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If you think breast cancer is only diagnosed in stages I, II, III or IV, think again. Deena Damsky Dell, MSN, RN-BC, AOCN(R), can tell you, "Stage 0 breast cancer is really cancer."
After an extensive career in nursing education and oncology critical care, Fox Chase recruited Deena in 2000 as a full-time clinical nurse specialist and director of the RN Graduate Transition Program, where she trains new nurses in oncology.
"To be honest, I was initially anxious about working solely with oncology patients. I quickly learned that at Fox Chase I had the special opportunity to give the type of care that I had taught nursing students all those years."
Deena has become the local authority on breast reconstruction at Fox Chase. She is called on a regular basis to meet breast cancer patients and answer their questions. "Because we are a small hospital with one focus, I get to do a little bit of a lot of things. I love everything I do!"
"I picked up my films and headed straight to Dr. Elin Sigurdon's office at Fox Chase."
Patients and staff members alike look to Deena for guidance because she knows first-hand what it's like to have stage 0 breast cancer. "In 1995, while working part-time at Fox Chase, my gynecologist called to tell me my mammogram was abnormal. She said we could wait 6 months - or I could see a surgeon," Deena recalled. "I picked up my films and headed straight to Dr. Elin Sigurdon's office at Fox Chase."
Dr. Sigurdson, a surgical oncologist who specializes in breast cancer, diagnosed Deena with stage 0 breast cancer, or ductal carcinoma in situ (DCIS). Dr. Sigurdson explained, "DCIS is not an invasive cancer because it stays inside the milk duct. Although it can grow, it does not spread into the normal breast tissue, the lymph nodes or other organs. But it is cancer and does require medical treatment."
"Elin is an excellent surgeon who listened to my needs and concerns."
Dr. Sigurdson performed 3 lumpectomies on Deena, who shared, "Elin is an excellent surgeon who listened to my needs and concerns. She worked with me to develop a treatment plan that we were both comfortable with."
Following surgery, Deena began a 6-week course of radiation therapy. "That combination of therapies gave me the local treatment I needed." During this time, in 1995, Deena continued to work full-time at Gwynedd-Mercy College and part-time at Fox Chase Cancer Center.
For the next 4 years, Deena was on "surveillance," meaning doctors tracked her progress during periodic check-ups. In 1999, Deena had another abnormal mammogram.
Although DCIS can recur as invasive breast cancer, Deena's stereotactic biopsy revealed that the recurence was stage 0. Although that was a relief, Deena was still nervous because she knew she would need a mastectomy.
Because Deena spent a lot of time caring for breast cancer reconstruction patients in the PACU, she knew what she wanted. "I didn't want implants, so I knew I'd have the TRAM (Transverse Rectus Abdominis Muscle) flap procedure. My plastic surgeon removed the fat, muscle and blood vessels from my lower abdominal wall to build a new breast."
Deena's next step was to see Dr. Mary Daly, a medical oncologist. "Dr. Daly thought the reconstruction was beautiful! That meant a lot coming from her," Deena said. "She put me on Tamoxifen for 5 years to prevent the breast cancer from recurring and to prevent a second breast cancer in my opposite breast." Apparently, it worked. It has been over 4 years since she stopped taking the drug and has had no sign of recurrence.
Nursing care was one of the reasons Deena chose to have her treatment at Fox Chase.
"I wanted to have my care here at Fox Chase not only because of the surgeon, who I knew was excellent, but also because of the quality of nursing care I knew I would receive."
Deena has earned national recognition for her accomplishments in nursing education and breast cancer care. She has authored a long list of articles that have been published and presented nationally.
"Everybody at Fox Chase knows my business so I get called to talk to patients all the time. It's one of the best parts of my 'unofficial' job!"