Breast Cancer Care for Breast Cancer Awareness Month
HAVING PERFORMED CLOSE TO 1,000 surgeries together, Drs. Ravi Tandon and John Colfry are committed to helping women fight and overcome breast cancer. With advances in technologies and techniques and an increased focus on breast reconstruction, the duo aims to return patients to normalcy as soon as possible. “A breast cancer diagnosis is serious but does not justify a poor outcome,” Dr. Tandon says.
Many local women who face the daunting challenges of breast cancer and surgical options come to Dr. Colfry and Dr. Tandon for their expertise. They see patients who have been recently diagnosed with breast cancer, have genetic predisposition to breast cancer, or who might have had a mastectomy years ago when modern breast reconstruction was not an option.
And there’s also patients like Lori Dean who is all too familiar with cancer. Lori says: “Cancer is no stranger to me. Both of my parents had cancer, which inspired
me to become an oncology nurse 18 years ago. I have since witnessed other family members and close friends experience this life altering disease. To give back, I donate time and sit on the board of a grassroots non-profit organization NOFA NOLA (No One Fights Alone NOLA) that raises awareness and money for individuals who are faced with the tragedy of this disease. Cancer encompasses my professional and personal life.”
While showering, Lori found a large cyst in her left breast. “The next day at work I brought it to the attention of a medical oncologist that I work with. She examined my breasts and recommended that I get a mammogram and ultrasound that day,” Lori reflects. “I was due for my regular screening (well a little overdue by about five months because I was helping to care for my mother who was on hospice care at the time) and work was hectic with COVID 19, and screening mammograms were being deferred blah, blah, blah….”
After the mammogram and ultrasound, the radiologist was concerned about findings in both breasts. That then lead to a breast MRI that showed an abnormality in the left breast. A biopsy then confirmed an infiltrating ductal carcinoma with overlapping DCIS (ductal carcinoma in situ) Stage 2A.
With her diagnosis, Lori calmy called upon Drs. Colfry and Tandon for treatment. “I was familiar with Dr. Colfry because I’ve worked with him in the past, but I didn’t choose him to be my physician because I knew him. That would be silly. I chose him because I’ve witnessed the care he provides to others, his outcome, and patients’ results. I’ve seen his gentle touch and I’ve heard the kind words he speaks to his patients when providing comfort and information to them,” Lori continues. “In my opinion, he is one of the best oncologic breast surgeons in the Greater New Orleans area.
“Dr. Tandon was one of two choices for a plastic surgery consult, initially. He came highly recommended by some colleagues that I trust with my life. After meeting with Dr. Tandon I cancelled my second opinion appointment because I knew after our consult that I wanted him to be my plastic surgeon. He was knowledgeable, very informative, kind, and patient with all of my crazy questions. He answered every one of them with confidence and grace. I’ve nicknamed my surgeons ‘The Dream Team.’ They, along with their staff members have been nothing short of amazing during this rollercoaster ride with cancer.”
The “Dream Team”, as Lori coined them, treats patients in a multi-disciplinary group approach ensuring that goals and concerns are met. As a plastic and reconstructive surgeon with expertise in microsurgical breast reconstruction, Dr. Tandon shared options with Lori. “Lori was well educated and appropriately concerned about her diagnosis,” Dr. Tandon says. After hearing Lori’s aesthetic wishes, they opted for a bilateral nipple-sparing mastectomy and immediate hybrid reconstruction. A nipple-sparing mastectomy keeps the nipple and areola intact along with breast skin.
When possible, Dr. Colfry performs nipple-sparing mastectomies on patients who do not have disease near the nipple. “The cosmetic results with this approach are incredible,” Dr. Colfry says. The procedure accompanied with immediate reconstruction has become popular due to its wonderful cosmetic results.
Drs. Colfry and Tandon performed the immediate hybrid reconstruction combining natural (autologous) tissue with implants. Also known as composite breast reconstruction, it’s a procedure that provides natural looking breasts by combining silicone or saline breast implants with the patient’s own autologous fat. However, in thinner patients, the volume may not be sufficient. Combining these techniques with an implant gives added projection and size to the reconstruction, optimizing the results. With a modern goal of restoring breast shape to as normal and natural as possible, the hybrid reconstruction does just that. Advances in this technique and nipple sparing mastectomies has beautifully reached new heights of what’s possible in reconstructive surgery all while decreasing mastectomy deformity and better addressing patient’s aesthetic desires.
Dr. Colfry is among a few breast fellowship trained surgeons in the region. Following medical school at Louisiana State University in Shreveport, he completed general surgery training at Atlanta Medical Center, then specialized in surgical breast oncology at MD Anderson Cancer Center in Houston.
Dr. Tandon is one of a few microsurgical fellowship trained surgeons in New Orleans. After medical school at Vanderbilt University and general surgery training at Tulane, he specialized in plastic surgery at Albert Einstein College in New York City. He then completed a microsurgery fellowship at NYU focusing on advanced microsurgical breast reconstruction techniques. “Our team sets us apart. The united effort that we put forth is what makes all the difference in the positive results that are patients receive,” Dr. Tandon says. “The ultimate focus is on the patient’s care to optimize the individual’s experience, but we also include the patient’s family because they are also affected.”
When asked about her progress, Lori says, “All of my health results have been very favorable, and I’ve been more than happy about that. But I am equally as happy with the cosmetic results. I am very fortunate and blessed to have received a lot of help and support from family, my work family, and friends who have given me the internal strength necessary to maintain a positive attitude and outlook.”
Lori continued treatment with an aromatase inhibitor (a medication taken for five years to block estrogen), meditation and lots of hugs from her kids. “My recovery has been way better than I ever expected. A few minor bumps in the road but for the most part everything has been manageable. I’m currently waiting to be cleared to return to work and enjoying time spent with my family and friends. I’m also enjoying being able to perform daily activities on my own such as driving and doing small chores. Gaining my independence back has been liberating!”
Looking ahead, Lori is excited about her new outlook and focus. “I think I can improve ways to decrease stress by better balancing my work and personal life. As a mother and caretaker, it’s difficult to put yourself first. Then I think of being on an airplane and how airline attendants educate the passengers on what to do in case of emergencies. Using that scenario in everyday life seems practical to me now. I should know where the exits are and should ALWAYS put the oxygen mask on myself first,” says Lori. “Without a healthy me I can’t be much help to others, and helping others is what makes me thrive. Now, I’ll be able to help others with a new perspective, a true understanding of what our patients are experiencing after being newly diagnosed with cancer.”
Dr. Colfry adds: “The term ‘multidisciplinary’ has become cliché in medicine, but it really holds true for breast cancer patients. Everyone works together to provide personalized care for the patient and offer her appropriate options. Nurses, surgeons, medical oncologists, radiation oncologists…we all coordinate our efforts for the best treatment outcomes.”
It’s the many patients like Lori that keep Drs. Colfry and Tandon passionate about their work. They hope to continue advancing their expertise and helping those who are faced with cancer. “I would recommend my doctors without reservation to anyone who is in need of their services. They are professional, knowledgeable in their fields, and skilled at their crafts. The doctors and their staff members are kind and compassionate. They are present and always engaged.
“Having cancer is challenging. The disease is life altering, but the journey can be seamless, and the experience can be good. That’s what these doctors (and their staff and ancillary departments) did for me. They made the road easier to travel.”
To learn more, visit ravitandonmd.com. Reach Dr. Tandon’s office at 504-455-1000, and Dr. Colfry’s at 504-325- 2900.