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The proactive fight
Choosing to have a prophylactic mastectomy before you are diagnosed with breast cancer is a decision some patients are making.

By JULIE FELDMAN
Photos by Dan Bishop

October 2013

Ruth Mueller was at high risk for breast cancer so chose to have a mastectomy.

It was a lightening rod when Angelina Jolie wrote, "My Medical Choice," about her decision to have a preventative double mastectomy. The article was published in The New York Times and the phones started ringing off the hook at the Wauwatosa office of Dr. Hanadi Bu-Ali, a breast cancer surgeon with Wheaton Franciscan Medical Group. "It was crazy. Everyone wanted to get tested for the gene, even some people without high risk for breast cancer. The positive thing was that the article got peopleís attention."

"Iím glad she wrote the article because it did get more awareness out there," says 53-year-old Ruth Mueller of Richfield, "but it was old news to me." Mueller had lived with the trauma of high risk when the subject of breast cancer was taboo and had a bilateral prophylactic mastectomy years ago. What she and Jolie have in common is the breast cancer gene. BRCA 1 and BRCA 2 are variants of the breast cancer gene that increases your lifetime risk of ovarian cancer by as much as 40 percent and breast cancer by as much as 80 percent.

Mueller was a preteen when she lost her mom to breast cancer. Her grandmother and an aunt on her momís side died from the disease too. "Mom died in 1973. Nobody talked about breast cancer back then so we didnít think about family risk." It hit her like a ton of bricks three decades later, when one of her six sisters fought and lost an agonizing battle with the disease. "It was so difficult to watch her struggle. I knew I never wanted to go through anything like that."

So Mueller got genetic counseling. When she tested positive for the breast cancer gene, something snapped. "I cried in the doctorís office. Iím not even sure why. I knew I had to do something. I had my ovaries removed right away but I wasnít able to accept losing my breasts. I wasnít ready to make that decision."

She pushed the risk to the back of her mind, got regular checkups and promised herself that her breasts would go if one more sister was diagnosed. In 2009 it happened. Another sister was diagnosed and Mueller scheduled her mastectomy. "By that time I had come to terms with it. I had reconstructive surgery right after the mastectomy. I knew it wouldnít be as traumatic to wake up and know I had something there." Instead of using implants, Muellerís new breasts were fashioned from her own abdominal muscle and tissue. Other reconstruction advances include skin- and nipple-sparing surgery. By federal law, insurance companies should cover the cost of breast reconstruction if there is a medical reason for having a mastectomy.

Brookfield plastic surgeon Dr. Philip Sonderman counsels women about their choices. "Nothing is perfect. The recovery can take up to two months. There is going to be scarring. The breast skin will be numb. At the same time most women are extremely satisfied with the results and comfortable going in. They can view before and after pictures online and after the surgery they can wear a bathing suit or low-cut dress and look and feel whole and feminine."

There is a flag for genetic counseling if you have a first degree relative with breast cancer who was diagnosed under the age of 50, any family member with male breast cancer, a first degree relative with ovarian cancer, a strong family history of colon, prostate or pancreatic cancer, or if you are a breast or ovarian cancer patient who is under the age of 45.

"Most women with the breast cancer gene choose to have the surgery," Bu-Ali says. "You might think they would be paralyzed by fear but interestingly itís just the opposite. They want to be proactive." Mueller has turned the tables on breast cancer. Her lifetime risk is now reduced to between 5 and 10 percent and her big dream for the future focuses on celebrating life. "I guess Iíd like to be a grandma one day."

Commish takes a stand against cancer

After a routine physical in 2004, Major League Baseball Commissioner and North Shore resident Bud Selig was heading out the door when his doctor noticed a suspicious blemish on Seligís forehead. At his suggestion, Selig consulted a dermatologist.

Within a few days, Selig had a diagnosis of Stage 4 melanoma.

"I was in shock," says Selig, who says he has never been a sun-worshiper.

He underwent surgery to remove the lesion and a biopsy later revealed he was cancer-free.

While relieved, Selig also felt compelled to warn others about the dangers of skin cancer. Major League Baseball seemed like the perfect public platform. Then during a dinner engagement in January 2008, Selig encountered several prominent Hollywood executives who were starting a new initiative called Stand Up 2 Cancer, which focuses on accelerating cancer research to get innovative therapies to patients faster.

At his wifeís urging, Selig appealed to MLB club owners and when Stand Up 2 Cancer officially launched later that year, all 30 teams pledged $10 million to the organization.

"Itís a privilege for me and Major League Baseball to join this magnificent effort," Selig says.

Five years later Selig continues to rally Major League Baseballís involvement in the fight against cancer. To date, the professional sports group has donated more than $30 million to the cause. In 2012, MLB dedicated Game One of the World Series to Stand Up 2 Cancer.

 - Rebecca Konya







 

This story ran in the October 2013 issue of: