Photo: Gustavo Huerta, Houston Chronicle / Staff Photographer
Some women no longer feel like they ever had breast cancer when they look in the mirror, thanks to a complex new procedure available at Houston Methodist in The Woodlands.
Breast Cancer does not run in Tana Key’s family. The occupational therapist had a normal mammogram. But not even a full year later, she began to feel what was only suspected to be a small, flared-up lymph node.
A thorough investigation in the dense tissue eventually resulted in the discovery of a small spot of Ductal carcinoma in situ — breast cancer, stage 0. But the diagnosis was not a death sentence.
After deciding to remove both breasts, a bilateral mastectomy, Key, 48, learned that precancerous cells were found in her other breast as well. She believes the early detection made it possible to prevent the potentially fatal spread.
“I chose the more aggressive surgical route because I didn’t want to have to worry anymore,” Key said.
Following the emotional experience, she turned to the Houston Methodist Institute for Reconstructive Surgery at the hospital off Texas 242 in The Woodlands, where she became the first patient there to undergo a less commonly performed, profunda artery perforator flaps procedure, also known as a PAP flap surgery with “ReSensation” technique.
The procedure involves taking excess fat tissue and small blood vessels from deep within the back of the patient’s thigh, along with donated nerve grafts, to give the woman innervated breasts that not only look but feel natural.
Now Key has not only defeated cancer, but regained sensation, confidence and peace of mind.
She praises the Houston Methodist team for their care and skill, which inspired her to return to work for the hospital system’s outpatient therapy clinic and gave her a chance to live a normal life again — including to care for her patients at another facility and to paint rocks to cheer up members of the hospital’s breast cancer support group, which she believes empowered her throughout and beyond the recovery experience, during the novel coronavirus pandemic.
“When I look mirror, I see no scars,” Key said. “I don’t see that anything has been done. I don’t have to have that constant reminder.”
Reconstructive Plastic Surgeon, Dr. S. Benjamin Albright was assisted with a team, including Key’s breast surgeon, Dr. Liza Thalheimer, his partner Dr. Steven Gordon, and physician’s assistant Katie Borths, PA-C to perform the two procedures for Key.
He shared after a patient has removed part, one or both breasts they have the option of either implants or the excess fat tissue for reconstruction. While implants have a shorter surgery and recovery, it could also rupture and not age as well. The breasts also remain permanently numb after the tissue, where nerves travel to the skin, has been removed.
“Nerves are remarkable in that they want to regenerate, the body will try to rebuild itself, but if you put an implant there those nerves just can’t make it through the implant, they can’t get out to the skin, so patients can’t recover sensation in their breasts,” Albright said.
While some women are not bothered by the loss of feeling, others feel as though the reconstructive breasts are foreign and have asked Albright to remove the implants and converted to tissue-based reconstruction which can have that sensation returned.
This is an uncommon technique in the plastic surgery community where Albright said there has not been a lot of people interested in restoring sensation. Up until roughly the last decade, he said the industry was more focused on moving the tissue and getting it to survive, which is now able to be completed safely and consistently.
“This is the next task we are trying to tackle is to figure out how we can make a breast that looks like a breast also feel like a breast so that the woman feels more complete, so that she feels like she has more than the body part restored but the actual sensation and awareness of it that she is missing,” he said.
Key’s neighbor Barbara Carmichael, 65, of The Woodlands underwent reconstruction with body tissue in 2015 with a different surgeon, shared her reassuring experience and recommended the option to Key. After experiencing weight loss, she went to see Dr. Albright for revision and the ReSensation technique as well.
She described remarkable results, similar to Key, in that she doesn’t feel like she had breast cancer when she looks in the mirror either.
“I have never focused on any of my scars, I feel complete, in some ways I don’t feel like I went through any of the surgery to begin with and I can’t think that is not a fantastic outcome,” Carmichael said.
“I didn’t let cancer define me,” Carmichael added. “Cancer is a moment in time in my life. It was something presented to me and I took on the challenge and I surpassed the challenge. I think this surgery, while it is extremely long, it is at tedious at times recovery, it is something doable from a long-term result and a desirable result that can give you confidence. It is pretty amazing, and I am quite confident in anything I wear.”