By: Sammy Cusimano
In order to achieve success, there must be an individual commitment to a group effort. Having the right team members in any endeavor is crucial to a successful outcome. Dr. Ravi Tandon and Dr. John Colfry are the united front helping so many women today in the battle to overcome breast cancer and the impact that it has on so many lives. “A breast cancer diagnosis should not be an excuse for poor outcomes,” says Dr. Tandon. Times have definitely changed in the realm of breast cancer treatment. Not only are the present-day technologies and advanced techniques making treatment more effective and efficient, but also, there is an increased focus on the breast reconstruction phase to help patients resume as much normalcy in their lives as timely as possible. Drs. Tandon and Colfry contribute greatly to the hope and recovery of so many local women who face the daunting challenges of breast cancer and the surgical options that come with it. Their patients include women who have been recently diagnosed with breast cancer, have a genetic predisposition to breast cancer, as well as women who may have had a mastectomy years ago, when the modern breast reconstructive surgery options of today were not available. Drs. Tandon and Colfry’s shared passion for helping women who are going through the experience of breast cancer removal and cosmetic reconstruction is what drives them to continue evolving in their medical practice.
Being one of the few microsurgical fellowship trained surgeons in New Orleans, Dr. Tandon has embraced his journey in the medical field as a testament to his lifelong dedication to his practice. Following medical school at Vanderbilt University and general surgery training at Tulane University, Dr. Tandon specialized in plastic surgery in New York City. After beginning a microsurgical fellowship at New York University, Dr. Tandon focused primarily on reconstruction of oncological defects under the wing of his mentor, renowned surgeon and “guru” of breast reconstruction, Dr. Bob Allen. Dr. Tandon trained under Dr. Allen learning advanced microvascular techniques for breast reconstructive surgery.
Dr. Tandon works at Jansen Plastic Surgery, with his two partners – Dr. David Jansen and Dr. John Guste. All have a strong interest in breast reconstruction and bring a team approach to the complex reconstructive cases. “I enjoy being part of a team that constantly strives to bring the latest techniques and technologies to our patients’ reconstructions and improve their outcomes,” Dr. Tandon says about working with his partners.
Dr, John Colfry is one of only a handful of breast fellowship trained surgeons in the region. After completing medical school at Louisiana State University Shreveport, Dr. Colfry completed general surgery training at Atlanta Medical Center. He went on to specialize in surgical breast oncology at the world renown MD Anderson Cancer Center in Houston, Texas.
Dr. John Colfry is a breast surgical oncologist at Touro. “I am most proud of the radioactive seed breast surgery that I brought to Touro from my training experience at MD Anderson. I use tiny radioactive seeds to precisely localize and remove breast cancer. The results are more precise, less tissue disturbed, better cosmetic results and require less second operations to clear tumor. These seeds can also be placed in lymph nodes to target diseased lymph nodes and only remove a few rather than unnecessarily remove non-diseased lymph nodes. This means less surgery for patients and lower rates of lymphedema (arm swelling) after lymph node surgery,” explains Dr. Colfry.
When at all possible, Dr. Colfry performs nipple sparing mastectomies on patients who do not have disease noted near the nipple. This means all of the breast tissue is removed, but the patient keeps her skin and nipple to allow for reconstructive surgery. “The cosmetic results with this approach are fantastic,” says Dr. Colfry.
Dr. Tandon and Dr. Colfry utilize a multi-disciplinary approach in the treatment and recovery of breast cancer patients. As patients undergo the process of oncology, radiation and surgery, they work together to help restore as much regularity to the patients’ lives as possible. Dr. Tandon states, “We bring family-friendly, personalized care to each patient.” The concept of family and community is a crucial part of patient treatment and recovery. It helps to make the entire process more effective by providing the right warmth and support to patients during the challenges that they face during their experience. “What sets us apart is our team,” states Dr. Tandon. “The united effort that we put forth is what makes all the difference in the positive results that patients receive under our care. The ultimate focus is on patient-centric care to optimize the individual’s experience, but also to include and focus on the patient’s family because everyone is affected.”
