Woman Chooses Preventive Surgery to Reduce Breast Cancer Risk

Kathy McGee says she had resigned herself to what seemed like a fact: She would have breast cancer. Both her mother and two aunts had fought the disease, so McGee started regular breast cancer screenings at age 35 and decided to pursue genetic testing for the BRCA 1 and 2 mutations. Women who have this harmful mutation are five times more likely to develop breast cancer than women who do not have such a mutation.

It was in 2008, after learning she was positive for the BRCA1 gene mutation, that she decided to take preventive action. 

Through the FORCE (Facing Our Risk for Cancer Empowered) conference, she connected with patients from across the United States facing similar hereditary cancer risks—a step she credits for giving her the knowledge and confidence she needed to take control of her future cancer risk.

McGee elected to have a preventive bilateral salpingo-oophorectomy, a procedure to remove her ovaries and fallopian tubes to reduce the risk of developing reproductive tract and breast cancers. 

She then connected with a high-risk breast cancer screening program and began what she called a "rollercoaster year of MRIs, biopsies and mammograms.” Each new round of testing became a little scarier. "I was 50 years old with three children, a husband and a successful nursing career. I wanted to live as long as I could to be here for my family. Too many people in our family have died young, and I didn’t want to be one of them,” McGee recalls. 

She decided to take the second step in reducing her risk for breast cancer:  a preventive bi-lateral mastectomy to remove her breast tissue and surrounding lymph nodes followed by DIEP (deep inferior epigastric perforator) flap breast reconstruction. The procedure creates new breasts using the patient’s own tissue. 

"I had met other women at the FORCE conference who had amazing outcomes with DIEP reconstruction. I really liked the idea of using my own tissue in reconstruction,” says McGee.

DIEP Breast Reconstruction 

It was a fellow nurse practitioner at Cincinnati Children’s Hospital Medical Center who told her about Minh Doan Nguyen, MD, PhD, a UC Health plastic surgeon affiliated with the University of Cincinnati Cancer Institute. Nguyen is the only surgeon in the Greater Cincinnati area who offers the DIEP flap procedure.

For McGee's case, UC Health surgical oncologist Elizabeth Shaughnessy, MD, PhD—and the reconstructive surgeon (Nguyen) worked side-by-side to complete the mastectomy and breast reconstruction on the same day. 

With the DIEP flap approach, tiny blood vessels from the transferred tissue are surgically reattached to the chest wall. The procedure spares the abdominal muscles, reducing the risk for complications associated with traditional TRAM (transverse rectus abdominis muscle) flap reconstructive surgery. The result is a more natural breast, both in feeling and appearance. 

"Beyond knowing that my surgeons had impressive surgical skills, I needed to like my surgeons—to feel that they understood me and my personal motivations. I had a wonderful surgical team in Dr. Nguyen and Dr. Shaughnessy. Their entire support team—Kathy, Lacey, Kristen—was so professional.” 

McGee had her procedure in December 2010 at UC Health University Hospital. 

"I can’t explain what a relief it was to have that pathology report after surgery telling me I was cancer free. It helped me from a holistic healing perspective,” she says. "I don’t think I realized until then that I was resigned in my mind that I would eventually get cancer.” 

McGee has used the experience to encourage others in her family to seek genetic testing to fully understand their risk.

"Once I made the decision to take preventive action, I never looked back,” she adds. "My body isn’t the same, but the change was worth it to have peace of mind.” 

Breast Cancer Care at the UC Cancer Institute

Nguyen and Shaughnessy are part of the multidisciplinary breast cancer team affiliated with the University of Cincinnati Cancer Institute, one of four institutes affiliated with UC and UC Health. To learn more about the UC Cancer Institute’s multidisciplinary care team, visit uccancer.com/breastcancer. To schedule a screening mammogram, call 513-584-1500.