Two Women, Two Different Decisions, One Similar Goal: Empowered Breast Cancer Decisions
Choosing to Have Breast Reconstruction After Mastectomy: Erin Buss, Double Mastectomy, Age 40 (Part 2 of 2)
A two-part series profiling two women who made different decisions when answering the question “Should I have breast reconstruction after a mastectomy?” Because there is no “wrong” answer, and opting for breast reconstruction after a mastectomy depends on an individual’s priorities, Rocky Mountain Cancer Centers (RMCC) explores the decision-making process two breast cancer survivors went through. Though they made different decisions, they arrived at the same place: a satisfying life with cancer behind them. To read about a woman who chose not to complete breast reconstruction after a mastectomy, read our profile on breast cancer survivor Leslie Welte.
A Career Revolving Around Breast Cancer Didn’t Prepare Her for Her Own Diagnosis
Erin Buss spent much of her career working in fields related to breast cancer, working first in Pfizer oncology and later in genetic testing and diagnostics. Additionally, she had a “slight” family history of breast cancer which led her and her OB-GYN to adopt a more rigorous screening schedule than many other women her age. So, when she received her own breast cancer diagnosis shortly after her 40th birthday, she might have been more informed than most women on the topic, but that didn’t mean she was better prepared.
“You can’t always assume educated patients don’t get overwhelmed or confused by the conversation,” she said. “One piece of advice I held really close to me was: seek medical care where I felt most comfortable and most cared for, and that was definitely with Dr. (Sami) Diab and RMCC.”
Erin had triple-positive breast cancer and, because of its location, the mass dropped into her chest wall during exams. That meant the tumor was already fairly large by the time it was discovered, despite her best efforts at preventative screenings. Partially because of the type of cancer and partially because of her proactive and driven personality, Erin and RMCC launched an aggressive treatment and surgery plan.
She underwent six rounds of TCHP (a special combination of medicines given in a specific order – Taxotere, Paraplatin, Herceptin, Perjeta) followed by a double mastectomy. While the treatment was successful, it didn’t completely clear out the cancer cells, so she completed 12 of 14 scheduled rounds of chemo after the surgery but had to discontinue before the final treatments because of negative side effects. She then underwent 25 rounds of radiation and a year of adjuvant chemotherapy.
“When you’re in the midst of a medical crisis, you feel an overwhelming sense of urgency to make decisions and check off boxes. Now that I’m through it, I think it’s important to take your time with your decisions,” Erin said. “Now I coach women going through breast cancer treatment to be mindful, see how your body responds to treatment, take more time than I did. Dr. Diab reminded me several times that we had a plan but often the plan changes and don’t panic when the plan changes.”
Making Hard Decisions: ‘I tapped into all the resources I knew I had available’
Like many breast cancer patients, Erin faced difficult decisions, not just pertaining to her medical treatment but to her personal and professional life, as well. The first involved changing her career focus.
“Working in that field, I had to have some conversations about if it was the right environment for me to be working at that time in my life (while facing her own breast cancer). I ultimately got out of the metastatic cancer field,” she said.
Both her cancer doctor and her Physician Assistant, John Novak, helped support her in all the decisions she faced. Plus, Erin took advantage of the social workers at RMCC, as well as her own therapist, and help from friends to process the intense emotions she faced in her journey.
Because Erin’s breast cancer growth was driven by hormones, her best option for living cancer-free was ovarian suppression — the complete removal of her uterus, fallopian tubes, and ovaries.
“Dr. Diab went over survival rates according to different treatment options,” Erin said.
She also asked other experts she knew through her work and received the same answer: cancer treatment followed by total hormone suppression would offer the best chance of reducing recurrence.
“Ultimately, it came back to the level of trust I had in Dr. Diab, knowing he had my best interest in mind and wanting to avoid ever having to deal with this disease again,” she said.
As a single woman without kids, Erin made the complicated decision to have a complete hysterectomy.
“My best friend was in that appointment with me – and she has two adopted children – and she reminded me that families come in all shapes and sizes,” Erin said. “I would have lots of options – but only if I’m alive. It’s a personal decision for everyone but having to never face cancer again was my priority, not having children that I may never have the chance to raise.”
New Body, New Goals, a New Lease on Life: Choosing Breast Reconstruction
Compared to the other decisions Erin’s cancer diagnosis forced on her, choosing to have breast reconstruction following her double mastectomy was more straightforward. She was a young woman who, thanks to an aggressive treatment approach, still had a lot of life ahead of her. Having breast reconstruction was important, not only in terms of how others saw her, but how she felt about herself.
However, Erin’s impatience at “checking off all the boxes” and putting her cancer behind her was tempered by her body’s need to recover from an arduous year of cancer treatment and surgeries.
Luckily, she found an incredible breast reconstruction surgeon who factored in her priorities and “was very intentional with her approach,” Erin said. “She reminded me that we needed to take our time because of what my body had gone through with radiation and chemo.”
Thus, Erin’s breast reconstruction surgery had to be postponed for a year for the best cosmetic results – which was one of her main goals. After that, she had two additional revisions, necessitated by the amount of scar tissue from her double mastectomy.
While Erin and her breast surgeon were working on achieving the reconstruction they hoped for, Erin finished out the year of adjuvant therapy she had begun. She will have endocrine therapy for five to 10 years, as well as bone density treatments since her hysterectomy places her in the “post-menopausal” status at 42 years old.
Now that her breast reconstruction is completed to her satisfaction and she has powered through the majority of her cancer treatment, Erin has directed her formidable energy toward new goals.
“I made it my mission to educate and empower women, especially young women, who have been diagnosed with breast cancer,” Erin said. “I want to help them understand the journey and find their voice. I was working with a team at RMCC that I trusted, and I could ask any question that was important to me. I want to remind other women that they have power in this situation.”
While most of this mentoring has been informal – “an organic group of women supporting women” – there have also been more organized opportunities for Erin to contribute to helping others. She’s presented for The US Oncology Network, the Colorado Cancer Coalition, and the University of Colorado Anschutz Breast Center.
“I don’t know if it’s a ‘calling,’ but helping other women understand and manage their treatment has been empowering and therapeutic for me,” she said.
Erin Buss and Leslie Welte have little in common, aside from their shared breast cancer diagnosis. So it’s perhaps not surprising that they would make different decisions about breast reconstruction. However, they share two other important commonalities, to be accurate: They both successfully battled cancer and moved on with cancer-free lives. And they both felt empowered to make the treatment decisions that were best for them.
If you’re deciding whether or not to have breast reconstruction after a mastectomy, there are different factors and priorities you might want to consider. Learn more about breast reconstruction.