Dr. Tandon and Dr. Colfry positively impact the lives of so many patients and their families every single day with their caring and personal approach to helping women diagnosed with breast cancer to heal and recover every step of the way. One such example of their exceptional medical care is the inspirational story of Cate Carlin. On May 25, 2016, Cate was diagnosed with breast cancer. She was 36 at the time with three-year-old twins and a happy, fulfilled life. She had been taking the standard precautions as most women do of getting mammograms every 6 months, especially since her mother had breast cancer when she was a younger woman. During one of her routine mammograms, Cate’s doctors saw something concerning. Upon further diagnosis, it surprisingly turned out to be breast cancer. This was a very unexpected turn of events for Cate. She and her family were in the process of getting ready to leave on a trip when she received the diagnosis. Suddenly her world had been completely rearranged. This experience is numbing to the patient and their family as they go through it. It is an unimaginable flood of emotions hitting a person all at once.
Cate states that she was not prepared for the diagnosis at all. Her initial reaction was panic and concern about how she would tell her family, especially her children and her own parents. Cate and her family had previously been living in Houston for quite some time before relocating to New Orleans two years before her diagnosis. Her first inclination was to move back to Houston to be closer to the MD Anderson treatment center to get the best care possible. She knew this would be a very big decision that would affect her entire family. While searching for possible local options in the New Orleans area as an alternative to moving back to Houston, Cate decided to call Dr. Colfry. Within one week of her diagnosis, Cate and Dr. Colfry met for the first time. Although the first few days after her diagnosis were a complete blur due to the spectrum of intense emotions and mental distress of the overwhelming circumstances, Cate recalls the first meeting with Dr. Colfry with complete clarity. She states that from the moment Dr. Colfry met with her all apprehension went away. He set Cate at ease instantly with his kind, caring demeanor and his highly professional approach to every aspect of her diagnosis. Cate brought her family and even another physician with her to the first meeting with Dr. Colfry. In this very scary and uncertain time for Cate and her family, what helped alleviate so many fears was the fact that she felt Dr. Colfry had a solid plan. It was during that initial consultation that Cate knew she had found the right person to help her overcome this major obstacle that she was now facing.
Dr. Colfry laid out a precise plan of action for Cate. She had two lumps (each one centimeter) on one breast. The first step was surgery. The primary focus was to remove the cancerous tissue. While Cate was undergoing the necessary steps of the entire process, Dr. Colfry also conducted genetic testing which was pivotal in Cate’s decision to choose to have a bilateral mastectomy. The guidance of Dr. Colfry helped Cate to make an effective decision that would be most beneficial for her health in the long-run.
Cate was equally impressed with Dr. Tandon’s exceptional approach to her diagnosis. Much like her experience with Dr. Colfry, Cate remembers the warmth and compassion of Dr. Tandon from the first moment that she met him. Cate was relieved to learn that there were so many more options than she realized pertaining to the reconstruction process. Dr. Tandon
helped her to find the best options that would suit her specific situation.
“Being diagnosed is like learning a foreign language,” says Cate. She states that from the moment of her diagnosis she began learning so much about breast cancer and the terms that are involved with it. It was a learning experience directly related to her own body in every sense. Cate was becoming knowledgeable of surgical options as well as reconstruction techniques every step of the way.
On July 7, 2016, Cate was facing head-on the reality of her oncologic surgery and immediate reconstruction. She would be having a bilateral mastectomy with bilateral DIEP Flap reconstruction. She states that Dr. Colfry and Dr. Tandon helped ease her nerves by allowing her to focus on herself and her family and less on the logistics of the surgery and recovery process. She felt that they were taking her under their collective wing and that she was in extremely good hands. Both Dr. Tandon and Dr. Colfry continued to support Cate after her surgery. Each of them checked on her, even on the weekends, while she recovered in Touro Hospital for 3-4 days. “I felt I was on the right team,” says Cate.
As Cate began the recovery process following the surgery, Dr. Colfry in conjunction with Cate’s medical oncologist, Dr. Laura Beth Ramirez, decided that Cate would not need chemotherapy during her recovery. In the past, chemotherapy was utilized more than it should have been in many cases. Now, there is an Oncotype test in which lab results can help doctors determine if the therapy is beneficial to the patient in question or not. Dr. Colfry came to the conclusion that in Cate’s case chemotherapy was not necessary. Instead, Cate’s oncologist was able to set up a 10-year medication plan for her that was a better option for her recovery.
