A Team Approach: Hope After a Breast Cancer Diagnosis

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You never know when you will experience a life-changing day. For 39-year-old Velma Modacure-Johnson, the events of an otherwise typical July day in 2018 sent her life in a direction she never anticipated. On that day, Velma discovered a lump in her breast.

Being a nurse, Velma knew that quick action was crucial. She immediately contacted her OB-GYN, who scheduled a mammogram. The mammogram confirmed the presence of a suspicious mass, and a biopsy was arranged right away. Then, Velma received the awful news – she had breast cancer. She knew, intellectually, that breast cancer can strike any woman. In fact, Velma was aware that she had a higher-than-average risk due to her family history; her mother was diagnosed with breast cancer in the early 1990s. Still, as Velma put it, “You never think it will really happen to you.”

Dr. John Colfry is a Touro breast surgical oncologist. Dr. Colfry performed his residency at Atlanta Medical Center and then completed a fellowship at the renowned MD Anderson Cancer in Houston. Despite his extensive training, experience and skill, Dr. Colfry acknowledges that he is only one piece of Velma’s care contingent, “The term ‘multidisciplinary’ has become cliché in medicine, but that word really holds true for breast cancer patients. Everyone works together to provide personalized care for the patient and offer them appropriate options. Nurses, surgeons, medical oncologists, radiation oncologists – we all coordinate our efforts for the best treatment outcomes.”

At first, Velma and her care team were hopeful that her cancer could be addressed with a lumpectomy, a surgical procedure where only a small portion of breast tissue is removed. Unfortunately, this was not to be the case. The cancer was stage 3, meaning the primary tumor was large and cancer had spread to several nearby lymph nodes. Dr. Colfry recommended a mastectomy, complete surgical removal of the affected breast.

By now, Velma had just turned 40. She was still young by any measure and had a husband along with two young children. She was more than determined to fight the cancer and survive, so she requested aggressive treatment – a double mastectomy. Dr. Colfry relates that this approach is not right for every patient, but given the nature of Velma’s cancer and her family history, he felt her decision was appropriate. Velma underwent surgery on October 4, 2018.

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Velma’s surgery was by no means the end of her treatment. She also needed radiation therapy as well as chemotherapy. There were good days and bumps in the road, like when she suffered a bout of pneumonia. However, one of Velma’s most important treatments was not an anti-cancer therapy at all. It was reconstructive breast surgery.

Dr. Ravi Tandon is a cosmetic and reconstructive plastic surgeon. He is also a friend and colleague of Dr. Colfry. While Dr. Colfry provides surgical treatment for breast cancer, Dr. Tandon provides surgical reconstruction to survivors of this disease, restoring their appearance and giving them a sense of reclaimed normalcy. The two surgeons have handled over 1,000 cases together.

Dr. Tandon earned his medical degree from Vanderbilt University and completed an elite microsurgical fellowship at New York University Medical Center where he was mentored by Dr. Bob Allen, a pioneer and legend in the field of surgical breast reconstruction. With his partners, Drs. John Guste and David Jansen, Dr. Tandon presents multiple reconstructive options to breast cancer patients, including implants and autologous flaps – “natural” reconstruction that uses the patient’s own tissue.

After extensive consultation with Dr. Tandon, Velma chose DIEP flap breast reconstruction. This advanced technique does not require the removal of any muscle. Instead, Dr. Tandon removed fatty tissue from Velma’s abdominal area to use in her breast reconstruction. Velma, laughing, explains that she was delighted with the results, “I got a tummy tuck as well as larger breasts.”

Drs. Colfry and Tandon work closely together so that their patients can enjoy the best possible medical and aesthetic results. For instance, Dr. Colfry strives to perform nipple-sparing mastectomies whenever possible, allowing his patients to retain their areolas and nipples after breast reconstruction. This was not possible in Velma’s case, but Dr. Tandon’s group offers nipple reconstruction as well as 3D nipple tattooing. These options meant a lot to Velma.

She relates, “They say that appearances don’t matter, but that is not really true. Yes, what’s on the inside counts more, but I wanted to see me when I looked in the mirror, and I didn’t see that after my mastectomy. Thanks to Dr. Tandon and his team, now I see myself in the mirror. They helped me retain my femininity.”

Today, Velma is proud to be cancer-free. She and her medical team will need to be vigilant for the remainder of her life, but her battle is won for now. Velma says, “Breast cancer was part of my life, but it wasn’t the end of my life.” She also cannot praise Drs. Colfry, Tandon and the rest of her treatment team enough. “They were so accommodating and so caring. They gave me options and guidance, and that made me feel empowered as both a patient and a woman.”

Velma’s advice to those women also facing breast cancer is “to have faith and hope. It doesn’t have to be religion, but have faith in something more than yourself. Rely on your support group. I had my family, my co-workers and friends, my doctors and nurses. I was never alone.”

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