The younger mother’s world was shattered by the examination.
At 36, Heather Tubigan of western affluent Chicago discovered an olive seed-sized lump in her left shoulder. It was a tumor that was malicious. Her swollen nodes were now affected by the cancer.
Terrified, the client about involuntarily asked her doctor to reduce both of her breasts, even though the tumor afflicted only one part.
Tubigan, then 40, recalls that” all I want to do is get rid of them both.” I merely desired them to leave. … When you have tumor, you just want to get rid of it”.
However, the doctor urged her to make a second opinion. The tumor-containing breast had to be removed, but the doctor explained that there were many advantages to keeping the good breast intact, including preserving the sensation on one side of the chest that would disappear after surgery.
That reduction of feeling is often more serious than some breast cancer patients is immediately comprehend while grappling with a life-changing condition. Modern medicine is only beginning to understand how the lack of experience after a mastectomy can impact the lives, connection, gender, and emotions of breast cancers survivors. From the comfort of a smile to sexual arousal, modern medication is just beginning to understand the different functions of the breasts.
” I was switching off for a long time. Would I keep it? Or” Would I no”? Tugan recalled. ” Because just the idea of not having my shoulder and not being able to feel, that was very, very difficult to me. I had no idea what it was. You can’t help but feel it out and hardly feel anything.
In a pioneering job, University of Chicago-led researchers are working to rebuild that sense of touch for patients who have undergone surgery. A bionic breast, a group of doctors, neuroscientists, and bioengineers is developing an implanted device that will be used to resuscitate patients after mastectomy and reconstruction.
According to Dr. Stacy Tessler Lindau, main investigator of the Bionic Breast Project and UChicago Medicine gynecologist, “our surgical method to reconstructing chest after cancer treatment has been focused strongly on the look, the form of the chest, rather than the features.” ” And we’re trying to change that knowledge with our work”.
Quick 2025 is expected when the first clinical trial to evaluate a crucial part of the device is conducted, according to Lindau.
The American Cancer Society estimates that there are more than 4 million survivors of breast cancer in the country. Additionally, more than 100, 000 people global undergo surgery every year.
The artificial breast project received a$ 3.99 million grant from the National Cancer Institute in summertime 2023 to begin clinical trials. The implant device is partially based on the work of University of Chicago scientist Sliman Bensmaia, who contributed to the creation of prosthetic limbs that gave paralyzed or amputation patients a realistic sense of touch.
After working together for about seven years on a technology to regain a sense of experience in the breasts following a mastectomy, Lindau and Bensmaia met and collaborated until their sudden and unanticipated passing in August 2023.
While breast reconstruction you cellulite restore the look and form of the chest, Lindau said some mastectomy patients also experience a sense of physical and psychological loss equivalent to that of a person who loses a limb.
Some women describe the loss of breasts as” the loss of their femininity and identity,” she said. And it represents an existential loss. It calls into question, for some people, their humanity”.
” Connection with your child”
Tubigan had a unilateral mastectomy in 2020 after much thought and was left with her right breast.
She’s grateful her surgeon, Dr. Nora Jaskowiak, surgical director of the UChicago Medicine Breast Center, took the time to counsel her through the decision, weighing the risks and benefits of removing one breast versus both.
Tubigan finds the bionic breast project fascinating. She said it’s exciting that an implantable device might one day give her left side a sense of touch.
” I’d actually be interested in doing it,” Tubigan said. ” To not have that sensation, I’ve learned life without it. But I’d be willing to also restore it, of course.
Tubigan, who is now recovered, said embracing her 9-year-old son Ryker can be incredibly comforting because she feels a sense of touch in her remaining breast.
” When I hold him on my right, I can really feel him”, Tubigan said. I don’t really feel anything on my left. I only feel pressure, is the best way to describe it. There’s no sensitivity to it”.
Each breast cancer case is unique, according to Jaskowiak, her surgeon, and she stressed that she tries to assist patients in better understanding their options and the potential long-term effects of various treatment options.
However, the breast’s sense of touch is one crucial aspect that patients might otherwise overlook.
” We spend tremendous time talking people through it, really having them informed about these choices”, she said. If you have a bilateral mastectomy, you won’t feel that sensation on your chest wall when you hug someone. Or you won’t feel like a child sitting against your chest with your breasts completely numb when you hold your grandchild.
