janet decided to have reconstructive surgery. Although Dr. Marengo had just joined the NorthBay Cancer Center staff, his reputation as a reconstructive surgeon was spreading fast.

“He gave me such hope,” she recalls. “Dr. Marengo is wonderful. After the surgery, I was ecstatic; I felt complete and whole again.”

Janet’s first surgery took place in June of 2013, and the second was in January, 2014. She’s very glad she went through with the procedures, although recovery from the first was difficult. “That’s because I didn’t listen to my doctor and tried to do too much. The second time, I listened and knew what to expect.”

Janet hopes other people can learn from her experience. “Just because you don’t have health insurance doesn’t mean you can’t have a mammogram. There are services, such as Solano Midnight Sun, that can help you.” (The Solano Midnight Sun Breast Cancer Foundation is a nonprofit organization that provides both emotional and financial support to women who are uninsured or underinsured. For information, visit

And, listen to your doctors, she advises. “They will tell you what your limitations may be. Learn everything you can about the procedure so you know what to expect, and reach out to others who may have had a similar experience. Then you’ll be prepared.”

Know the Symptoms

Being aware of how your breasts normally look and feel is the first step toward keeping up with your breast health. Mammograms and regular exams are important screening tests that can help detect breast cancers in early stages. If you have any of the following symptoms, consult your doctor right away.

  • A lump in your breast is the most common symptom of breast cancer. Lumps can be hard and painless, while others are painful. But not all lumps are cancerous.
  • Swelling in and around your breast, collarbone or armpit.
  • Skin thickening or redness, particularly if your breast starts to feel like an orange peel, or gets red.
  • Breast warmth and itching may be a sign of mastitis, or inflammatory breast cancer.
  • Nipple changes. If your nipple turns inward, or the skin on it thickens, gets red or itchy, or you have a discharge (other than milk).
  • Pain, especially if it is severe and persistent, and is not related to your menstrual cycle.

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