Cate has reclaimed her life again thanks to the incredible medical care of Dr. Tandon and Dr. Colfry. She continues to get checked every six months, while continuing her medication regimen as well. Dr. Tandon and Dr. Colfry’s care for their patients beyond the surgery procedure. They help their patients to transition back into the daily routine of everyday life, after going through the process of breast cancer removal and breast reconstruction. “Dr. Tandon and Dr. Colfry care for and want the best for their patients. They are so empathetic and kind with everyone. They create the team connection and supportive atmosphere among the patient as well as the family throughout the entire process,” says Cate. She continues, “Their skill and professionalism as surgeons is equal to their empathy and compassion as caring, kind human beings.” Dr. Colfry states, “Cate is the perfect example of the flawless merging of surgical oncology and reconstructive surgery that results in a home run cure and perfect cosmesis.”
Dr. Tandon elaborates on the reasons as to why many patients are now exploring their options with breast reconstruction even years after a mastectomy. He states, “Historically in the United States, less than half the patients would get breast reconstruction because they were not aware of the options, etc.” Dr. Tandon explains that one of the main focuses of consultations with his patients is directed towards educating patients of their reconstructive options. States, including Louisiana, have even passed legislation to ensure that every woman who undergoes a mastectomy is advised of her reconstructive options and has insurance coverage for these surgeries. Dr. Tandon states that in the past with breast reconstruction, the cosmetic part of the recovery process was not as important. The removal of the diseased tissue was the main focus of the process; however, that has significantly changed. More women every day are learning that they can have a successful cancer operation with reconstruction that can be on par with aesthetic breast surgery.
Under Dr. Tandon’s care, there are two main paths that patients have when choosing breast reconstructive surgery: autologous (using the body’s own tissue to replace breast tissue) or implant (silicon based). “We individualize the reconstruction plan for each patient,” states Dr. Tandon. There are advantages to both methods depending upon each patient’s needs and circumstances. With an autologous approach, a patient’s very own lower abdomen tissue is used to replace breast tissue that is removed during the surgery. There is a longer recovery time involved in this procedure; however, once the surgery and recovery is complete, the patient does not need to have any follow-up procedures performed years later. Essentially, the patient gets somewhat of a “tummy tuck” to replace the removed breast tissue. Patients get results that look and feel very natural due to Dr. Tandon adhering to the principle of replacing “like” with “like” regarding tissue of the body during surgical procedures.
When patients receive breast implants as part of their reconstruction process, there is less downtime from the beginning compared to using abdomen tissue as a replacement for the breast tissue. Dr. Tandon uses “gummy bear” silicone implants that do not leak if they rupture. These modern advancements in the quality of breast implants make the option of using artificial materials much more viable than in years past. The breast implant option has become a very safe choice with many advantages, when applicable to a specific patient’s needs.
One of the modern techniques involving breast implant surgery that Dr. Tandon utilizes to help improve the overall experience for patients is a pre-pectoral implant inserted above the muscle. By using this technique, there is decreased pain for the patient as well as no animation deformity (implant moving when the chest muscles are flexed). Patients are much more satisfied with this modern advancement in breast implant surgery, due to the quicker recovery time and noticeably less muscle animation problems.
Dr. Colfry elaborates on the fact that breast cancer is no longer a disease that mostly affects older women. It is becoming more common in the present-day for young women in their thirties and some even in their twenties to receive a diagnosis of breast cancer. He states it is essential for younger women to not be afraid of reaching out and seeking medical help in preventing and overcoming breast cancer. “Self-awareness of the breasts is so important, especially for younger women,” says Dr. Colfry. Regular mammograms and doctor visits are crucial to staying self-aware so that the chance of treatment success, if any cancer is detected, will be strong. The key to Dr. Tandon and Dr. Colfry’s success as such a powerful team is good communication between each other. With their incredible tandem efforts, they are able to help rebuild lives, give well-founded hope and make patients feel whole again.
Please visit www.ravitandonmd.com for more information or call