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No lump – just a constant pulling sensation under her right arm. It was probably just a sore muscle, says Lynn Walkuski, who lifted weights and did vigorous aerobics almost daily. Her primary care physician suggested checking it when Lynn’s mammogram was scheduled in two months.
At the time of the mammogram, a shadow was found, still no a lump. A three-dimensional mammogram revealed a mass, and on the same day, Lynn had a biopsy.
When her physician called to give her the diagnosis, Lynn was taking care of her sister who had stage 4 renal cancer.
“You’ve tested positive for breast cancer,” says the oncologist who was also managing the cancer treatment for Lynn’s sister.
Two days later, Lynn saw a surgeon and geneticist. Both suggested that the tumor was a typical, mundane one. Because Lynn was 55 years old, there was less than a one percent chance for the cancer to have genetic component, indicating the most aggressive form of breast cancer, BRCA 1 and BRCA 2.
Even though Lynn had five cousins with breast cancer – all from the same family – the geneticist used statistics to support her strong stance against aggressive cancer.
Lynn used gut intuition to support her next steps.
“I needed different minds to look at my case and give me second opinions,” says Lynn, who teaches eighth-grade math and science at Discovery Middle School in Canton. “That’s the way I process information. I’m also a prayerful person, and I asked for guidance from God. At the heart level, I knew I needed to get different opinions.”
She arranged appointments at three additional medical centers.
In the meantime, she had another problem. “I had to cut out many people from my life because they told me to forget about seeing doctors and drink a special herbal tea,” says Lynn, a vegetarian who seldom drank alcohol and didn’t smoke or do drugs. “I asked them to support me in my decision and if they couldn’t, then they didn’t have a place in my life. I lost a lot of friends.”
A few different women recommended a breast surgeon, Jessica Bensenhaver, M.D., at Henry Ford Cancer Institute. A Henry Ford Breast Cancer Program staff member quickly scheduled an appointment. When Lynn arrived, she knew it would be her last stop.
“At the first meeting, I was impressed that members of the treatment team were present, Dr. Bensenhaver, a plastic surgeon and a nurse navigator,” says Lynn. “Dr. Bensenhaver was the only physician who asked for the tissue sample, rather than make a second opinion based on palpitation and the write-up of the initial diagnosing doctor.”
Says Dr. Bensenhaver, “We always review the entire case from imaging to pathology to make sure nothing has been missed. In Lynn’s case, it was the familial predisposition that was missed. That’s what made her concerned.”
“Doctors are always busy and rushed,” says Dr. Bensenhaver, “but you always have to listen so patients feel their current concerns have been addressed and they feel confident about what you’re telling them. Every patient deserves that. If there’s any concern after talking with a physician, find another physician to talk with, even if it’s simply for reassurance.”
After an examination and physical history was taken, Dr. Bensenhaver and the breast cancer tumor board – comprised of medical oncologists, radiation oncologists, breast cancer surgeons, reconstructive plastic surgeons, pathologists and nurse navigators – met to review Lynn’s case.
Within an hour, Dr. Bensenhaver returned to see Lynn in clinic, and explained that considering Lynn’s age and the type of tumor, this might be a typical “boring cell.”
It wasn’t. This was an aggressive form of breast cancer, called triple negative ductal carcinoma, which was caused by a BRCA 1 genetic mutation. If both breasts weren’t removed, another cancer would likely appear, not an offshoot of the current one.
“I made a very peaceful decision. At my gut level, I knew this was the doctor who would have to care of me. My daughter, who was sitting next to me, agreed,” says Lynn, a single parent for 17 years.
“Lynn had an innate sense of what she needed to do,” says Dr. Bensenhaver.
To prepare for reconstructive surgery, the breast cancer surgical team assessed her, and within three days, Lynn’s breasts were removed. From the date of the first diagnosis to the time of surgery, 16 days had passed.
Two weeks after surgery, Lynn received a call from the medical center where her first diagnosis had been made. “We have your test results,” says the geneticist.
“It doesn’t matter,” says Lynn. “I’ve already had a double mastectomy.”
“Oh my gosh, you tested positive for BRCA 1. You must have ESP,” says the geneticist.
