Becky’s Breast Cancer Plan Fits Her Lifestyle

Early one evening last summer, Becky Michael of Lincoln said a little prayer before checking her breast biopsy results.

“I try to live a healthy life, and part of that is getting a mammogram every year,” says Becky, 53, who’s an English language arts education specialist for the Nebraska Department of Education. “They’d all been good, but my most recent showed a tiny lump that required a biopsy.

“As I read the results in my kitchen, I saw: ‘Findings positive for breast cancer.’ I was quiet for a moment, then felt total shock and disbelief — I thought, ‘This cannot be happening to me.’ I sat there a long while before I could tell my husband.”

At her breast biopsy appointment two weeks earlier, Becky met oncology nurse navigator Carmen Orr, RN, who’s part of the team of nurses, doctors and other clinicians providing comprehensive, breast cancer care that’s centrally located at Bryan’s Breast Cancer Multidisciplinary Clinic.

“Women having biopsies for possible breast cancer are very understandably worried,” says Carmen, “so we meet patients at that biopsy appointment to answer their questions and follow up afterward. For women whose results show they do have cancer, we’re in touch with support and more information about their care within a week, often within 24 hours of them hearing the diagnosis from their doctor.”

“You know,” Becky says, “I’d actually been feeling fine, and I was so surprised to find out I had breast cancer. It turned out that my tumor was so small that I couldn’t feel it during breast self-exams, but my mammogram and biopsy picked it up. I just feel so fortunate that we found it early.

“It really helped me that Carmen called the very next morning to ask how I was doing and talk over our next steps.”

Fitting Becky's Care to Her Life

Patients newly diagnosed with breast cancer can typically find that their first appointments with cancer care specialists are scheduled over many days at different offices — which is a scenario that can lead to fragmented care.

To resolve that potential problem, the doctors and clinician team at Bryan’s multidisciplinary clinic come together for initial care planning meetings, at times that are convenient for their patients. There, patients and families talk with the doctors, ask questions about care options and find treatments that best fit their needs and their lifestyle.

On the day of Becky’s planning meeting, she brought along family support — her husband, Dr. Bill Michael, who is a psychiatrist at Bryan Heartland Psychiatry, and her sister, Amy Spomer. “It was a real comfort to have them with me, and our exam room was comfortable and beautifully done so it didn’t seem like a hospital room,” Becky says.

“My doctors and my team had already discussed my case. So, each came ready to talk about their part in my treatment, and the doctors had all my treatment options ready for me and Bill to look over. Then, for each possible treatment path, we talked about potential side effects and chances of recurrence, and I chose the treatment that fit best into my life, what was best for me.”

Collaboration and Care

The clinic’s chief medical director, breast surgical oncologist Rachel Jendro, DO, FACOS, of Bryan Breast Surgical Specialists, says, “Becky’s physicians include myself as her surgeon, plus radiation oncologist Joseph Kam Chiu, MD, and medical oncologist Haris Zahoor, MD, both of Cancer Partners of Nebraska.”

Nurse navigators have a key role on the team, too. They’re equal parts coach, care coordinator and key problem solver for the patient throughout their cancer treatment.

“Patient advocacy is a huge part of what our nurse navigators do,” Carmen says. “An essential part of that is helping patients understand and address issues that could be barriers to their best care.” These issues can include fear, grief, stress or anxiety about having breast cancer and going through treatment, or nuts-and-bolts problems like how to arrange for more childcare, or manage time demands around treatment schedules and medical appointments.

Also, an oncology social worker, like Joselyn Hayes, meets with families to plan for day-to-day changes like fatigue that can be expected during cancer treatment, and to talk about financial concerns and other common questions.

Certified genetic counselor Maddie Kaltenberger, MGC, explains testing that can show whether a patient carries a gene passed down through her family that could cause breast cancer.

Other doctors working with Bryan’s Breast Cancer Multidisciplinary Clinic include radiation oncologist Jacqueline Kelly, MD, and medical oncologist Joni Tilford, MD, also of Cancer Partners of Nebraska.

“There is absolutely no question that’s too small or trivial to ask during our care planning meetings with patients,” Dr. Kelly notes. “We’re all in one place on purpose, and that purpose is so you, our patient, can move ahead with a clear action plan.”

Dr. Tilford adds, “Our goal as a team is to help patients overcome breast cancer and move on with their lives. It’s an honor to help them at each step of that journey.”

Map to Breast Cancer Recovery

“The clinic’s team approach saved so much time and stress for me,” says Becky. “Talking to all of my doctors and clinicians in one morning, in one place, was a godsend rather than going to multiple doctors’ offices at different times, then waiting for them to talk to one another, then get back to me. I’ll be very honest — learning I had breast cancer was exhausting and frightening; walking out of our care planning meeting with a detailed plan, I felt like I had a map for my recovery from this breast cancer, and I could move on with my life.”

The first step of Becky’s treatment was lumpectomy surgery performed by Dr. Jendro.

“My recovery from surgery was pretty smooth,” Becky says. “In fact, I was able to travel to an education conference for work a week later. It was a great relief to be back to my normal life so soon.”

Becky will begin radiation therapy soon with Dr. Chiu and talk further with Dr. Zahoor about possible chemotherapy and endocrine therapy. In the meantime, she’s back to her favorite routine for the most part, including Sunday evening family dinners with Bill, their daughters Grace, 21, and Olivia, 25, and Becky’s parents, Pastor Larry and Linda Spomer, who recently moved to Lincoln and live nearby.

“None of us knows what life will bring,” Becky says. “I do know that my doctors and I caught my breast cancer really early, and that gives me peace of mind. Bryan’s multidisciplinary team approach gave me options that helped me fit my treatment into my life, rather than the other way around.

“The great support and information I’m getting from the team along with my treatment is going to help me do well and thrive during my breast cancer recovery, and that means everything to my family and me.”