Personalized Treatment: Kathy’s Story

As a mother of three, Mother’s Day always held a special place in Kathy Rumski’s heart, and this year, she planned to spend it the same way she traditionally did — with her children and mother. However, something happened that led her to break from that tradition. She instead went to the Susan G. Komen Race for the Cure and found solidarity and inspiration there.

Months before, Kathy and a friend scheduled their annual mammogram appointment together. They had plans to go out to lunch afterward, but those plans changed when the doctor told Kathy post-mammogram, “We need to do a biopsy.” The words hit her hard, especially since her sister, Debbie was already living with Stage 4 breast cancer.

After the biopsy, Kathy learned that she also had breast cancer. She was referred to St. Clair Hospital breast surgeon Tara L. Grahovac, M.D., for treatment. “Kathy had ductal carcinoma in situ, which does not have the ability to spread outside the breast tissue,” explains Dr. Grahovac. “However when we did a lumpectomy, the pathology showed invasive triple negative breast cancer, which can spread. Often we add chemo to the treatment plan for that, but she had a small focus on invasive cancer and her axillary lymph node biopsies were negative. This was a rare case where we could skip chemotherapy; she was referred directly for radiation therapy.”

As she prepared for radiation therapy, a CT scan revealed an abnormally large lymph node underneath the sternum. “It would be unusual for such a tiny cancer to spread that way, and we don’t usually remove lymph nodes in that area, so close to the heart, but if the node was found to contain breast cancer it might change our decision regarding chemotherapy.”

It was a complicated case, but Dr. Grahovac decided to consult Mayo Clinic for an eConsult with breast surgeon David R. Farley, M.D. to see if they had encountered anything similar. Ultimately, they chose to remove the lymph node. Fortunately, the biopsy on that node was negative.

“I was happy with the availability of a Mayo Clinic eConsult,” says Dr. Grahovac. “There was a quick turn-around. I have found patients appreciate evidence-based medicine; they are often well informed and they use the Internet a lot. There are no perfect answers, but having access to Mayo Clinic is such a benefit because it is a great resource and its important to speak with other physicians who are treating this disease; a Mayo Clinic consult is a meeting of the minds. It helps us to customize care to each individual patient.”

Kathy appreciated that Dr. Grahovac consulted with Mayo Clinic and also with Dr. Grahovac’s colleague and fellow breast surgeon, Raye J. Budway, M.D. Kathy had complete confidence in her care. “I was fortunate that I was referred to Dr. Grahovac; she and her Physician Assistant Alexis Joseph, PA-C, have been phenomenal.”

Due to Kathy’s circumstances, she decided to break from her Mother’s Day traditions and join other breast cancer survivors at the Race for the Cure. It all worked out perfectly when her daughter secretly assembled a team for her.

“At the event, there is an area that is only for survivors,”Kathy says. “You walk in there alone. Then you stand with the other survivors, and they have music and speeches. I saw thousands of people looking at me, cheering for me, and I cried when I spotted my team out there. It was very emotional. The whole day was an incredible gift, and I plan to make it a tradition.”

This story is an edited version of a full report published in our Summer 2017 edition of HouseCall. If you want to read the full write-up — which includes more information — you can visit the St.Clair website and download a copy of our Summer 2017 HouseCall here.