Email this pageCharlotte's Story
A woman trusts her instincts—and three remarkable doctors—to save her from breast cancer.
Charlotte McCabe describes herself as a very analytical woman. But it was by trusting her intuition that she may have saved her own life.
While giving herself a breast self-exam in August of 2006, Charlotte thought she felt a lump. “But I had just had a mammogram a couple of months before,” Charlotte recalls. “I thought, ‘This couldn’t be a problem.’
She forgot about the lump for a while. Then, in October, she felt a strong pull to do something about it.
“It was Breast Cancer Awareness Month,” says Charlotte. “I thought that maybe I shouldn’t ignore this.”
She went for another mammogram, which still showed nothing remarkable. So her radiologist decided to perform an ultrasound and a needle biopsy just to be sure. She was sent home with the reassurance that it was probably nothing, but she'd have an answer within the next few days.
It was a time that Charlotte put to good use. “I had this weird sensation,” Charlotte says. “I felt this need to mentally prepare myself, so in case it was cancer, I could handle it. I remember thinking, ‘I’ll end up at Strong if it is.’”
Her faith in Strong Memorial Hospital came from experience: Twenty years earlier, her husband had nearly died after he crashed his crop-dusting airplane. He recovered after two months in Strong’s ICU.
Charlotte’s mental preparations over her own situation proved to be time well spent. Two days later, she received the news that she had breast cancer.
Since she would need a mastectomy, her first step was to find a surgeon. Charlotte’s rational side kicked in, and she gathered recommendations from friends and colleagues. She decided to interview two surgeons, one of whom was Dr. Kristin Skinner of the University of Rochester Medical Center’s Strong Memorial Hospital and the Wilmot Cancer Center.
“I got such a good feeling from her,” says Charlotte. “Both surgeons gave me the same choices, but I felt better about Dr. Skinner and being at Strong. I knew I would get the best care there.”
Charlotte adds: “And being analytical, I Googled her, and read articles about her. I was very impressed.”
Dr. Skinner told Charlotte about the different options she had after surgery, the most innovative being something called a free TRAM flap reconstruction. Dr. Skinner explained that, in a TRAM reconstruction, Charlotte’s breast would be rebuilt using tissue from her own abdomen.
While this reconstruction gives women a very natural breast, it is also involves a highly delicate kind of surgery called microvascular surgery. Tiny blood vessels must be reattached to provide blood flow to the transplanted tissue. So Dr. Skinner would need to work in partnership with a plastic surgeon who had this highly specialized skill. As it turned out, a renowned surgeon with that expertise was also at the University of Rochester Medical Center: Dr. Howard Langstein, Chief of the Division of Plastic and Reconstructive Surgery.
Once her decision was made, Charlotte’s practical nature kicked in again. “I said, “How soon can we get this done?” Charlotte recalls. Thanksgiving had just passed—she hoped to have her surgery and be home by Christmas.
With her surgery requiring two top surgeons, scheduling could prove troublesome. But just two weeks later, on December 12, Charlotte had a successful mastectomy and TRAM reconstruction. (While these surgeries can be performed at separate times, she opted to have both at once.)
Charlotte was told that her surgery and reconstruction were very successful. She came to believe that even more in the days following: “Dr. Langstein would come in and ask if he could show different interns and residents ‘his work!’ They all said, ‘That’s fabulous!’ They’d seen a lot of TRAM reconstructions, but I guess mine was especially good.”
She went home a few days later, on December 16—exactly one month after her diagnosis.
At the time of her surgery, a biopsy of Charlotte’s sentinel node was also performed. The draining of lymph fluid that occurs within the body can cause cancer cells to spread, so pathologists would need to examine the tissue. A week later, Charlotte learned that the cancer had indeed entered her lymph system. So on January 4, 2007, the lymph nodes under her arm were also removed.
“So that meant we had to talk about chemo,” Charlotte says. “But I was okay with that because it was kind of like an insurance policy for me.”
Charlotte was businesslike in her approach. “I knew I was going to go to Wilmot,” she says. “I wanted the doctors who were on the leading edge of clinical research, who knew the latest and greatest treatments. I couldn’t have cared less about what color the walls were painted!”
Charlotte met with Dr. Michelle Shayne, an oncologist at the Wilmot Cancer Center. She explained Charlotte’s course of treatment and answered her questions. Dr. Shayne told her that they could get started whenever she was ready. Charlotte replied, “I’m ready now!”
Charlotte’s treatment involved, in her words, “both good news and bad news.” First, she would have to undergo five months of chemotheraphy with all of the usual side effects. Then, because her cancer was a very aggressive form, she would need IV treatments for an additional nine months. But this would be very targeted therapy. The “lock and key” mechanism of the prescribed drug would be used to block specific receptors on any remaining cancer cells and stop them from growing. The side effects would be minimal.
Just a little over a year after starting chemotherapy, an MRI would reassure Charlotte that the treatment had worked.
When asked how she faced her cancer with such an air of calmness, she replies, “It was really strange. I’m a fairly analytical person. My sister is the crier! I just want to know what I have to deal with. Give me all the information I need. I’m not going to worry about the ‘what if’. I’ll deal with the known and find out all I can about the unknown. Then, I’ll just take the best course of action.”
Still she admits, “From time to time I’d think, ‘Oh my God, this could kill me.’ I cried. I had moments when I thought I couldn’t do this anymore.”
For Charlotte, having the right doctors made all the difference. “I liked Dr. Skinner from the start. I could relate to her. She was down to earth, smart, and real. She was always very straight with me and never made me feel rushed. There are some surgeons who are very clinical. She wasn’t like that. There’s a real warmth to her.”
Charlotte expressed her gratitude to her two doctors in the one way that came naturally: by baking. At her follow-up appointments, she delivered a blueberry pie to Dr. Skinner, a pecan pie to Dr. Langstein, and a peach pie to Dr. Shayne.
In the wake of her unexpected encounter with breast cancer—she has no family history of the disease—Charlotte now hopes to help other women catch breast cancer early.
“I’m a writer,” says Charlotte. “So I sent an email out to friends and co-workers when I was first diagnosed, and updates as things progressed. I think it's important to talk about cancer, because it can help make it less scary for people. And I want them to know you really need to be vigilant, you really need to do everything you can to protect your health.”
One of her co-workers wrote back, telling Charlotte, “I’ve been meaning to go get a mammogram. Now I’m going to call.”
