Lillian Digiovanni completed nearly eight months of aggressive breast cancer treatments, including surgery, chemotherapy and radiation. When asked to describe the experience, she kept coming back to one word: “fortunate.”
She says she was fortunate her cancer was detected at all; fortunate to have a dedicated team of cancer experts close to home at CentraState; and fortunate to maintain a positive attitude with the help of family and friends, especially her husband, Fred, who was there for her every step of the way.
“You have to look at cancer this way: This is what I was dealt, and I’ve got to play the hand,” the 64-year-old from Manalapan says. “You just have to be optimistic, and say, ‘I’m going to fight this.’ I feel that being optimistic is 50 percent of the recovery.”
Lillian says she wanted to share her story to let other women know about the importance of being screened for breast cancer, as well as the importance of pursuing aggressive treatment.
Not a Typical Diagnosis
Lillian went for a Doppler ultrasound to screen for potential blockages of her carotid arteries, the main arteries on each side of the neck. The scan was normal, but it noted abnormal lymph nodes around the muscles in the neck, says Alexander Petcu, MD, Lillian’s primary physician who is board-certified in internal medicine and on staff at CentraState.
“The lymph nodes were an incidental finding, but I was concerned they could indicate more serious disease,” Dr. Petcu says. “That’s why we encourage people to go in for screening tests and routine care—sometimes you discover important warning signs.”
Dr. Petcu referred Lillian to Bhavesh Balar, MD, a board-certified hematologist/oncologist on staff at CentraState. During his exam of Lillian, Dr. Balar noted a lump—an enlarged lymph node—under her right arm.
‘A Total Shock’
Lillian had the abnormal lymph node surgically removed by Amit Kharod, MD, a board-certified general surgeon on staff at CentraState. A biopsy showed she had metastatic breast cancer, meaning it had spread from the breast to the lymph nodes. The news came about a month after Lillian had undergone her annual screening mammogram at an out-of-state facility where she used to live. That mammogram was reported as normal.
“It was a total shock,” Lillian says. “When he said to me that I have breast cancer, I was thinking, ‘Are you talking to me or the person behind me?’”
A Dedicated Cancer Team
By pursuing her treatment at CentraState, Lillian was immediately able to schedule all of the follow-up tests she needed, including a breast MRI, breast ultrasound, and state-of-the-art 3-D mammogram. The tests pinpointed the mass in her right breast that was not noted in her earlier, traditional 2-D mammography.
“Finding the primary tumor when you have a patient who presents with just a suspicious lymph node can be very difficult,” Dr. Kharod says. “It truly took the efforts of a multidisciplinary team to make the right diagnosis and create a treatment plan.”
Lillian had partial mastectomy surgery with Dr. Kharod at CentraState to remove a 1.5-centimeter tumor from her right breast as well as 10 additional lymph nodes under her arm.
“She is a vigorous, active woman and we wanted to be aggressive in treating her,” Dr. Kharod says. “Ultimately, she was willing and able to go through breast-conservation surgery, a state-of-the-art procedure in which we remove the mass with the best cosmetic result possible.”
At the end of that month, she began nearly four months of chemotherapy, using the latest treatment modalities.
“She received the absolute standard of care that would be prescribed by any of what are considered the ‘best-known’ cancer centers,” Dr. Balar says. “Her prognosis is very good.”
Lillian’s treatment ended with the last of her radiation treatment under the care of Joseph M. Pepek, MD, a board-certified radiation oncologist on staff at CentraState.
“Radiation is a key therapy for any woman who has gone through breast-conserving surgery for breast cancer,” Dr. Pepek says. “Lillian did well with her treatment. We know from studies that radiation therapy reduces the risk of local recurrence from breast cancer by about 60 to 70 percent.”
For at least five years, Lillian will continue taking medication that limits the production of estrogen, which can promote the growth of her type of breast cancer.
She also underwent therapy at CentraState’s Lymphedema Treatment Center—one of only a few programs in New Jersey that is recognized by the National Lymphedema Network.
Lymphedema is an abnormal accumulation of fluid between cells that causes swelling—most often in the arms and legs—and can result from cancer treatment.
“I’ve been using a new word, ‘reborn,’ and that’s how I feel,” Lillian says. “I feel very, very fortunate that I had excellent doctors on my side at CentraState. After something like this, you start to appreciate the small things in life. The blue skies, the birds—you just kind of take the time to smell the roses.”