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Published on April 18, 2019

Maine woman comes to Cape Cod for innovative breast surgeryMaine woman comes to Cape Cod for innovative breast surgery

Lisa Lucas, DO, a family physician in Maine, had worried for years if she would get the cancer that seemed to run rampant among women in her family.

But it wasn’t until her husband, Romeo Lucas, DO, an OB/GYN, heard a presentation by Cape Cod Healthcare breast surgeon Kathryn H. Dalton, DO, FACS, about a nipple-sparing mastectomy procedure that Dr. Lucas, 38, decided to travel from Maine to have surgery at Cape Cod Hospital. With the hidden scar technique used by Dr. Dalton and fellow Cape Cod Hospital breast surgeon Jill Oxley, MD, the breast surgeon makes the incision under the fold of the breast, leaves the skin and nipple intact, and removes the interior tissue. A plastic surgeon then inserts tissue expanders and, about three months later, breast implants.

“It all just worked out. Dr. Dalton has a very calm presence, which I really appreciate,” said Dr. Lucas, who underwent a double prophylactic mastectomy on March 5.

Dr. Lucas is one of several women in recent months who traveled from off-Cape to have breast surgery performed by Dr. Dalton and Cape Cod Healthcare plastic surgeon Michael A. Loffredo, MD. The two doctors use a hidden scar technique that relies on a 4-inch incision in the bottom fold of the breast – the area where an underwire bra might fit. Other nipple-sparing techniques use a lateral incision that leaves visible scarring, Dr. Dalton said. The hidden scar surgery is more technically challenging for the surgeon but pays off for the patients, she said. “Now we can do breast surgery and get beautiful outcomes.”

Like Dr. Lucas, many of the hundreds of women who have sought out Dr. Dalton in the last five years wanted preventive surgery. These patients have the time to research techniques and surgeons and are able to pick their providers, Dr. Dalton said. While her first passion is empowering her patients, another priority is promoting Cape Cod as a great place for care.

“Cape Cod is the perfect place for destination medicine,” Dr. Dalton said. “It’s an absolutely beautiful place to recover and we also have the most incredible doctors here.”

Impact Early in Life

Dr. Lucas’ decision to have a mastectomy at Cape Cod began 20 years ago. She was affected by breast cancer early in life when she lost her grandmother when she was 8 years old, and then her lacrosse coach at 18 years old. Subsequently, another coach and several family friends were diagnosed and survived. She considered becoming a research scientist but her love of people directed her toward practicing medicine.

Not too long after, her mother was diagnosed with multiple sclerosis, followed by Stage 4 breast cancer. She had a double mastectomy, but because of the MS, decided to forgo reconstruction and further surgery. Meanwhile, other women in what Dr. Lucas describes as her “large Italian family,” were diagnosed with reproductive cancer or had genetic testing that indicated an increased risk for cancer.

In the meantime, Dr. Lucas was practicing in New Jersey. She was married and had three children, a daughter and twin boys. But the couple decided to move from New Jersey back to Maine, where life was quieter and where they had attended medical school. In the fall of 2017, her mother moved in with them. Life was busy with young children, two working parents and caretaking.

But after her mother died in 2018, Dr. Lucas decided it was time to take care of herself and do something to protect her own children from losing their mother. Although her genetic tests for breast cancer were negative, and her imaging so far had been clear, she had dense breasts and recurring breast pain that was frightening.

“For years, I’ve been talking about going and seeing a breast surgeon mainly for the purpose of discussing my risk and my options and what screening I should do,” Dr. Lucas said. “I heard something different from every person. It probably went on for five to seven years where, I thought, I’m getting closer and closer to 40 and I don’t have a plan of what I’m going to do here.”

Working With Dr. Dalton

And then her husband heard Dr. Dalton speak at a medical conference about the hidden-scar, nipple-sparing breast surgery. He had known her at the College of Osteopathic Medicine at the University of New England in Biddeford, Maine, where he and his wife went to medical school.

“He came home that day and he said, ‘If you’re going to see anybody, we’re going to go down and see Dr. Dalton,’” Dr. Lucas said.

She met with Dr. Dalton in December and reviewed a worrisome patch of dense tissue on the mammogram. Dr. Dalton determined she qualified for prophylactic surgery.

“So then we started a real conversation. I just said, I can’t handle this anxiety anymore – looking at my children every day thinking I’m going to die young,” Dr. Lucas said. “So, I just asked about my options.”

Dr. Dalton also arranged for an appointment that day with Dr. Loffredo. After talking with him, Dr. Lucas made the decision to have Dr. Dalton do the double mastectomy at Cape Cod Hospital and to have Dr. Loffredo as her plastic surgeon.

Fortunately, the pathology done during the surgery came back clean. Dr. Lucas was off pain medication within four or five days and had almost full movement in her arms within a few weeks. She has made the three-hour trip to Cape Cod twice for check-ups and is due to be back again in May for the implant surgery.

A month out from the mastectomy, she was back at work and making plans to open her own practice in Freeport, Maine. And she was looking forward to getting back to something else important in her life – running and exercising.

She has nothing but praise for her doctors and Cape Cod Hospital staff.

“Everybody was so great,” Dr. Lucas said. The staff knew she was from Maine and frequently offered their help to make the process easier, she said.

“[Staff at Cape Cod Hospital] were so respectful and nurturing. It was obvious that they were very familiar with my surgery and how to care for me afterwards. They even went as far as to suggest places for my kids to play while they were here on the Cape. It meant I could focus on my own healing.”