Jennifer Karchinski, of Green Bay, had always enjoyed the challenge of a 10K run or walk but with a full-time job and a family, she couldn’t always find the time to participate. However, in June 2018, Jennifer and her two daughters, Alexandria, 12, and Michelle, 8, trained together and finished a 10K in two hours and 22 minutes. The motivation was simple. After undergoing a mastectomy and breast reconstruction surgery, Jennifer is determined to help her daughters live healthier lives.
Diagnosed with ductal carcinoma in situ (DCIS)
In September 2016, Jennifer, then 45, was diagnosed with ductal carcinoma in situ (DCIS), a noninvasive cancer in her left breast.
“My husband and I were surprised because there is no history of breast cancer in my family,” Jennifer said.
Jennifer and her husband, Jeff, researched options for treatment and gathered recommendations from friends. They decided to get a second opinion through the Froedtert & MCW Cancer Network. Jennifer met with Amanda Kong, MD, a breast surgical oncologist with the Froedtert & MCW Breast Cancer Program.
“Jennifer was diagnosed in the Green Bay area with stage 0 cancer, otherwise known as DCIS,” Dr. Kong said. “When she came to us for the second opinion, we did further testing, including a needle biopsy that revealed additional atypical cells.”
Within a matter of weeks, Dr. Kong performed a lumpectomy procedure to remove the DCIS, as well as a surgical biopsy to remove the area of abnormal cells. The biopsy revealed more DCIS. Ultimately, Jennifer and Jeff decided a mastectomy would be the best option.
Own-tissue breast reconstruction using DIEP flap technique
Together, they researched breast reconstruction and implants, particularly the DIEP (deep inferior epigastric perforator) flap procedure in which stomach fat and skin are transplanted to the chest to reconstruct the breast without an implant. The Karchinskis liked the natural aspect of the procedure.
“I didn’t want implants because it wasn’t right for me,” Jennifer said. “I was more comfortable with the DIEP flap technique.”
Dr. Kong referred Jennifer to plastic surgeon Erin Doren, MD, for reconstructive surgery. Dr. Doren is one of a limited number of plastic surgeons in Wisconsin that specialize in the DIEP flap technique.
“DIEP flap reconstruction recreates the breast using the patient’s own soft abdominal tissue,” Dr. Doren said. “Once the tummy tissue is transplanted to create a breast, it is there for life and does not require maintenance such as removal and replacement like breast implants. Long-term studies have shown that women who use their own tissue for breast reconstruction are often more satisfied with their breast and body image than those who have implants.”
The surgery involves precisely separating the skin, soft tissue and tiny blood vessels from the abdomen without removing any of the abdominal muscles. These abdominal blood vessels are then matched to blood vessels supplying the mastectomy site to form the new breast.
Jennifer had the mastectomy and DIEP flap procedure on the same day, Dec. 21, 2016, at Froedtert & MCW Froedtert Hospital. She went home five days later and spent the next six weeks recovering in preparation for her nipple reconstruction procedure. The DIEP flap technique has a shorter recovery period than some other breast reconstruction procedures because it preserves the patient’s abdominal muscles to prevent loss of core strength. Jennifer did not require chemotherapy or radiation therapy because her cancer was noninvasive and still in an early stage.
In August 2017, Dr. Doren reconstructed Jennifer’s nipple. This surgery is usually done at the end of the process, three to six months after the mastectomy and initial reconstruction procedure. Once the breast mound reconstruction is complete, women have the option to have nipple reconstruction. Some women also choose to get a three-dimensional tattoo of the nipple. Jennifer opted to have her left nipple reconstructed, without the tattoo.
“I was very pleased and felt whole again,” Jennifer said.
“One of the things that helped get Jennifer through her breast cancer and reconstruction was her positive attitude,” Dr. Doren said. “It allowed Jennifer to heal faster.”
“Dr. Kong and Dr. Doren explained everything to us in ways we could understand, which was very important to us,” Jennifer said. “I would highly recommend the Froedtert & MCW breast cancer team. I love how everything turned out.”