It’s important to know your own body. It can save your life. Just ask Sarita Fobbs-Worrell.
The mother of two knew there wasn’t something quite right. She finished breastfeeding her second child, but continued to have a small amount of discharge from one breast from time to time. And then she found several small lumps.
Because Sarita had dense breasts — a risk factor for breast cancer — along with a history of fibrocystic changes (lumps), her doctor recommended a preventative screening management schedule. She underwent testing with mammography and ultrasound every six months for two years.
On the final check-up in the series, radiologists were concerned about a new mass discovered in one breast. A biopsy the next day showed Sarita had cancer.
"The behavior of my body was kind of alarming, so I kind of knew," says Sarita.
New Practice Streamlines Breast Cancer Surgical Care
Sarita met the diagnosis head-on with dignity and courage. She turned to Penn Medicine, where her 92-year-old grandmother was being treated for breast cancer. Sarita’s care progressed quickly from there, with the help of the new, streamlined Integrated Breast Center, Surgical and Reconstructive Services at Pennsylvania Hospital.
Part of the Abramson Cancer Center at Pennsylvania Hospital, the Integrated Breast Center, Surgical and Reconstructive Services brings together breast surgeons and plastic surgeons in the same clinic. Breast surgeons perform surgery to prevent, diagnose and treat breast cancer. Plastic surgeons perform breast reconstruction, often in the same surgery to treat breast cancer.
"The clinic addresses the specific needs of our patients and allows us to streamline our care," says Sarita’s breast surgeon, Dahlia Sataloff, MD, chair of the Department of Surgery at Pennsylvania Hospital. "Our entire team of nurses, nurse practitioners and surgeons is focused on providing the highest level of patient care."
Appointments with both surgeons can be scheduled on the same day to help reduce travel time and time away from work and family for patients. The highly collaborative environment also allows surgeons to have immediate one-on-one consultations as they plan care for shared patients.
The close working relationship between surgical specialties further improves patient care. "If I’m seeing a patient and I need input, then the breast surgeon comes in. It’s not unusual that we will see a patient together," says Said Azoury, MD, Sarita’s plastic and reconstructive surgeon. "The breast surgeons can ask me questions or give me insight into a new patient they want to send to me, which makes it very useful."
Team Approach to Breast Surgery
Sarita was one of the new clinic’s first patients in August 2022. In addition to the clinic’s breast and plastic surgeons, her team also included other Penn Medicine specialists in oncology, radiology, genetics and fertility. “It moves so fast and everybody works so well together,” she says. “My experience was amazing. It was a smooth process and it was a fast process, but not overwhelming."
Sarita had stage I cancer — the earliest stage for most types of invasive breast cancer. "I had just had a mammogram six months prior and there was nothing, so it was caught extremely early, which is good," she says.
Diagnosis confirmed that it was hormone receptor-positive, HER2-negative breast cancer. Cancer that is positive for hormone receptors (HR) is fueled by hormones. Cancer with negative features of the gene HER2, or human epidermal growth factor receptor 2, tends to be less aggressive than HER2-positive breast cancer. Doctors use this information to determine the best course of treatment.
Dr. Sataloff performed a nipple-sparing double mastectomy. In the same surgery, Dr. Azoury placed tissue expanders designed to make room for breast implants. During office visits over the next few months, the expanders were incrementally adjusted with saline injections. Sarita’s final reconstruction surgery was on December 16, 2022.
Positive Attitude, Great Prognosis
"Sarita is very optimistic about everything," says Dr. Azoury. "She had complete trust in her care. It feels good to know that the patient has 100 percent trust in their providers, because it gives us comfort when making decisions in her care, knowing that we are doing what is best for her."
Sarita’s condition did not require chemotherapy or radiation, though her oncologist prescribed hormone-blocking medication.
"I feel good," says Sarita. "I look good considering what I’ve been through. I still look natural. The doctors did an amazing job. All of them were very attentive to everything that I went through."
The Integrated Breast Center, Surgical and Reconstructive Services occupies a new patient-focused space at Penn Medicine Washington Square. The design is intended to be soothing, efficient and informative. “How the patient will experience the environment is very important,” says Dr. Sataloff.
When Sarita visits, she brings a positive attitude. "I’m cancer-free, thank God. I have to fight the good fight for grandma and advocate for other women to know your body, listen to its signs and take action when something does not feel right," she says.
Dr. Sataloff will monitor Sarita’s cancer recovery for the next few years. Dr. Azoury will continue to check her implants periodically for as long as Sarita has them.
"I couldn’t ask for a better team," says Sarita, now 42. "I cried a lot, but I told them my tears had nothing to do with me having cancer. It was gratitude for the workflow and the care of doctors. It was a lot of grateful tears."
To make an appointment at the Integrated Breast Center, Surgical and Reconstructive Services, please call 800-789-7366 or request a callback.