Celebrity chef Sandra Lee made news earlier this year when she announced that she had been diagnosed with breast cancer and would have a double mastectomy.
Lee was diagnosed with ductal carcinoma in situ (DCIS), a non-invasive type of cancer that begins in the milk ducts of the breast. (DCIS is the most common type of non-invasive breast cancer and accounts for about 25% of all cancers detected by mammogram.)
Lee’s treatment began with lumpectomy, however her surgeon was unable to obtain clean margins (the remaining breast tissue still showed signs of cancer). Although radiation was a treatment option, Lee didn’t want to undergo six to eight weeks of that treatment, and worried that she might later have to relive the entire experience in the opposite breast. So on the advice of her physicians, Lee, who tested negative for a BRCA gene mutation, decided to have both breasts removed.
As Lee herself has said, “Breast cancer beats you up in two ways, both physically and emotionally.” Most women who have been told they have breast cancer would probably agree. It is difficult to hear the diagnosis, and it is incredibly tough to wrap your mind around having your breasts taken away. To make matters worse, Lee developed a massive infection after her bilateral mastectomy that caused painful swelling around the scar tissue, and didn’t initially respond to treatment. Last week she was back in OR for surgery to treat the infection. Now she’s back home with IV antibiotics and home nursing until the infection has been completely eradicated.
If you’re facing mastectomy, Lee’s story is undoubtedly troubling and you’re probably wondering whether you’ll face the same difficult outcome. All surgery has risk, but in fact, most women do not develop post-mastectomy infections. Skin is the body’s natural barrier to infection; anytime it’s opened, infection has an opportunity to sneak in. Precautionary procedures, including a sterile operating environment and washing incision sites with antibacterial wash protect you during surgery. After surgery, drains are placed at the surgical site to prevent fluid build-up that could lead to infection. Additionally, most mastectomy (and breast reconstruction) patients are given antibiotics during and after their operations.
Despite these precautions, infection does happen sometimes, and that is why it is so very important to know the early warning signs—redness or warmth in the skin, fever, chills or unusual fatigue—and have them treated as soon as possible. Caught early on, most infections respond well to oral antibiotics. Allowed to progress, infections that do not respond to oral antibiotics may require hospitalization, intravenous antibiotics, and possibly additional surgery to drain off excess fluids, as was the case for Lee.
If you are diabetic, a smoker, obese or you have certain other health conditions, you are more likely to develop a post-operative infection. In Lee’s case, she was diagnosed with lupus anticoagulant, an autoimmune condition that creates a greater-than-average likelihood of developing blood clots. Health insurance that covers the cost of mastectomy must also pay for infections or other complications that are directly related to the surgery.