Posted on Friday - 10/04/2019 to Up Close
Ibironke Adelaja, MD with breast cancer patient, Judi Preuss
By Barbara Anderson
The hard lump felt like a rib underneath her left breast, but when the skin dimpled, Judi Preuss suspected something else. A mammogram, ultrasound and a needle biopsy showed breast cancer.
Preuss, 56, of Clovis was frightened. “What you feel at the moment is that you are going to die,” she said of the diagnosis she received last September.
She wanted the cancer gone – whatever that entailed. She made an appointment with Ibironke Adelaja, MD, a UCSF Fresno surgeon whose specialty is breast surgery. She told Dr. Adelaja that she wanted a double mastectomy.
“I was ready to have no breasts,” Preuss said.
But Dr. Adelaja, who had performed the needle biopsy of Preuss’s breast, suggested another option. She could remove the cancerous mass with a partial mastectomy (breast conserving surgery) that would be followed by radiation. Studies have shown a partial mastectomy with radiation has the same survival as removal of the entire breast.
And Preuss was surprised when Dr. Adelaja told her the surgery could be done without leaving a horrible scar across her breast.
“The idea behind the scar-sparing surgery is that a woman would look in the mirror when they are done with their treatment and not be continually reminded that they had undergone a surgery or a disfiguring surgery for breast cancer,” Dr. Adelaja said.
Dr. Adelaja has special training in a breast surgery technique that allows a tumor to be removed through an incision that is made in a hard to see location, such as under the breast or underneath the arm. The surgery leaves a barely visible scar once the incision heals. She also performs nipple-sparing mastectomies, which hides the incision at the bra line.
She is a member of a UCSF Fresno team of breast surgeons at Community Medical Centers (CMC) who have been trained in Hidden Scar™ breast cancer surgery. CMC is one of only a handful of hospital systems in the country named a “Hidden Scar System of Excellence,” and the first in California to receive the designation, according to CMC.
The American Cancer Society predicts more than 268,000 new cases of breast cancer nationwide in 2019, and 27,700 of the new cases of breast cancer will be diagnosed in California. Fresno County has about 530 cases of breast cancer a year, according to the federal Centers for Disease Control and Prevention. Surgery will be recommended for many of the women, but not all are aware of Hidden Scar™ surgery and that it is available in Fresno, Dr. Adelaja said. “They come to see me with the assumption “my breast just has to come off.”
Preuss had not heard of Hidden Scar surgery™ prior to her appointment with Dr. Adelaja. “It’s asking a lot of people to explore all their options when they’re terrified,” she said. And she was hesitant when Dr. Adelaja suggested she could remove the cancer without leaving a disfiguring scar. “It’s hard to make decisions about your appearance when you just want to live,” she said.
Patients need to know their options for breast cancer surgery, but always the main goal is to perform a medically sound procedure where you are removing all of the cancer with a clear margin, Dr. Adelaja said. In some instances, Hidden Scar surgery™ is not recommended, depending on the location and extensiveness of the breast cancer, she said. “But when I can, I do try to hide the scar.”
In Preuss’s case, Dr. Adelaja was able to safely remove the cancer, leaving behind only a tiny scar under the left breast. Preuss had radiation and chemotherapy (both recommended in her case) after surgery.
Preuss had considered going to Stanford University Medical Center for breast cancer surgery, but she is grateful she found Dr. Adelaja. “We were so blessed to be able to stay in the San Joaquin Valley,” she said. “I feel I was brought to Dr. Adelaja. She was the best person to help me.”
Dr. Adelaja is happy Hidden Scar surgery™ is an option UCSF Fresno can offer to patients in the Valley. “When they experience it, they’re quite pleasantly surprised,” she said. “There is no reason someone should have to leave Fresno to have this advanced type of breast cancer surgery.”