Tuesday, October 01, 2013 - Breast Cancer Can't Stop a Rising Star

Genetic testing put breast cancer patient Suzanne Mernyk on a journey she hadn't expected. Now vibrant and healthy, she's gone from desk job to stage, doing what she loves most.

Breast Cancer Can’t Stop A Rising Star

Just another routine mammogram.That’s how the day began as Suzanne Mernyk reviewed her calendar.

It was March 2009. She doesn’t need a reminder about the rest of the story.The image showed a very clear growth that concerned her doctor enough to recommend a biopsy – and further, a breast surgeon.

Mernyk’s internist referred her to Breast Care Services of Greenwich, affiliated with Greenwich Hospital.

Learn more about breast cancer services at Smilow Cancer Hospital’s Greenwich Hospital Campus’s Breast Center.

“Monday I had the test and Tuesday I got the call,” she said.“It wasn’t the cyst my doctor had expected. It wasn’t my hormones doing weird things as I’d expected. I had invasive ductal carcinoma,” said Mernyk.

Cancer at age 47. Wasting no time, Mernyk got several medical opinions. Based on her research, she decided her best option would be lumpectomy surgery to remove the cancer and surrounding tissue.

But first, she would get chemotherapy to shrink the tumor so she would have a better cosmetic outcome.

Game Changer
Meanwhile, a new piece of medical history came to light. Mernyk knew her mother had been successfully treated for breast cancer in her 50s, but then she discovered an aunt on her father’s side had been diagnosed with breast cancer in her 40s.

Due to her young age and family history, Mernyk agreed to genetic testing. That’s when the bomb hit. She tested positive for an inherited mutation in the BRCA1 gene, which greatly increases the risk of developing both breast and ovarian cancer.

See Cancer Genetics.

“This was more devastating than getting the cancer diagnosis,” she said. If she went ahead with the lumpectomy as she initially envisioned, she still had a strong chance of getting cancer in her other breast.

“Being a single woman with hopes of meeting a mate and having this history was a terrible emotional hit.”

For women who test positive for the BRCA1 and BRCA2 gene mutations, the risk of breast cancer can jump as high as 80 percent.

Breast surgeon Laura Lazarus, MD, notes preventive surgery can reduce the risk of breast cancer by 90 percent to below the ”healthy gene” average. Dr. Lazarus worked with Mernyk on a care plan that would start in May with chemotherapy.

Treatments were on Fridays so family members could stay with Mernyk on weekends. Mernyk considered herself lucky.

“When I was feeling sad about going through this alone, I’d go to my support group. I met married people who felt more alone than I did because their partners weren’t there for them. These types of illnesses reveal all sorts of things about the nature of relationships.”

See Cancer Support Services.

If she allowed it, Mernyk was well aware cancer could cripple her emotionally. Her corporate job wasn’t bringing her the joy she expected, so she began leaning more on her longtime passions – performing and writing.

​Medical Director Barbara Ward, MD (left), reconstructive surgeon David Greenspun, MD, and breast surgeon Laura Lazarus, MD are among the multidisciplinary medical team at Greenwich Hospital's Breast Center. The Center is fully credentialed by the National Accreditation Program for Breast Centers, assuring patients the highest quality care and breadth of services, from diagnostics, advanced treatments and clinical trials to counseling and survivorship programs.

“Flap” Surgery
In September, it was time for surgery. “I was distraught about what I knew I had to do,” she said. “Dr. Lazarus introduced me to Dr. David Greenspun, a reconstructive surgeon who told me about the DIEP (deep inferior epigastric perforator) flap surgery they were doing at Greenwich Hospital.”

The DIEP procedure follows mastectomy surgery. Excess skin and fat from the patient’s abdomen are used to create a new breast without using implants. “The option to have nipple-preserving mastectomies in combination with natural-tissue breast reconstruction allows a woman to achieve breasts that appear and feel natural,” explained Dr. Greenspun.

For Dr. Lazarus, collaboration with reconstructive surgeons in planning the mastectomy is critically important. “This allows me to give each patient the best opportunity to have a natural-appearing breast by preserving the skin of the breast and, when oncologically safe, the nipple and the area around it, so that there is as little scarring as possible.”

The surgery to remove and reconstruct Mernyk’s breasts took nine hours. “I had breasts when they put me out and I had breasts when I woke up,” she said, thankful for the successful outcome.

A great majority of mastectomy patients are able to undergo immediate breast reconstruction without compromising their cancer treatment, according to Dr. Lazarus. Not only are the aesthetic results better compared to delayed reconstruction, the emotional benefits can be significant: better body image, less depression and improved quality of life.

DIEP flap surgery was relatively new at Greenwich Hospital when Mernyk was treated. In the four years since then, hundreds have been performed.

Other options now include LAP (lumbar artery perforator) flap surgery, which uses fat from “love handles” at the waist, and TUG (transverse upper gracilis) flap surgery, which uses tissue from the inner thigh.

Also, newer breast reduction procedures done before mastectomy surgery now make nipple sparing surgery possible for very large-breasted women.

Live from New York!
Today Suzanne Mernyk is active and healthy, with a twinkle in her eye. Living in Manhattan, she’s a playwright, actor, writers’ workshop leader, and yes, a stand-up comic who has entertained audiences at Caroline’s, Gotham City and other comedy clubs in the city.

Content with the direction her life is taking, the vibrant 52-year-old admits that at times she can still feel insecure about her body. Emotional scarring and other after-effects of treatment are not unusual for cancer survivors, whether or not they have had extensive surgery.

As the number of survivors grows, cancer rehabilitation services have become the new and final step of treatment.

See Cancer Rehabilitation Services.

Team Support
“From the beginning, Dr. Lazarus told me to pick a team I felt comfortable with and confident about, because these are people you’re going to have a relationship with for years and years,” Mernyk said.

“Greenwich Hospital has a very supportive group of professionals. It doesn’t feel like an institution. Everyone really cared about my progress. Dr. Greenspun and Dr. Lazarus did an awesome job and were very concerned about my recovery. I’m very grateful for that.”

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