‘My Cancer Nightmare Turned Into a Dream’

After treatment for triple negative breast cancer that included a total mastectomy, Chastity Jones was ready for a new look and a new chance for a healthy life.

A bad implant infection caused Jones to rethink her options and when she finally healed, her oncologist suggested the Center for Breast Reconstruction at the Helen F. Graham Cancer Center & Research Institute.

Director Stephanie Caterson, M.D., an experienced plastic surgeon who specializes in microsurgical breast reconstruction, offered Jones one of the most advanced procedures available called DIEP (deep inferior epigastric perforators) flap surgery.

“What started out as my cancer nightmare turned into a dream,” Jones said. “I look better now than I did before my cancer, when I called myself healthy. I feel beautiful.”

Stephanie Caterson, M.D.

Caterson took skin and fat from Jones’ lower abdomen below and around the belly button along with some tiny blood vessels called perforators to reconstruct a more natural-looking breast completely from her own tissue.

ChristianaCare is the only center in Delaware performing microsurgical flap breast reconstruction.

“Extensive training in microsurgical techniques is required to perform such an advanced procedure,” said Caterson, who completed her fellowship at Harvard University in 2006.

“We are the only center in Delaware performing microsurgical flap reconstruction,” she said. “Across the country, this level of expertise is largely confined to major academic institutions.”

For Jones, the experience was life-changing. “At our very first meeting, Dr. Caterson set the tone for a level of care that was exceptional,” Jones said. “She understood my entire cancer journey before she ever touched me, and her hands are truly magical.”

Women with breast cancer who are not eligible for breast-conserving surgery or who have a genetic risk for breast cancer may request breast reconstruction following mastectomy.

Although implant-based reconstruction is still a popular choice, for a woman who qualifies, using her own tissue for breast reconstruction creates a natural-looking and natural-feeling breast that is healthy and long-lasting.

“DIEP flap surgery can also be a lifeboat to bring in healthy tissue to remove scarring and replace tissue damaged by radiation treatments,” Caterson said.

With perforator flap surgery, recovery time is longer than traditional breast implant surgery, usually five to six weeks, but reconstructing the breast using tissue from the abdomen, inner thigh or buttock has advantages.

Unlike an implant, the reconstructed breast adjusts with body changes associated with aging or weight fluctuations, for example, to maintain lifelong symmetry on both sides of the chest. The aesthetic effect of a tummy tuck or inner thigh lift from where the tissue is taken can be an added benefit.

‘We help our patients develop a personalized plan to achieve the absolute best outcome.’

— Stephanie Caterson, M.D.

“At the Center for Breast Reconstruction, we offer a full range of techniques to help women facing breast surgery reach their goals,” said Caterson.

“We have the experience to fully evaluate our patients and to help them develop a personalized plan to achieve the absolute best outcome.”

What is more, she says, being part of an entire cancer care community like the Graham Cancer Center makes it more viable for patients who are good candidates to choose advanced microsurgical options.

“There are a lot of components that must work well together for patients to have successful microsurgical breast reconstruction,” said Caterson, who has performed almost 2,000 perforator flap procedures in her career.

The procedure  involves working collaboratively with the entire team of colleagues across disciplines including medical, surgical and radiation oncology. Radiology plays a key role in producing imaging studies essential for pre-operative assessment. The breast reconstruction team works seamlessly with operating room and infusion staffs.

Post-operatively, coordination with nursing education, rehabilitation, counseling, nutrition and other support services is essential.

“This is such a big operation,” Caterson said. “My component is important, but we have to integrate with all the other aspects of patient care to achieve successful outcomes.”

For Jones, having her care at the Graham Cancer Center also meant never having to travel elsewhere for essential services like genetic counseling and testing, nutrition, psychosocial oncology and social work.

“I did get a second opinion in Philadelphia, but I know I made the best decision to stay closer to home,” Jones said. “I not only received excellent care, but my doctors, the staff and even the other patients were always compassionate and encouraging.

“The beautiful people at the Cancer Center were an avenue of hope when I felt most hopeless. They were an inspiration and a lifeline.”