“If I can help one other person, it will be worth it.”
Surgery was not new to local musician and cancer advocate Sarah Swain, when she entered Cape Cod Hospital last in June of 2019. As a carrier for the genetic mutation PALB2, which raises a woman’s risk of breast cancer, she had elected to undergo a double mastectomy and a procedure known as a salpingo-oophorectomy (removal of her ovaries and fallopian tubes) in 2017 with a general surgeon, along with obstetrician Tara Chute, MD and plastic surgeon Michael Loffredo, MD. She later had breast reconstruction surgery with Dr. Loffredo.
The latest surgery was a revision surgery to refine the original reconstruction procedure.
“I had it done in June and I couldn’t be happier,” Swain said recently.
Swain learned of her genetic risk for reproductive cancer after a routine mammogram in 2016. Her surgeon ordered the test based on Swain’s family history. Her mother had died at age 50 of ovarian cancer, her grandmother died after a third bout with breast cancer, and her uncle on her maternal side died from brain cancer, all between 2005-2010.
Swain’s genetic testing was done at Cuda Women’s Health Center in Hyannis and all women who receive mammograms through Cape Cod Healthcare are screened to see whether they are candidates for the testing. The risks with the PALB2 mutation are similar to that of the more commonly known BRCA2 genetic mutation.
Swain’s mammogram and a follow-up breast MRI showed no signs of cancer, but she elected to have her breasts, ovaries and fallopian tubes removed so that she could go through life without worrying about developing cancer. The surgeries put her percentages of getting cancer below that of an average person with no genetic risk, she said.
“I’m a ‘rip off the band-aid’ personality,” Swain said back in 2017. “I’d rather just do it and move on with my life.”
Swain has never regretted her decision, she said.
“The peace of mind I have is priceless,” she said.
She understands that other women in her position may choose to keep their breasts and ovaries and be carefully screened for the rest of their lives, which is an option for carriers of PALB2 and BRCA2 mutations.
“It’s a one hundred percent individual decision,” Swain said. “I just knew, for me, that every time I felt a little twinge, I would be worried.”
Her quality of life has stayed the same, with the help of an estrogen patch recommended by Dr. Chute, which restores the hormones her ovaries would have produced. She is also pleased that there was no scarring from where her ovaries were removed.
Swain’s revision surgery this past summer also went smoothly, and she is effusive in her praise of the staff at Cape Cod Hospital.
“I really can’t say enough about them. They were all so professional and caring,” she said.
She stayed in the hospital overnight and returned home the next day.
“Everybody was completely adherent to all (COVID-19) precautions. I felt totally safe at all times,” Swain said.
Swain agreed to share her personal story about her journey with the PALB2 mutation and her subsequent surgeries because she wants to help other women and families who have lost loved ones to cancer and wondered why.
“We’re so blessed to be able to have this knowledge,” she said. “With my mom, when I think of all the things she blamed it on... and she sometimes blamed herself and my grandmother also had a whole reasoning as to why her cancer happened. In the end, it was no one’s fault, it’s in our genes and I am so grateful to be given power and choices through this important testing.”
When Swain learned she had the genetic mutation, she started researching it and said it was hard to find people’s stories that weren’t opinionated and negative. Her own decision was made easier by an encounter with a musician friend who had undergone the surgery the year before, and she wanted others to have personal stories to help them in their decision process.
“I figure if I can help one other person, it will be worth it,” she said.
As for her decision to have the surgeries locally, Swain said she is completely satisfied.
“I feel like I had better outcomes than a lot of people who went elsewhere,” she said. “Knowing I can drive 15 minutes and see any of my doctors, if I have a concern is so comforting.”