In this week’s episode of ‘In conversation with…’ we spoke with Theresa Poon, a young woman diagnosed with stage 0 breast cancer back in late 2019, after she found a lump while breastfeeding her son.
During our discussion, Theresa shared her uncomfortable past experience of breast cancer treatment, in particular the pain of Technetium-99 from a previous sentinel lymph node biopsy (SLNB). Fortunately her new surgeon, Dr Manpreet Kohli, MD offered her an alternative procedure this time around – a ‘delayed’ SLNB.
She told us how her experience of this pioneering Magtrace® procedure – only available for patients undergoing a mastectomy in the US – had highlighted the importance of finding the right surgeon for the individual, saved her unnecessary surgery and has given her more freedom to care for her young children.
Theresa was diagnosed with breast cancer for the first time many years ago, which was when she was first introduced to the sentinel lymph node biopsy technique. Her surgeon at that time was using a combination of Technetium-99 and blue dye.
A total of seven lymph nodes were removed in that procedure for further analysis and it was later found, prior to the start of chemotherapy, that there could still be residual disease. But what really stuck with Theresa throughout the whole experience was the discomfort felt from the radioactive tracer.
“It’s a long stinging pain… it’s like when they insert an IV into you but the pain lasts for an hour. It doesn’t go away until you get the anesthesia, then you wake up and it’s OK.” Theresa explained.
"I saw patients left and right that were crying because the pain was just unbearable for them."
That’s when Theresa sought a second opinion, which came from New Jersey’s Monmouth Medical Center and their Director of Breast Surgery, Dr Manpreet Kohli, MD. Dr Kohli had just adopted the Magtrace® lymphatic tracer and thought there was a better course of treatment for Theresa.
“With Magtrace we could determine if there is invasive cancer after a mastectomy and then come back to address it if needed, based on the pathology results.” Dr Kohli told us.
With the course of treatment agreed, Theresa was injected with the Magtrace® after anaesthesia before undergoing the mastectomy procedure. Fortunately, the results came back and – as is the case with up to 80% of high-risk DCIS patients – confirmed that the cancer had not spread.
Theresa had been spared her nodes and subsequent invasive surgery was not needed.
“It felt wonderful because I was very scared of lymphedema as I’m always lifting things and my children might do house chores – and the swelling can just happen any time. “
"Being offered the opportunity of not getting any lymph nodes removed if it wasn't cancer was great!"
Since receiving the positive news, Theresa has been able to return to normal life but was keen to share her experience and provide advice to other woman experiencing the same diagnosis she had.
“You just have to call your doctor and tell them, I have a lump. I’m uncomfortable. I want to get it looked at – what would you suggest?” Theresa said.
"Everyone's different, every doctor's different. But just getting looked at is very important because cancers can progress quickly".
Looking back, Theresa believes that a healthy, positive relationship with your physician is essential in processing the treatment pathway ahead. She now mentions Dr Kohli to those she knows if they are ever in doubt about their breast health.
“I recommend her [Dr Kohli] everywhere I go. I tell people, you need your breast exam? Go to Dr. Kohli!”
"I really wish more doctors everywhere would offer this quickly because there are a lot of women who need it now"
Note: ‘Delayed’ SLNB is currently only indicated for use in patients undergoing a mastectomy in the US.