08 May 2019

Jennifer’s Breast Cancer Journey

Jennifer is an ongoing patient of mine who has recently undergone treatment using the SPY machine. Jennifer is married with two children and lives in Sydney. Thank you Jennifer for bravely sharing your breast cancer journey with Warrier Practice.

When were you initially diagnosed?

I was diagnosed just before Christmas. I had two lumpectomies in January, a bilateral mastectomy in late March and then a second surgery five days later to have tissue expanders inserted. It all happened quite quickly.

When did you first think think/find out you had cancer?

Since I was around 20, I’ve had cysts and lumps appear in my breasts and always got them checked out at a standard imaging centre, then my GP suggested, just for peace of mind, that I go to a breast doctor. I could go there every year, get a regular breast screening and not have to worry about it.

Then in December last year I had a routine mammogram which showed calcification. Some calcification appeared on the mammogram the previous year but it had become bigger. The breast doctor said it could be hormonal or a sign of abnormal cells. I had more imaging and they decided to do a biopsy, then a couple of days later I was told I had DCIS (Ductal Carcinoma In Situ).

What happened next?

I was referred to a breast surgeon at the same clinic who performed a lumpectomy. The pathology came back saying that the pre-cancer cells had extended to the margins of the tissue that was removed and I had to have another lumpectomy. That also came back without clear margins. The surgeon said the next stage was having a unilateral mastectomy. When I asked what that involved, the surgeon explained that I would be cut across the breast, the nipple would be removed, and a flat tissue expander inserted, meaning that you come out of the operation without a full breast, and I would need follow-up visits to the clinic to get the expander filled with saline.

I had a friend though who was diagnosed a year ago with a lump and ended up coming to Chris O’Brien Lifehouse. In her case it had all happened quite quickly too. They found her cancer and she had a unilateral mastectomy with A/Prof Sanjay Warrier. She told me she highly recommended him.

As I started talking to other people I found out that a lot of them had been to Chris O’Brien Lifehouse and so I ended up seeing Sanjay and his team. Sanjay explained that the surgery here would be performed a different way to what I had been told at the other clinic. It would involve a cut underneath the breast and would try to retain the nipple with the help of a piece of equipment he called a SPY machine. He said he also fills the tissue expander three-quarters full with saline at the time of the operation, so you come out with a breast and can have one or two further visits afterwards to fill it up more if needed.

Sanjay explained that there was a risk that the tissue could die during surgery from poor blood supply. He mentioned a previous patient who had benefitted from the SPY machine, which shows the blood flow in the breast during surgery. During her surgery, because there was scar from a previous lumpectomy, using the SPY machine he could see the skin around the breast starting to die. As a result he stopped her surgery after removing the breast tissue. A week later she came back and he put the tissue expanders in.

As it happened, when I underwent surgery my nipple did start dying from poor blood supply. Sanjay and his team did the mastectomy on both sides and halted there. It was good that I actually knew what had happened to that previous patient because afterwards I could see, looking at my nipples, that one didn’t look as healthy as the other. They gave me a heated blanket in hospital after the surgery which encouraged blood flow, and I could see the nipple healing after a couple of days. A week later I went back for another operation to have tissue expanders put in. That was just five weeks ago now, and in two months’ time I will get the silicone implants put in.

What was your experience with Sanjay and his team?

I had a wonderful experience with Sanjay and his team, from the moment I spoke to Sanjay’s Practice Manager, Andy, I felt at ease. Andy, Sanjay and the breast nurse Kate were all lovely. I felt confident with the advice Sanjay gave me.

Sanjay explained to me how the SPY machine worked. As a patient, being able to visually see what the machine does and how it works is really helpful, and when anyone mentions SPY you know what they are referring to. From my experience with prior surgeries, many doctors don’t explain anything to you and so the way Sanjay deals with patients is so valuable in terms of explaining the procedure and what patients should expect upfront.

The other positive experience I had at Chris O’Brien Lifehouse was the whole pre-admission visit. You go through the paperwork but you also meet Kate, the breast nurse who works with Sanjay. She explains what to expect and how the drains that are put in place after the operation work. After the operation Kate also gave me her direct number so that I could contact her if I had any questions or concerns.

I felt good going into it because I had a lot of information. You don’t always know what to ask but Kate was quite upfront saying, this is what will happen, this is how you’ll feel and so on. Overall it really made it a very positive experience for me and I’m so grateful to Sanjay and his team. I would recommend him to anyone going through breast cancer.

Have you had a good support network going through this?

I have had a great support network. My husband was wonderful and we had lots of school mums helping with pick up and drop off, because you can’t drive while you’ve got the drains in and I had them in for three weeks. We’ve still got food in the freezer that friends made us, I had people bringing flowers, and work was great and that just made all the difference too. We just felt like we had all this help, you get this outpouring of support from other women which is so amazing.

There’s not one person that doesn’t know multiple people who have been affected by breast cancer. There’s a support network with people with this issue that there isn’t with other things, also probably because of the large amounts of awareness, but that’s just been such a massive help.

How are you feeling?

Really good now. I went back to work three weeks after the operation and during the school holidays we were able to get away to visit my sister in northern NSW. I feel like I have had a good experience through a difficult situation and I hope I can help others by sharing my story.


We do have more information on the SPY Machine for your viewing pleasure.