When breast cancer patients undergo mastectomies, they can experience an unexpected change: loss of sensation in the chest and the breast itself.
Ami Brasure, of Bethesda, Maryland, said that when she was diagnosed with breast cancer in February and was confronted with the need to have a mastectomy, she said she could not imagine never feeling things like stepping into the shower to feel if the water is hot.
“I couldn’t imagine not feeling someone like, hug me,” Brasure said. “I just could not imagine living the rest of my life that way.”
That’s what led Brasure to look for a surgical team who could perform a mastectomy that would help preserve sensation and she found that at MedStar Georgetown University Hospital.
On June 25, Dr. Lucy De La Cruz, chief of the Breast Surgery program at Georgetown and system chief of Breast Surgery at MedStar Health, performed a first-of-its-kind robotic bilateral nipple-sparing mastectomy coupled with nerve reconstruction.
The approach used by De La Cruz and plastic surgeon Dr. Kenneth Fan allowed for immediate breast reconstruction with a permanent implant, a biopsy and a technique that aids in preserving sensation in the breast.
In an interview with WTOP, the two women, the surgeon and her patient, talked about the novel surgical process and recovery.
“She’s the hero of the story,” De La Cruz said. “She’s very courageous. I want to say that, Amy, you are very courageous.”
De La Cruz explained that the approach used by the surgical team at MedStar allowed for a less invasive, streamlined surgical process.
“When she went into the operating room, she had cancer in her breast,” De La Cruz said. “I take out her cancer using the robot, right? I take out her lymph nodes using my hands, using the same incision, and then the plastic surgery team is right there waiting for me to be done, taking out the cancerous and the breast tissue, and then they reconnect the nerve, and they put an implant in, and then they close everything. So we are doing it in one stage, one surgery.”
The incision is just 4 centimeters, made underneath the breast, resulting in a hidden scar that is invisible.
Based on MedStar’s own data, De La Cruz said 87% of their patients have regained sensation at the 18-month mark postsurgery.
Along with preserving the nipple and ultimately preserving sensation, the procedure Brasure underwent also helps prevent phantom pain, according to De La Cruz.
“When patients get amputated arms, they get something or legs, they get phantom pain, and the phantom pain has to do because we’ve cut a nerve and we’ve left it without a connection,” she said. “So it’s continuously sending signals. Hey, where are you? Where’s the other part of the nerve?”
But in the procedure that Brasure underwent, with a nerve graft, the possibility of phantom pain is reduced.
“I will dare to say that in my patient population, our post-mastectomy phantom pain is less than 5%,” De La Cruz said.
The surgery itself was a same-day procedure, with Brasure able to go home by 4:30 p.m.
“Three days later, I took a walk down the street to Starbucks,” Brasure said.
Brasure said she’d braced herself to expect more than just some discomfort after her surgery, but was pleasantly surprised.
“I psyched myself almost up for what the worst-case scenario was, and my recovery was fairly smooth from this procedure,” Brasure said, adding that she had “pretty decent” range of motion, and within three days, “I went out and took my first walk, like down the block to go get a cup of coffee, that kind of stuff.”
“I did take some time to splurge on trashy TV, so I did watch all seasons of ‘Secret Lives with Mormon Wives.’ I’m all caught up on that, but overall, like it was pretty good. I was back to work within four weeks,” she added.
Her advice to other breast cancer patients is to research their options and advocate for themselves.
“Like in the surgical process, my first surgical consult, they did not focus on preserving the nerves that Dr. De La Cruz spoke about — that she can see very easily when she does the procedure to preserve it. If you don’t hear that nipple sparing is an option, you don’t hear about sparing your nerves as an option. Go get another opinion,” Brasure said.
De La Cruz emphasized that part of the goal in nipple-sparing mastectomies and reconstruction is to preserve sensation.
“None of this impacts the oncologic outcome: her cancer’s out, her lymph node was sampled, her margins were good. None of this has actually impacted her ability to be cancer-free,” she said.
De La Cruz said the new approach means that women don’t have to compromise in their health care.
“The balance in the 21st century has shifted. Where before it used to be like, ‘It doesn’t matter what I look like, I have cancer. I’m going to take this out,'” she said.
Now, she said, in 2026, women can also work with their doctors to consider how the surgery will affect function postsurgery, as well as their appearance and how they feel.
“And there are options,” De La Cruz said.
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