tool in diagnosing
breast cancer
Biopsy proves helpful
tool in diagnosing
breast cancer
By gloria stravelli
Staff Writer
FARRAH MAFFAI Meg Levinson is a nurse/practitioner in charge of Women’s Diagnostic Services for Riverview Medical Center, Red Bank. She was recently diagnosed with breast cancer and is undergoing chemotherapy treatments.
Women are often frightened and upset after being told they may have breast cancer, and Meg Levinson is there to offer reassurance and help those who have just undergone diagnostic testing.
"What we see is that when a woman talks to the radiologist and hears, ‘We’re recommending you have a biopsy,’ women vary greatly in the way they react," said Levinson, manager of Women’s Diagnostic Services at Riverview Medical Center in Red Bank.
"I pull them into my office and start talking to them and give them as much information as I feel they can handle," she said. "I give them a brochure that has a lot of information in it, including my telephone number.
"The biopsy word is very scary," continued Levinson. "We’re giving them information, and the radiologist just gave them information, which is really not what they had in mind — it wasn’t what I had in mind either."
Manager of Women’s Diagnostic Services for three years, Levinson recently underwent surgery to remove a malignant lump in her breast and is midway through chemotherapy treatment.
According to the American Cancer Society, Levinson, who has a family history of breast cancer, is one of 200,000 women who will be diagnosed with breast cancer this year; 40,000 will not survive. The ACS has designated October as Breast Cancer Aware-ness Month.
A native of Red Bank, Levinson joined the staff of the medical center in the late 1970s as a nurse/practitioner with a focus on maternal/child health, and has continued to focus on women’s health issues.
At the same time, Riverview has expanded services to women, renovated and expanded the maternity unit into the Women and Children’s Pavilion, added diagnostic services, and established Women’s Diagnostic Services as a department separate from radiology.
"The center does all testing specific to women, including mammograms, bone density, ultrasound and stereotactic breast biopsy," explained the Shrewsbury resident. "All diagnostic services that are specific to women are clustered here in response to the realization that women have special needs."
Situated on the fourth floor of the hospital’s Blaisdell Wing, Women’s Diagnostic Services is staffed exclusively by women and performs approximately 12,000 procedures per year.
Like many of the women who come to Riverview for mammograms, Levinson had an annual mammography in August that did not detect a lesion. Her physician, however, detected a lump during a subsequent breast exam so another mammography was done, and again no lesion was detected.
Her doctor’s finding wasn’t confirmed until an ultrasound was done.
"That’s why it’s important to go for a breast exam by a doctor every year," noted Levinson, whose ultrasound detected the lesion and who underwent an ultrasound-guided biopsy within a few days of the finding.
"It’s done as an outpatient procedure," she explained. "The surgeon is assisted by the radiologist who uses ultrasound as a guide for the taking of samples of breast tissue. The woman is awake, but the area is numbed."
"The ultrasound and stereotactic biopsy are minimally invasive," explained Dr. Debra Camal, a surgeon on Riverview’s staff who specializes in breast surgery. "A core needle-type biopsy is done under the guidance of computer imaging, and multiple tissue samples are taken.
"The samples tell you what you need to know about the area," continued Camal, who has a practice in Shrewsbury. "If it’s benign, in most cases you don’t have to do anything. If it’s precancerous, it gives you very valuable information about that area in terms of how to do the surgical procedure."
Stereotactic biopsy also can make it possible to get faster results; the results of Levinson’s biopsy were available within 24 hours.
"I knew that with my strong family history, I had a chance of developing breast cancer," explained Levinson, whose mother and sister are breast cancer survivors. "But it still hits hard. I had a lot of anxiety, but once I sat down with my surgeon and developed a plan for treatment, I felt comforted. I took a friend with me to sit in with the surgeon. Even though this is a field that I’m very familiar with, I needed somebody else to hear what the surgeon said. Women feel very overwhelmed, and I was in the same place," she explained.
Based on the specifics of Levinson’s case, her surgeon recommended a lumpectomy rather than a more radical mastectomy. Within a week of the biopsy, Sept. 5, her surgery was performed. She went home after a few hours and was back at work within a week. Post-surgery consultation on treatment options with her oncologist was like talking with an old friend — the two were schoolmates at Mechanic Street School in Red Bank. Together, they decided on a course of treatment that calls for a 12-week chemotherapy regimen followed by six weeks of radiation therapy.
Halfway through chemo, Levinson said she is feeling good, and, thanks to advances in anti-nausea medications, is not suffering from the nausea that debilitates some other cancer patients.
But she is enduring another side effect of therapy. Her brunette locks had fallen out over the previous weekend.
"I knew that I was going to have hair loss, but I didn’t do anything about it until last week," she said. "It was the part I was paralyzed about. It’s the hardest part so far.
"I didn’t want this to interrupt my life in any way," continued Levinson. "That was really important to me. And maybe that’s why losing my hair is so devastating because it’s like an announcement to the world that I’m going through this traumatic event."
Levinson said the support of hospital staff is sustaining.
"I’m sitting in my office crying, and they’ll come in and give me hugs," she said. "All the women that work up here — we’re an incredible team — and they’re very tuned in to being very supportive. It’s wonderful being able to have them around me."
While her professional life has been focused on women with breast cancer, Levinson said being diagnosed with the disease has given her insight she did not previously have.
"I have a much better understanding of some of the feelings people may have, and what is more helpful to them. I had no idea hearing the word ‘cancer’ would blow me away."
The future is something Levinson is unwilling to speculate on.
"It’s all about how I’m going to get through this; it’s all about the here and now," she noted. "What I’m finding most helpful is people to help walk me through this part of the process, and to know that feelings I have are normal and are to be expected."
In the moment, she is drawing strength from those around her.
"I’m drawing a lot of strength from co-workers, family and friends. I’m talking to old friends who are kind of coming out of the woodwork, like a girlfriend I hadn’t seen in a long time. We went hat shopping the other day, and she showed me how to do the scarf thing.
"It’s a total journey. Now I’ve started this journey and I know that whatever way it turns out, what comes of it is that I’ll be able to help other people. It really gives me incredible perspective on what this is about," Levinson said.