MammoSite: A Survivor's Story

Dani Ligett (center) with sister Gaby (l) and friend Jane (r) at the 2008 Norris Cotton Cancer Center fundraiser last July.

Dani Ligett and I were introduced through our cancer center’s volunteer program. The first time we met, she was lying in a hospital bed with a 24-hour-old tram-flap reconstruction. Within 10 minutes I’d yanked my shirt off to show her what the final product might look like. We’ve been friends ever since. Dani, an elementary school guidance counselor, was one of the first women to have MammoSite treatment at Norris Cotton Cancer Center, northern New England’s largest cancer facility.

Dani and I met recently, on a gray, surprisingly mild November late afternoon, sipping coffee in the comfort of soft armchairs at our local inn. This is her story.

Four years ago this Christmas, I went for my usual mammogram. The next day, I was standing in front of a class of fourth graders, and the classroom phone rang. It was Margie [the director of our cancer center's breast program]. And I knew right away. I hung up the phone and went back to teaching.

I went in the next day with my friend Carla for another mammogram. The radiologist came in and said, "You have a calcium deposit pattern that strongly suggests cancer. We need to do a biopsy to confirm it."

She left the room, and I said to Carla, "She just told me I have cancer, didn't she?

"Yeah."

"I'm in cancer mode, aren't I?"
 
The radiologist had come back into the room, and said "Yeah.”

Dani had a bilateral biopsy—“the worst 3 hours of the entire cancer experience”—and the pathology confirmed it: DCIS. But a lumpectomy performed just before Christmas brought other, more ominous results: IDC. Invasive cancer.

After surgeon Kim Grafton did a sentinel node biopsy—thankfully negative—Dani met with her oncologist. She was estrogen- and progesterone-negative; HER2-neu-positive. But back then, Herceptin wasn’t widely prescribed; it was considered dangerous. And with no nodes involved, she was considered “right on the line” for chemo.

Dani and her doctors decided to treat her cancer with radiation.

I pushed really hard from the beginning for MammoSite. The radiation oncologist told me, "Protocols haven't been approved for using MammoSite for IDC." It made so much sense to me to keep the radiation site-specific that I continued to push.

In the middle of our planning, the radiologist went to the annual San Antonio Breast Cancer Symposium in Texas, where good outcomes were being reported for IDC patients getting brachytherapy (MammoSite). As a result, she agreed to let me give it a go, as long as I understood that the long-term studies to prove positive results just weren't there yet.

"Let's go," I said.

MammoSite involves inserting a catheter with a balloon at the end into the breast, positioning it so that the balloon can be inflated to fill the hole left by the excised tumor. The balloon is inserted on Friday; the incision heals over the weekend, and treatment begins the following Monday.