A mastectomy can be a life-saving operation, but it does result in significant scarring that can leave a patient struggling with body image and self-confidence.
Local surgeon Dr. Diane Drugas is offering a robotic approach.
She recently walked WGN News’s Medical Watch team though the robotic surgery lab at UI Health.
“The patient is on the operating table and the robotic arms are attached to the little instruments we insert into the patient as well as a camera,” she said. “It gives better visualization. It’s a 3D screen that the surgeon visualizes the surgical field with. And for areas that are hard to fit your hand into it gives you more precise surgery.”
Traditionally used for pelvic and abdominal procedures, Drugas, a breast surgeon, is applying the technology to her line of work as an alternative to an open mastectomy.
“The traditional open mastectomy sometimes leaves patients with disfiguring scars and some patients struggle with body image and sexuality and even depression,” she said. “So the advantage of this technique is that it is virtually scarless there is no scar put on the breast at all.”
With a robotic approach, the only incision Drugas makes is a two-to-three centimeter opening near the arm pit. From there she threads a camera and instruments through to reach the breast tissue.
“The surgeon controls the arms with little hand pieces you see on the console,” she said. “Then the gland is dissected from the skin like we do in a traditional mastectomy.”
It’s a procedure she’s been perfecting for months.
“There’s definitely a learning curve. We’re used to doing it the open way,” she said.
So far, she’s performed four robotic mastectomies on patients who opted for prophylactic breast removal due to an increased risk for cancer.
Faith Isemonger carries the BRCA gene mutation. Her sister does, too, and is already fighting stage four cancer.
“I have seen what my sister went through and I’m like, I don’t want to do this,” she said. “So I decided it was best for me to go ahead and have it done prophylactically.”
With her sister, Hope, by her side, Faith Isemonger underwent the robotic procedure in April. It took eight hours, much longer than a traditional open procedure.
“The downside I think is that it takes much longer,” Drugas said. “It takes at least 80 minutes longer and some patients aren’t medically fit to be under that long.”
Even with the extended procedure, Faith Isemonger, 49, is relieved her risk for breast cancer is now much lower.
“Unfortunately, the surgery lasted for eight hours but I think it was well worth it in the end,” she said. “I wasn’t in a lot of pain. I really didn’t take a lot of pain meds — a little scarring which was great compared to what my sister had to go through having a traditional mastectomy done.”
Christine Masterson knows what a traditional mastectomy feels like. She had the open procedure done on her right breast after being diagnosed with cancer earlier this year.
“I’m ok with the scaring. It’s part of who I am now, and it’s a story,” she said.
But when it came time to have her other breast removed to reduce the chance of her cancer returning, the veteran police officer opted for the less-invasive approach in September. She says she’s happy to share her story with others contemplating the robotic procedure.
“To let people know there are other options out there. You don’t always have to get the full mastectomy and in hindsight it was better for me,” she said. “Less scarring, easier recovery than the first surgery.”
“I’m excited about it,” Drugas said. “I think it’s wonderful for preserving body image and recovery and I think we have a lot to offer patients with it.”
The robotic mastectomy is not yet an option to remove cancerous breast tissue. And Drugas says the procedure is best for patients with less breast volume, generally a C-cup or smaller. And, so far, the complication rates appear to be comparable to a traditional mastectomy.