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Palomar Health’s Women’s Center helps breast cancer patient navigate scary road

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Knowing a woman’s lifetime risk to get breast cancer is 1 in 8; Dawn Barra’s anxiety instantly skyrocketed after her obstetrician detected an abnormality during her annual breast exam.

Dawn immediately went for a mammogram, (a low dose x-ray) which confirmed her OBGYN’s suspicion that something was abnormal. The definitive answer would come through an ultrasound guided breast biopsy, where a small tissue sample is removed from the suspected area and diagnosis confirmed by a pathologist.

Unfortunately the diagnostic imaging center she was working with couldn’t follow through.

Breast cancer survivor Dawn Barra visits with the Palomar Health Jean McLaughlin Women’s Center patient navigation and care team who helped her through treatment.

“There was all this unknown. You don’t know if you have cancer or not. Then the place says they won’t do it (the biopsy),” Dawn said.

She went online, found the Jean McLaughlin Women’s Center at Palomar Medical Center Poway, and made a call.

“This beautiful woman answers the phone,” Dawn remembers.

After telling her nightmare story of delays and insurance debacles, the woman on the phone (who happens to be Program Assistant Nancy Jenkins) said, “she would deal with it,” Dawn said.

Nancy went to the imaging center Dawn had been working with, got the records, and coordinated a biopsy at the Women’s Center during Dawn’s spring break (she is a grade school art teacher).

“I had been treated like crap (at the other clinic) and Nancy scheduled the biopsy within the month,” Dawn said.

Within a week of the biopsy, Palomar Health Certified Breast Health Navigator Susan Gimbel had the results and gave Dawn a call. As a nurse navigator, Susan works one-on-one with Women’s Center patients, sharing options, referring services, and explaining hard to understand procedures. With a caseload of less than 100 at any given time, Susan is able to provide personal attention.

“I remember her asking ‘are you alone, are you sitting down?’” Dawn said of her phone conversation with Susan.

After telling her the biopsy had come back positive for breast cancer, Susan began educating her on the plethora of options. Susan answered all Dawn’s questions, from the simple to the most technical.

“She’s so knowledgeable. She went over every question (in detail),” Dawn said. “When I told people I had a nurse that was with me every step of the way, they said they’ve never heard of that, they didn’t have that.”

Because Dawn is of Jewish ancestry, Susan let her know she was at risk for a genetic mutation, where the cancer has a high probability of reoccurrence, or possibly developing in the opposite breast. To test for such genes, Palomar Health is one of only three local health systems that employs a genetic counselor. Susan made an appointment for Dawn to see her.

“That freaked me out a little,” Dawn said of learning that she might be at increased risk for the breast cancer returning even after surgery or developing other possible cancers, like ovarian cancer.

Dawn met with Palomar Health Licensed, Certified Genetic Counselor Cheryl Cina in the Women’s Center, where they discussed Dawn’s genetic history in detail and took an oral DNA swab. The good news is that the genetic test came back negative, meaning Dawn did not carry the genetic mutation.

After going over all her options with Susan, Dawn chose Dr. Stefan Moldovan to be her surgeon. Together they decided a mastectomy would be the best option. Due to the negative genetic mutation test, they would only remove the affected breast, but chose the more invasive mastectomy (total breast removal) over a lumpectomy (partial removal).

Dawn made the difficult decision after consulting with her husband Valentine, who happens to be a molecular biologist.

“There is no one right answer,” Susan said. “It’s a personal decision.”

Dawn says she felt very comfortable having the surgery at Palomar Medical Center Poway (formerly Pomerado Hospital) because she’d birthed her son there and both her son and husband had previously had successful surgery there.

“I liked Pomerado. I requested to have my surgery there,” Dawn said.

That didn’t mean she didn’t have anxiety. A few weeks before Dawn went in for surgery, a friend of a friend died in a fluke accident on the operating table in a Los Angeles hospital. It was on her mind the days leading up to her surgery and she kept needing reassurance she wasn’t going to die.

“The anesthesiologist Dr. Kim was so wonderful,” Dawn said. “I told him ‘I am afraid to die.’ He assured me I wasn’t going to die and taught me how to breathe (to overcome the fear).”

After Doctor Moldovan removed the cancerous tumor and all breast tissue, Dr. Abhay Gupta performed the plastic surgery, reconstructing her breast. She was then rolled into the recovery room.

“When I woke up I thought I was in heaven,” Dawn said. “The recovery room nurses were amazing.”

Now two years post operation, Dawn still attends the breast cancer support group, led by Susan, at the Women’s Center every chance she gets. Women in the support group are in different stages of the process. It was here that Dawn was “showered in concern” before she had her surgery from people she didn’t know who’d been through it before.

“Who else can be there in that way for you?” Dawn asks.

“Having the support I got… there’s no amount of money that could replace the team I had at the Women’s Center.”

To see a video on Dawn Barra’s fight against breast cancer, please click here.

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