“No, I have divine guidance and a Henry Ford doctor,” says Lynn.
There was a long silence on other phone.
Lynn’s cancer turned out to be stage 1. The tumor had embedded itself in a muscle near a lymph node. If she had waited longer, Lynn wondered if the cancer would have moved into her lymph node.
“Dr. Bensenhaver called it. She is very gifted. She could palpitate the tumor when others couldn’t feel it; she recognized the cells and estimated when it began growing. That turned out to be the time when I began feeling tightness under my arm,” Lynn says.
Lynn’s story didn’t stop there. A port was inserted into her left clavicle region to prepare for the required chemotherapy.
Then, Dunya Atisha, M.D., director of breast reconstruction and microvascular surgery at Henry Ford, performed a procedure to insert tissue expanders, preparing Lynn for breast reconstruction surgery. “I didn’t have enough fat on my chest to hold a B-cup,” she laughed. Later the expanders would be inflated periodically.
“At my post-surgical office visits, several members of my team were present, so I didn’t need to schedule multiple appointments,” says Lynn.
Henry Ford medical oncologist Vrushali Dabak, M.D., wanted to do four to six rounds of chemotherapy. “I was afraid of getting sick, and she was very compassionate, especially because I was still caring for my sister with cancer. The chemotherapy plan that Dr. Dabak created didn’t have any side effects – no neuropathy, no nausea, no fatigue,” Lynn says.
Not at first.
Eight days after the end of the fourth round, Lynn had a rare allergic reaction – extreme itching and swollen arms. Thanks to prednisone, the reaction generally subsided within a few days. Also, she lost all of her hair, but it later grew back even thicker.
“Still, I had enough confidence in Dr. Dabak to find a different combination of drugs and allow her to do the last two rounds of chemo,” Lynn says.
Six weeks after chemotherapy ended, Lynn had an oophorectomy to remove her tubes and ovaries, a standard practice for women with BRCA 1. Gynecologist Monique Swain, M.D., who is part of the Henry Ford breast cancer team, adjusted her operating room schedule so she could perform surgery at Henry Ford West Bloomfield Hospital, closer to Lynn’s home and work.
Since Lynn had previously developed a MERSA infection, the surgical staff took extreme precautions so she didn’t contract it again. They decontaminated her whole body and placed an antibiotic swipe in her nose to prevent the colonization of MERSA. “I came out of surgery just fine,” Lynn says.
Later, Dr. Atisha removed the tissue expanders and replaced them with saline implants. “She did a fabulous job,” says Lynn.
Lynn went back to teaching in September 2017 – six month after she first noticed the pulling sensation under her arm. During winter break, she had one more surgery, a nipple reconstruction. Now she sees her doctors every three months for check-ups. “I am my old self and better,” says Lynn.
“Dr. Bensenhaver once says that this type of tumor typically would have started growing 20 years ago, but my lifestyle of strenuous exercise and healthy eating may have postponed it,” says Lynn. “If that was true, I wondered what I could do to prevent cancer after the mastectomy.”
“I went vegan,” she says. “Dr. Swain and my oncologist agreed wholeheartedly.”
Although Lynn’s doctors kept her free of physical pain, she decreased emotional pain with faith and prayer. “I had amazing support from my friends, family and the community at St. John Neumann Church in Canton. Also, I kept off the Internet and didn’t compare stories of other women. I tried to focus on the moment and do what I needed to do now, not jump ahead,” she says.
The most important lessons learned from the experience?
“Follow your gut,” says Lynn. “When I trust my gut, I feel like God is guiding me. No matter how crazy things may seem, He has a plan and it is always good. Now, I have an enormous job to do on earth – show love and compassion to everyone I meet.
“To my daughters and other women, I say: Be aware of what you put into your body. It’s critical to your health. I had no idea that a vegetarian diet and rigorous exercise would have a profound impact on me.
“To breast cancer patients, I say: Take care of your body and your mind while you’re going through this. Surround yourself with supportive people and beautiful sights and good smells. Give yourself healthy foods and a stress-free environment whenever possible.
“To doctors at Henry Ford, I say: Clone yourselves!! Keep doing what you’re doing.”