Restoring Hope and Dignity

Advanced Approach Proves Effective for Women with Breast Cancer

September 2012 was shaping up to be a difficult month for Beverly Stewart. The 64-year-old Angel’s Camp resident had just learned her job would be eliminated and with it, her health insurance. Not yet old enough for Medicare, she was researching options when she attended a regular monthly meeting of the Soroptimists International of Calaveras County.

“The guest speaker that day was a breast cancer educator who was there to remind women of the importance of getting regular mammograms,” Beverly recalls. “I hadn’t had one in five years. Like so many women, we let work and other things get in the way, but after hearing her speak, I thought I better get mine before the end of the month.”

It was a fortunate decision. The mammogram revealed a lump and her follow-up tests indicated cancer.

Upon hearing the news, Beverly’s family members sprang into action, and she is grateful for the immediate support she received from them, especially daughter Shelley Johnson, who is director of Medical-Surgical Services at NorthBay Medical Center and NorthBay VacaValley Hospital.

“Without hesitation, Shelley said I should come to the NorthBay Cancer Center because they have the best oncologists and surgeons.” Beverley says. “My son-in-law said I could stay at their home for the treatments, rather than travel back and forth. And so I put it all in her hands.”

A diagnosis of breast cancer can be overwhelming. Until now, cancer surgery came first and plans for reconstruction followed at a later date.
—Dr. Jason Marengo

First, the lime-sized lump needed to be removed by oncoplastic surgeon Jason Marengo, M.D. He joined the Center for Specialty Care in 2012, and is one of only a handful of surgeons nationwide trained in both surgical oncology and plastic surgery.

Before the surgery, Dr. Marengo met with Beverly and explained his surgical philosophy: “I am in a unique position to provide a truly comprehensive surgical plan to my patients. Breast reconstruction is often only discussed in the context of recreating a breast after mastectomy, but I believe that reconstructive principles should be applied to every breast procedure, from the smallest breast biopsy to recreating a breast after mastectomy.”

He promised he would carefully remove the lump and reconstruct the breast so that Beverly would not really notice any difference. “I was so overwhelmed with everything at the time that my first reaction was to say, ‘Are you joking? I’m 64, do you really think that is important to me?’ But, in fact, it is! I was so emotional I just couldn’t process what he was saying at the time.”

“A diagnosis of breast cancer can be overwhelming,” Dr. Marengo says. “Not only do you have to make decisions about treatment, you also have choices when it comes to breast reconstruction. Until now, cancer surgery came first, and plans for reconstruction followed at a later date.”

Dr. Marengo has personal knowledge of the long-term effects of breast cancer surgery. “My grandmother had breast cancer at a time when procedures were much more invasive. I witnessed how she coped with the side effects of such radical surgery.”

Dr. Marengo applies the principles classically used in breast lift, breast reduction, and breast augmentation to not only remove a breast cancer, but through careful placement of incisions and the use of breast-shaping techniques, restore, and in some cases improve, the breast’s appearance. The idea, he says, is to remove the cancer with as little damage to surrounding breast tissue as possible. “My job is a marriage of surgical oncology and plastic reconstructive principles.”

After three weeks of radiation treatment at the NorthBay Cancer Center, Beverly’s prognosis is very good. She has taken this opportunity to make some positive life changes.

“I’ve lost 30 pounds, I don’t eat processed foods and I walk five miles a day. I haven’t felt this wonderful in years!”

And, she’s had some time to reflect on Dr. Marengo’s original promise. “He was so right; reconstruction is important. I fit in all my clothes; I didn’t need a new bra. I truly become more appreciative as time goes by.”

To book an appointment with Dr. Marengo, contact the NorthBay Cancer Center at (707) 646-4000 or the Center for Specialty Care, a NorthBay Affiliate, at (707) 646-4180.

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