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Stephanie Riley, local nurse and Air Force veteran, talks about double pre-emptive mastectomy

  • Steph Riley talks to her daughter Sam Riley, 7, while hosting a party at her home in Concord on Friday for friends and family who will walk with her on Sunday during the Making Strides Against Breast Cancer walk. Riley was diagnosed with early stage breast cancer after being inspired by her family history to get frequent mammograms. "I'm very open with the kids, so they know what's going on," Riley said. She will have a double mastectomy and reconstructive surgery later this month.<br/>(WILL PARSON / Monitor staff)

    Steph Riley talks to her daughter Sam Riley, 7, while hosting a party at her home in Concord on Friday for friends and family who will walk with her on Sunday during the Making Strides Against Breast Cancer walk. Riley was diagnosed with early stage breast cancer after being inspired by her family history to get frequent mammograms. "I'm very open with the kids, so they know what's going on," Riley said. She will have a double mastectomy and reconstructive surgery later this month.
    (WILL PARSON / Monitor staff)

  • Steph Riley examines a drawing of a breast cancer awareness ribbon made by her daughter Sam Riley, 7, several days ago, without prompting from her mother. Riley was diagnosed with early stage breast cancer after being inspired by her family history to get frequent mammograms. "I'm very open with the kids, so they know what's going on," Riley said. She will have a double mastectomy and reconstructive surgery later this month.<br/>(WILL PARSON / Monitor staff)

    Steph Riley examines a drawing of a breast cancer awareness ribbon made by her daughter Sam Riley, 7, several days ago, without prompting from her mother. Riley was diagnosed with early stage breast cancer after being inspired by her family history to get frequent mammograms. "I'm very open with the kids, so they know what's going on," Riley said. She will have a double mastectomy and reconstructive surgery later this month.
    (WILL PARSON / Monitor staff)

  • Steph Riley talks to her daughter Sam Riley, 7, while hosting a party at her home in Concord on Friday for friends and family who will walk with her on Sunday during the Making Strides Against Breast Cancer walk. Riley was diagnosed with early stage breast cancer after being inspired by her family history to get frequent mammograms. "I'm very open with the kids, so they know what's going on," Riley said. She will have a double mastectomy and reconstructive surgery later this month.<br/>(WILL PARSON / Monitor staff)
  • Steph Riley examines a drawing of a breast cancer awareness ribbon made by her daughter Sam Riley, 7, several days ago, without prompting from her mother. Riley was diagnosed with early stage breast cancer after being inspired by her family history to get frequent mammograms. "I'm very open with the kids, so they know what's going on," Riley said. She will have a double mastectomy and reconstructive surgery later this month.<br/>(WILL PARSON / Monitor staff)

Stephanie Riley doesn’t dwell on the shady side of the street. If there’s a bright side to something, she’ll find it, she’ll grab it, and she’ll hang on, and help those around her focus on it, too.

So if you see her today in the Making Strides walk for breast cancer awareness, she’ll probably be laughing, making funny faces and making other people smile – even though she’s walking because she was diagnosed this summer with early stage cancer, and in just 10 days is going to Concord Hospital for a double mastectomy and reconstructive surgery.

“We’re doing the Angelina Jolie,” she said, with a chuckle, at the kitchen table in her Concord home.

“It’s pretty radical surgery, but the gain to getting them both taken off, to not have to have radiation or chemotherapy, outweighs it. Part of me feels like they betrayed me, and I want them off. I would just always have been worried all the time. I don’t want to prolong the uncertainty forever,” she said.

Besides, she said, her grin returning, “if they take it all, I don’t have to do chemo or radiation, and I get the boob job I’ve always wanted.”

Jolie, an actress and activist, made the same decision before facing any specific diagnosis. She wrote in May in The New York Times that she received a bilateral mastectomy and reconstructive surgery after genetic testing revealed she was at high risk of developing breast cancer.

Experts believe only between 5 and 10 percent of women carry the genes that predispose them to breast (and often ovarian) cancer that Jolie carried. But pre-emptive mastectomies have been on the rise for years before she wrote her widely circulated essay.

Among women newly diagnosed with ductal carcinoma in situ, or the “Stage Zero” cancer Riley has, the surgery was performed 188 percent more frequently in 2005 than it was in 1998, according to the Journal of Clinical Oncology.

