Knowledge is Power when Managing Breast Cancer Risk

Miriam Margala vividly recalls her mother’s phone call from her native Slovakia, informing her she had been diagnosed with breast cancer. It was a painful experience that resulted in a partial mastectomy, the surgical removal of a large part of the affected breast, and the removal of all the lymph nodes near the breast.

So when Miriam was delivered the news that she was at high risk of breast cancer herself, and a candidate for surgical intervention to reduce that risk, she was nervous. As a PhD researcher and UMass Lowell adjunct professor, she also had a lot of questions.

Dr. Lerna Ozcan, a fellowship trained breast surgeon and Medical Director of the hospital’s Breast Care Center of Excellence, immediately put her at ease.

“She knew how to talk to me,” Miriam says. “She sent me research papers and medical studies so I could see the numbers and how the research was conducted.”

Beginning at a woman’s screening mammogram, a specialized computer is used to identify women who are at high risk of developing breast cancer. Women categorized as high risk are referred to the Breast Cancer Risk Assessment Program. Here a team of specialists, including an oncologist, breast surgeon, and a nurse practitioner work together with the common goal of preventing breast cancer or detecting it in its earliest stages.

“It’s an active surveillance program,” Dr. Ozcan says. “Most importantly, it helps with early detection of breast cancer, when it is highly curable. And by making some lifestyle changes and offering certain anti-estrogen medication, women are actively reducing their lifetime risk of breast cancer. That gives women a lot of reassurance and decreased anxiety.”

After a routine mammogram 2 years ago, Lowell General radiologists recommended Miriam receive a breast MRI due to dense breast tissue. She also received a score that assessed her breast cancer risk by using an advanced technology that considers imaging results as well as other factors like family history.

In addition to her high-risk score, the MRI showed atypical cells that were not yet cancerous, but could potentially harbor cancer. Miriam was referred to the Risk Assessment Program and received a surgical biopsy by Dr. Ozcan that confirmed the diagnosis.

Dr. Ozcan recommended removing the cells to greatly reduce that risk, and reassured Miriam that new surgical techniques would not leave her breast permanently disfigured.

During the biopsy, a locator chip was inserted into the breast to help Dr. Ozcan precisely identify the area that required removal. The surgery was successful and just a small scar is left behind, thanks to new reconstructive techniques that result in minimal changes to the breast. Within a day, Miriam was back to her running and walking routine.

Though her surgery was initially delayed due to the pandemic, Miriam says she was kept informed and her concerns were always promptly addressed.

“I didn’t have to do anything,” she says. “They would call me, register me, and tell me what to do. I couldn’t believe the details they take care of.”

Miriam’s risk of cancer has been greatly reduced, but she will continue to be monitored by the program, including more frequent imaging.

Miriam says she has friends who told her to go to Boston for her care, but she did her research, and found Dr. Ozcan to be just as qualified, with the additional convenience of having all her treatment close to home.

“I go to Lowell General and that’s it,” Miriam says, “and I’m absolutely satisfied.