Louisville Magazine

AUG 2014

Louisville Magazine is Louisville's city magazine, covering Louisville people, lifestyles, politics, sports, restaurants, entertainment and homes. Includes a monthly calendar of events.

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58 LOUISVILLE MAGAZINE 8.14 Surgery for Two Allison Hatmaker, 38, is a breast surgeon at Baptist Surgical Associates Breast Surgery. She graduated from the University of Louisville School of Medicine and completed her surgery residency at Vanderbilt University Medical Center, where she met her husband David Sun (pictured opposite page). About being married to a fellow surgeon, she says, "Tere's always something interesting to talk about. We both have a nerdy passion for tumor biology, so we'll fnd ourselves after the kids are asleep having conversations about the patients who came in or how brain tumors are diferent from breast cancer." She shared this story about removing a breast tumor from a woman in her mid-30s who was pregnant with her third child. "Speaking of my husband (a brain surgeon), we have very diferent operative ex- periences. His are pretty high-stress cases and not always predictable, but I tend to avoid exciting in the operating room when at all possible. One of the surgeries that stands out: the patient had been a classmate of mine and she was diagnosed with breast cancer when she was 29 weeks pregnant. She had two young girls and was pregnant with her third child, a little boy. "In general, pregnancy-associated breast cancers are not that common and often can be a bit more aggressive. She had noted a lump in her left breast and she had diagnostic imaging for that. Te imaging on the mammogram and ultrasound showed a lesion that was highly suspicious for malignancy, as well as a lymph node in her armpit that was suspicious. Your breasts, when you're pregnant, undergo changes that are quite remarkable — so physical exams can be difcult — but she felt like this mass persisted and that it was diferent from the other side. Tankfully, she had it evaluated. "We had the option of doing chemotherapy frst or doing surgery frst, and she really didn't want to do anything that might threaten the safety of the unborn child. She wanted to do the surgery frst. My frst child, a little girl. was about one at the time, so I knew very vividly what emotions she was going through about this baby. "Her initial plan was to do a (bilateral) mastectomy. But we shortened it to what we had to do, to shorten the time under anesthesia for both her and the fe- tus. So we did a lumpectomy, which is removing just the tumor, and we planned the incision so that it wouldn't interfere with the mastectomy later. "We had the nurses come down from labor-and-delivery, and they hooked up the fetal monitors. We had arranged for an anesthesiologist who had special training in obstetrics to come down and do her case. "We had her positioned properly (slightly on her side) and had the fetal moni- tors on. We heard the baby's heartbeat and heard the mom's heartbeat. Knowing the patient personally, relating to her as a young mother, and hearing the diferent sets of heartbeats contributed to a more intense environment in the operating room. As surgeons we're trained to have a lot of focus and concentra- tion in the operating room, to put any emotional component aside when you're operating, and to be in control. As the case got going, the emotional component as well as any background sounds faded. We took out the cancer and we took out all the lymph nodes in her armpit. "Seven weeks later she had a planned C-section and had a healthy baby, and she went on to chemotherapy. Ultimately, she decided not to have the bilateral mastectomy. She got through her treatment. She's got three children to take care of, and going through a big surgical procedure just wasn't what she wanted to do. She completed her radiation, she's cancer free and she's involved in support groups for women who've had breast cancer. She walked in the Kentucky Oaks survivor parade this year, and she's just done remarkably well. She was so coura- geous during all of it." W

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