Since her annual mammogram in early July, Riley has had a repeat mammogram, an ultrasound, an MRI and two biopsies.

Her right breast showed some cancer cells confined to the milk duct, and her left breast had some atypical cells – not cancer, but often a precursor.

“When we finally got the diagnosis I just said, I’m getting them cut off. I’m not going to be going through this over and over,” she said.

Lisa Delahanty, the advanced practice registered nurse who has been treating Riley at the Breast Care Center at Concord Hospital, said she’s not entirely surprised that Riley wanted the mastectomy to ease her mind about the future.

“It’s very overwhelming when you’re told you need a breast biopsy and you’re waiting for results,” Delahanty said. “A lot of times women will say waiting is the worst part,” and choose a pre-emptive mastectomy to avoid having to wait on results in the future.

But, she said, a lumpectomy with negative margins, combined with radiation, is considered as good as a mastectomy for removing cancer already in the breast.

Riley, an occupational nurse for the Army and a Lieutenant Colonel in the Air Force, has been open and accepting about her diagnosis and upcoming surgeries from just shortly after making her decision to get the surgeries. First, she posted about it on Facebook, and then she emailed her entire staff.

She told them the same thing she told her son, Shane, 12, and daughter, Sammy, 7: “I have breast cancer, but it’s in the stage zero category. So it is very treatable with surgery and radiation, which is what I am planning on having.”

Her intention is not to get attention but to hopefully inspire action, she said.

“I know I am in a very early stage, and there are so many people out there who have much more serious situations. I just wanted to stress I’m in the situation I am because it was early, and we caught it,” she said.

“It feels like these days, they’re putting out confusing things from the medical world about when you should get what tests, and I’m just glad I didn’t wait until I was 50.”

Riley is 46, the same age her maternal grandmother was when she died. She had some kind of cancer, but the family didn’t talk about it much.

Then Riley’s father died 15 years ago of lung cancer. Experiencing his illness inspired her and her four brothers to take better care of themselves and get routine tests and screenings every year.

She got her first mammogram when she was 35, just to get a baseline reading. She’s gone every year since.

There was nothing in the images last year. Since the initial call this July that she’d need a repeat mammogram, she’s spent some time running the past 12 months through her mind.

It’s been a stressful one at work, as she took on the duties of several different positions. She felt she wasn’t doing any of them as well as she could, and was worried a lot that something would have to give.

“I know cells are very fragile and cancer is just a mutation of a cell. . . . It’s really made me change my perspective of how I handle stress. Nothing at work is that life-changing that it should make my health be at risk,” she said.

She’s a little nervous about how much the surgery and recovery period could hurt and whether they’ll affect her fitness for work, but she’s mostly been keeping calm and staying off the internet, purposely not researching more than she’s comfortable with.

The only times she gets emotional about it all are when other people cry when she tells them about the diagnosis, or when she thinks about the care she’s received.

She’s worked at Concord Hospital for years, currently as a per diem nurse, so she shouldn’t have been surprised, she said, but still, it’s different being on the patient side of the relationship.

“It gets me choked up thinking how well they treated me. . . . They make you feel like you’re very important to them, and they just take the best care of you. I found when I had an appointment that had to go over the time, whenever I had to ask questions, you never feel rushed, they’re there for you to take as much time as you need. It’s so important for a patient to feel like you matter,” she said.

“I always try to take the best care of my patients, to treat them the way I would want to be treated, but I think I’ll be a better nurse on the other side of this.”

As an occupational nurse, part of her job is making sure members of the Army get their physicals and regular screenings. Her initial Facebook post has 104 comments from friends wishing her well and offering support – and saying they’ll be sure to schedule their own exams this year.

“It makes me feel great, like maybe my experience can effect a positive change somehow,” Riley said.

Sammy will turn 8 in late November. Being healed and healthy in time to plan a fun birthday party is Riley’s main goal, especially since she’ll probably still be in the hospital recovering the day of trick-or-treating in Concord.

But if she’s home and feeling up for it, she said, smiling mischievously, she thinks she’d go as a mummy, all wrapped up in bandages.

(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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