Breast Cancer Journey Takes an Uplifting Turn

When Nancy Macauda was called back to her radiologist’s office for an ultrasound following a routine breast mammogram in March of 2021, she wasn’t too worried about it. After all, she had been through these types of follow-up exams before, and everything always turned out fine. But this time was different.

“I made the appointment and went in for that second look, and it was picture after picture after picture,” the Trumbull resident recalled. “It was a feeling unlike anything else.”

As she laid there on the exam table, she asked the technician if she saw anything unusual on imaging. “She had been hovering over the same spot on my right breast,” Macauda remembers. When the technician left the room and returned with the doctor, Macauda braced for the worst.

Following a biopsy two days later, Macauda learned she had breast cancer and needed a surgeon. She immediately made an appointment with Melanie Lynch, MD, director of the Norma Pfriem Breast Center at the Smilow Cancer Hospital Care Center in Trumbull.

“Take everything off”

At 0.9 centimeters, Macauda’s tumor was the size of a pea. Her cancer was hormone-receptor positive and needed estrogen to grow, but she tested negative for a genetic mutation. She was clinically diagnosed at Stage 1A, which meant the cancer was 2 centimeters or smaller, and it had not spread outside the breast into the lymph nodes.

When Macauda first met with Dr. Lynch to discuss next steps, the surgical oncologist recommended a lumpectomy – sometimes referred to as a partial mastectomy – for her surgical treatment. “I was like, ‘Why aren’t we just taking everything off? I don’t care what I look like. I want the cancer out,” Macauda said.

“Let’s just talk for a minute,” she remembers Dr. Lynch telling her. “We can do whatever you want to do, but there’s no need for all that. With your pathology, with your biology, I think the course of treatment would be a lumpectomy coupled with oncoplastic surgery.”

Working with plastic surgeon Anke Ott Young, MD, who also specializes in oncoplastic surgery, Dr. Lynch explained that the procedure’s breast conservation approach would ensure a better aesthetic where both breasts would look symmetrical. “We definitely have to get the cancer out, that’s our main goal, and we’re going to do that,” Dr. Lynch told her. “The oncoplastic surgery is not going to hamper that at all.”

“I had total faith in Dr. Lynch and Dr. Ott Young,” Macauda said. “They kept me focused and explained everything in detail: ‘There is no reason for a radical mastectomy. You don’t need it. You’re young. This surgery will allow you the best option for a long, healthy and happy life.’”

Breast-conserving surgery

It turns out that Macauda was a perfect candidate for breast conservation surgery because of the size of her breasts. “Dr. Lynch said she could remove the cancerous tumor, and then Dr. Ott Young could reduce the size of the left breast to match it to the right."

Oncoplastic techniques can be used with a range of breast types, the surgeons explained. However, women interested in an oncoplastic breast reduction procedure, like Macauda’s, need breasts large enough to accommodate the technique.

Macauda’s three-hour surgery was followed up with a month’s worth of radiation therapy, and then hormone therapy. From beginning to end, she said she experienced little pain and little downtime. She is also very pleased with the transformation.

“Honestly, for such a horrible disease, it was a really positive experience,” Macauda said. Her advice for other women? “I would tell all women, ‘Get your mammograms! Do self-breast exams – catch it early!”

Learn more about cancer services at the Smilow Cancer Hospital, with Care Centers in Fairfield, Trumbull and Bridgeport.