The November 2015 issue of Boca Raton magazine features a story about FAU pre-medical student Elizabeth Hopkins and her decision to have a double mastectomy, in an effort to reduce her genetically high-risk for breast cancer. The procedure she had to rebuild her breasts post-mastectomy is a revolutionary approach to reconstruction by Dr. Hilton Becker of Boca Raton.
This is a continuation of that interview with Hopkins, who completed pre-med at FAU, is applying to medical schools and is interested in pursuing a career in medicine as a reconstructive surgeon.
Boca mag: Tell me a little about your family history and why you decided to have this [preventive] procedure?
Hopkins: My biological grandmother passed away from breast cancer. That was on my father’s side. My father passed away from stomach cancer. He lost all his brothers to various cancers. And most recently, I got a Facebook message letting me know that my cousin on my father’s side died from invasive breast carcinoma, and she was 39. So, I took it upon myself to get genetically tested. (With that much cancer in the family, I couldn’t see how it wasn’t hereditary.) I turned out to be BRCA2 positive, which causes a higher risk for early onset of breast or ovarian cancer, or various other types of cancer. So, I went ahead and made the decision to have a double mastectomy with reconstruction., and now I’m in the process for screening my ovaries.
Boca mag: When you went through the internship with Dr. Becker, is that how you learned about the option of this type of reconstruction?
Hopkins: No. I went to two other surgeons before I went to him. They both wanted to do a modified radical mastectomy with a horizontal incision. Dr. Becker uses a vertical incision. They couldn’t guarantee that I would be able to keep my own skin and my own nipples. And they wanted to place the implant behind the muscle, which causes animation deformity.
Boca mag: What is that?
Hopkins: It’s movement of the breast implant in an abnormal manner. So, any movement—working out, heavy lifting, normal flexing—the breast implant will move upward or out to the side, and you can have lateral rippling and overall deformity of the breast implant.
Boca mag: Oh, so placing the implant on top of the muscle….
Hopkins: Avoids it 100 percent. [Dr. Becker] was the only one I felt comfortable enough doing the surgery with because his technique allows you to have a skin- and nipple-sparing mastectomy.
Boca mag: What about the recovery?
Hopkins: The recovery is much less than a standard implant-based reconstruction because the implant is over the muscle. We’re not disrupting the muscle. When you go under the muscle, you will cut the muscle in various planes.
Boca mag: What is your outlook and prognosis?
Hopkins: Having done this, I’ve lowered my risk of early onset breast cancer from approximately 87 percent down to maybe 2 percent. And I’m very, very happy with the results. I have no regrets. I think my breasts now look better than they did before the surgery.
Boca mag: Is there any difference to how you feel, hormonally?
Hopkins: Yes. During the beginning of the process, when I got genetically tested, I had been experiencing pain in breast that I did not have before, and I had lumps in the breast, which came back on mammograms. I don’t have that now. I no longer have the need to have a mammogram now. And I don’t have the pain or the fibrous lumps that I had before. Overall, I feel better.
Boca mag: Anything else that I haven’t asked you, Elizabeth, that would be important to readers who have this concern with their genetics?
Hopkins: We have the ability now; we have the technology that allows us to prevent such a disaster from occurring. It is such a relief to not have to worry about that anymore. I believe the stress of it could have caused cancer on its own—just from having that weight on your shoulders. And more importantly, the technique that Dr. Becker uses gives you the appearance of having a breast lift or a breast augmentation with the vertical incision…For a woman, that means [you don’t have to be] afraid to look in the mirror, [or] to be with a man or have self-esteem issues.
More about the difference between Dr. Becker’s approach and traditional mastectomy/reconstruction
Most breast reconstructions are two-staged procedures. Surgeons first place an expander under the muscle, and then they exchange the expander for an implant months later. In some cases, the implant can be placed right after the mastectomy, under the muscle, in a single-staged procedure. The difference with Dr. Becker’s procedure is that he places an expandable implant above the muscle in a single procedure, thereby preserving the woman’s nipple, areola and surrounding skin. He also uses a vertical mastectomy incision, versus the horizontal incision of traditional mastectomy and reconstructions.
“This technique, when combined with an adjustable implant, addresses the complications related to sub-pectoral implants and traditional expanders currently used in mastectomies,” Becker says. “There are numerous advantages to using a vertical incision over a horizontal incision. From the surgical perspective, it allows for ease of access, and from an aesthetic perspective, this incision leads to a better cosmetic result with a scar that resembles that of a breast lift procedure. The procedure is minimally invasive as no new tissue planes are opened after the general surgeon has completed the mastectomy.”
Dr. Becker published results of a study with 31 women who had his single-stage breast reconstruction in the scientific journal “Plastic and Reconstructive Surgery.” The study documents those patients’ health for four and a half years after surgery. Results show low rates of complications and implant loss. “Benefits of this new procedure include the elimination of animation deformities (movement of the implants), elimination of asymmetry, less postoperative pain and discomfort and a faster recovery,” according to an FAU press release. “In addition, the natural position of the implant above the muscle leads to a more natural feel.”
For more posts from The Fit Life, click here.
Lisette Hilton, president of Words Come Alive, has had the luxury of reporting on health, fitness and other hot topics for more than 23 years. The longtime Boca Raton resident, University of Florida graduate and fitness buff writes for local, regional and national publications and websites. Find out more on wordscomealive.com.