Sandra Lee and 2017 Miami Breast Cancer Conference chair Patrick I. Borgen, MD
For television personality, author, and lifestyle maven Sandra Lee, who has donated much of her time to charitable causes, the roots of her controversial decision to have a bilateral mastectomy go back to her childhood, when her grandmother was diagnosed with an advanced and aggressive form of stomach cancer.
Her grandmother underwent radiation “and did all the things you have to do to get cured,” and she was cured, for many years, but then the cancer came back, Lee recalled during her keynote appearance at the 34th Annual
Miami Breast Cancer Conference®. It was much later when her grandmother turned 79 and Lee was on an Alaskan cruise with her that her grandmother broke the news that the cancer had returned. Lee wanted to get off the boat immediately and help her grandmother fight the cancer, but the woman was much more relaxed about it. She wanted to stay and enjoy the cruise.
Her grandmother’s experience was partly what made Lee, who was diagnosed in 2015 with early stage breast cancer, specifically ductal carcinoma in situ (DCIS), determined to fight her own disease. “For me, that really laid the groundwork for being extremely aggressive about dealing with the onset of cancer,” she explained during on-stage discussion with Patrick I. Borgen, MD, chair of the Miami Breast Cancer Conference®. Lee was introduced by Shannon Pulaski Esq, a representative for the advocacy group Bright Pink which focuses on empowering women to understand hereditary cancer risk and respond proactively.
Although treatment of breast cancer has improved enormously over the years, many women who have been treated successfully live with the constant fear that their cancer will return with a vengeance. Lee’s decision to have a bilateral mastectomy was based partly on a desire not to be plagued with worries and partly on not wanting to suffer the ravages of radiation, which she said was the alternative doctors offered her to a bilateral mastectomy. “I wasn’t going to count the percentages every year; I wasn’t going to live my life wondering when and if, and so I made a very clear decision.”
“The doctor who did the biopsy said I had medium-aggressive DCIS. ‘The concern with yours is that it’s in 3 different places. It’s at 10 o’clock, it’s at noon, and it’s at 2, and none of them are connected, so we’re going to keep an eye on you, but you’re going to have to make a decision as to what we should do,’” Lee recalled being told.
She did a huge amount of investigation on her own. She wasn’t satisfied to talk to just 1 or 2 doctors. She talked to many and encountered great divergence in opinion. She said there was a lot of information to digest and she had to hear things many times before she could absorb what she needed to know to come to a decision. But the 1 thing that was left out was the dramatic effect that mastectomy can have on the body, she said. “A mastectomy cuts the blood supply and it’s much harder to heal.”
She had managed to find a surgeon she could trust, but she wasn’t prepared for the aftermath—the slow recovery from anesthesia, the excruciating pain, the infection, and the swelling. She spent a full week in hospital after the first surgery, and what followed was a 3-month period during which she stayed at home in a reclusive state. Her weight dropped radically to 119 pounds, well below her current weight of 150 pounds—2 years later. She has 1 more surgery to go and she is hoping that’s the last.
Looking back, Lee noted that she wouldn’t change her decision despite her tremendous personal ordeal. She did have advice for the providers in the audience about communicating with patients, however. She was sympathetic to the fact that doctors and nurses have limited time and can’t possibly cover the scope of treatment and its impact to fully satisfy patients’ need for information. However, providers should make an effort to communicate and recognize that, especially during surgery, breast cancer patients are very helpless and need to know that their doctors share a connection with them.
“There’s no amount of words—confidence, connection, and communication—that you can give a patient in that moment. And that’s what your job is. Let the anesthesiologist do their job. You focus on that patient.”
”For that moment in time, to a patient, you are the most important person on the planet,” Lee continued. “As much as a woman wants to be with her kids or her partner or her family, it’s her doctor, and that needs to be reciprocated,” said Lee, who said she has talked with thousands of women about breast cancer since her diagnosis.