At the start of 2021, Tami Pope was struggling a bit. “I always run myself down during the holidays,” she said, “so I usually spend January and February recouping. But this time I was more tired than usual.”It’s only in retrospect that she sees this as a possible first symptom of what was to come. Then February brought a symptom that was harder to explain away: a noticeable pucker in the skin of her left breast.“I did not immediately think breast cancer,” she said. “But then I googled it, which I should not have done.”Googling led her to worst-case scenarios, which flooded her with fear and anxiety for days. Finally, she made an appointment with her gynecologist, who rushed her in for a mammogram. “And it was like that day, bam,” she said. “It never stopped.”She was called back for an ultrasound, and then sent for a biopsy. Finally, she got the news in a call from her gynecologist. It was cancer—invasive ductal carcinoma, to be exact. “I asked him if this is something I can beat,” she said. “He said, ‘Yes, it’s small and it’s early.’”He referred her to Cape Fear Valley’s Breast Care Center, where she met Elizabeth Sawyer, MD, FACS, the center’s medical director. Dr. Sawyer is a surgeon who specializes in breast cancer, and she’s often the first person a woman sees after diagnosis. “So many women have anxiety about breast cancer,” said Dr. Sawyer. “I really enjoy having the opportunity to educate women about it, and to ease some of those fears.”“As soon as she came in, I felt comforted,” Pope said. “She said what I had was the most common type of breast cancer, and it wasn’t very aggressive. And I had lots of treatment options.”After discussing those options, they settled on a plan: a lumpectomy to remove the tumor, and radiationto kill any cancer cells that might remain.After talking with Dr. Sawyer for a while, Pope met another woman who would play a crucial role in her treatment: Erin Champion, a Breast Patient Navigator. Her job is to guide patients through the complex process of breast cancer treatment, which can be a lengthy and emotional experience.Champion has a unique understanding of what patients may be going through. Seven years ago, while pregnant with her third child, she was diagnosed with breast cancer herself. “One of my first prayers after that diagnosis was, ‘If I’m going to go through this, please let it be for a greater purpose,’” Champion said. Pope said after meeting Champion, she knew she was in good hands. “You can’t look at her and not immediately feel better,” she said. “She just radiates kindness and love.”
Although Pope left that appointment feeling good about her treatment plan, she also believed it was prudent to get a second opinion. She traveled to Raleigh to find out what a doctor there would say. “As soon as he introduced himself, I knew that was not where I wanted to be,” she said. He gave me the same information, but it was not delivered in the same way. I felt like just another patient there, and it confirmed that I needed to do this in Fayetteville. I felt like Dr. Sawyer and Erin were put in my life for a reason.”Back at the Breast Care Center, Champion’s navigation skills would be put to the test over the next few months as Pope’s treatment became more complicated. “I was satisfied with the lumpectomy and radiation plan,” said Pope, “and I felt lucky that was all I needed. But a week before the lumpectomy, I don’t know. This feeling just came over me and I was sure I needed the mastectomy.”One reason, Pope said, was that for years she had been called after routine mammograms to come back for a second look. “I never worried about it, because it never turned out to be anything,” she said. “But I knew that after this experience, if I got that call after a mammogram I would probably freak out.” She called Champion and explained her change of heart. Champion spoke to Dr. Sawyer, who agreed to perform a mastectomy instead. They set the surgery date for May 4.Pope’s decision to remove both breasts presented another fork in the road: Did she want them cosmetically reconstructed, or was she content to do without?“I understand why some women don’t want reconstruction,” she said. “My initial thought was I don’t care, just take them and be done. But we talked about it, and I was a really good candidate to have the reconstruction. And I started to think if I didn’t do it, I might look back and wish I did.”This brought a new player to the team: Leif Nordberg, MD, who performs plastic and reconstructive surgery, including breast reconstruction after mastectomy. While most cosmetic surgery presents an out-of-pocket expense to patients, breast reconstruction is usually covered by insurance.“Dr. Nordberg was wonderful,” she said. “He took his time explaining the process and really made me look forward to having it done.”On the day of the mastectomy, Pope encountered the most serious obstacle yet: In the middle of surgery, her heart inexplicably stopped. The procedure came to an abrupt halt as she was revived, and she spent several nights in the hospital to investigate this worrisome new issue. “My heart recovered quickly,” Pope said. “I have gone through lots of tests since then and it’s completely recovered.”Pope described it as “broken heart syndrome,” a condition in which extreme stress temporarily damagesthe heart. And no wonder—in those three months since her own diagnosis, her father had passed away and her father-in-law was diagnosed with late-stage pancreatic cancer. With her heart on the mend, Pope was again cleared for surgery. But it wouldn’t be the one she had planned on.
“Dr. Sawyer said, ‘We need to hit the brakes on the mastectomy for a while,’” she said. “So I agreed to just do the lumpectomy for now, and come back to the mastectomy later.”After the lumpectomy, Pope’s lab work showed that there was still some cancer remaining, including in her lymph nodes. The news reaffirmed her choice for a mastectomy. “And it turned out I needed chemo too,” she said. “The plan just kept getting bigger and bigger.”After completing four rounds of chemo and a month of rest, Pope finally had her mastectomy in October. Dr. Sawyer removed all of the tissue from both breasts, sparing the skin and nipples for reconstruction. Then Dr. Nordberg stepped in, placing tissue expanders that would be filled over time and make room for implants to be placed a few months later. “I had my final surgery in June,” said Pope. “The expanders came out and the implants went in.”She said the true final result may not be visible for six to eight months—two years from her first symptoms—but she already loves how she looks and feels. “This team is amazing,” she said. “The way they cared about me completely, from my physical health to my mental health, my body image, how I would feel today and tomorrow and the next day ... I am just sograteful.”Dr. Sawyer said a multidisciplinary approach is key to the Breast Care Center’s success. As a surgeon, sheis joined by specialists in medical and radiation oncology, skilled nurses and ancillary services such as nutrition and social work.“We are all members of a team,” she said. “Everyone has a say, and we meet regularly throughout a patient’s care to discuss their progress. I’m proud to say we offer world-class care in the comfort of our hometown.”Pope said that for a case as complicated as hers turned out to be, a navigator like Champion is essential. “I can’t tell you how many times she talked me off the ledge,” Pope said. “I called her after hours, on weekends, anytime. She was a godsend.”Champion said it’s a pleasure to help during times like this. “Sometimes this looks like the path you’ll take,” she said, “and then it changes. Either your imaging has changed, or you have changed your mind about what you want to do. I’m there to listen, make sure theyfully understand the recommendations and options and then walk with them on the path they choose.”For others facing a breast cancer diagnosis, Pope has some advice. Keep up with your annual mammograms. Know your body, and if something looks or feels wrong, get it checked out. “And whatever you do,” she said, “don’t google it.”