These lifelong consequences can be hard to take into account as women are making treatment choices in a moment of fear and anxiety, Jaskowiak added.
There are many aspects of breast and chest sensation that we simply don’t consider, she said. ” But then, it might be lost.”
Throughout her battle with breast cancer, Tubigan and her husband longed to have another child.
” And we didn’t know if cancer removed that,” she said.
She had her eggs harvested to ensure her fertility before she went on chemotherapy and radiation therapy. But earlier this year, she and her husband conceived on their own.
We miraculously conceived naturally, she said.
Tubigan gave birth to a girl on November 8. Shortly after delivery, she nursed her newborn on her right breast, feeling her daughter suckle and snuggle against her chest during the feeding.
You and your child share this connection when you breastfeed them, for me. And it’s beautiful, she said. ” It’s not easy. It’s not appropriate for everyone. However, I believe the human body can do something amazing. You can produce a life … but being able to produce food and nutrition for your child, it just shows another sense of love”.
Faith is rewarded
Lindau has spent more than 14 years working with cancer patients to help them regain their sexuality both during and after treatment.
While she cares for patients with all types of cancer, more than half have breast cancer.
She said,” I came to realize how breast loss, along with the pain, itching, and other symptoms, really interferes with sexual function,” and how that is true. The breast is a very significant sexual organ for the majority of women.
Lindau explained that the nipple-areolar complex has an erection function, a similar physiology to the penis and clitoris. And for many women, having had a double mastectomy can make it particularly difficult for them to have an orgasm because many women lose the nipple and are unable to have an orgasm.
What will you do about this, a patient asked one day after seeing Lindau.
Around the same time, the physician became familiar with the work of Bensmaia, an international expert in the neuroscience of touch, whose lab and research partners at the University of Pittsburgh developed a robotic prosthetic device that restored a realistic sense of touch and allowed the patient’s thoughts to control the prosthetic arm and hand.
An iconic moment that President Obama invoked during his farewell address in Chicago in 2017 was a 28-year-old paralyzed man using that prosthetic to fist-bump President Barack Obama in 2016.
The president had remarked on the wonders he’d witnessed throughout his eight years in office, praising “our scientists helping a paralyzed man regain his sense of touch.” ” So that faith that I placed all those years ago, not far from here, in the power of ordinary Americans to bring about change — that faith has been rewarded in ways I could not have possibly imagined. And I sincerely hope so.
Bensmaia had previously stated to the Tribune in 2011 that the usefulness of a prosthetic is constrained without tactile feedback. For example, when lacking a sense of touch, patients cannot distinguish between the textures of corduroy and silk, similar objects such as a pen and a pencil, or even the feel difference between a poke compared to a punch.
People take ( their sense of touch ) for granted more than vision or hearing, he had said at the time.
Lindau contacted Bensmaia and inquired if he believed his work on the prosthetic hand could be applied to the breast.
” And he said, yes, I agree with you that that’s a viable concept”, she recalled. He expressed his excitement in particular because, despite the work being very meaningful, there were few people with such an amputation injury who would be eligible for sensory restoration.
In contrast, Lindau said the proportion of breast cancer survivors who might gain from a bionic breast was “orders of magnitude greater.” In August 2023, Lindau and Bensmaia received the multimillion dollar National Cancer Institute funding for the clinical trial.
She continued,” And he passed away a few days later.” ” Due to the tragedy, I felt an enormous sense of loss. And a double-down commitment to bring the bionic breast project to life”.
Experiments and bold ideas
Participants in the first clinical trial will be screened by the project if they have already planned to have a two-stage double mastectomy combined with a breast reconstruction procedure.
When the mastectomy is performed, the breast tissue will be taken out like it normally is, the breast portion of the intercostal nerves, which run along the ribs in the chest and provide sensation to the breast, will also be removed during this process, Lindau said.
The reconstructive surgeon will attach tiny electrical leads to the cut nerves, which are about as thin as coarse strands of hair and are similar to an old-fashioned coil telephone cord. These electrical leads will travel out of the skin under the arm. The patient will recover after the mastectomy, according to Lindau.
About six weeks later, the participant will come into the clinical research center and the project team will connect the leads coming through the skin with an energy source.
And those experiments will help us identify and respond to the query,” Can we deliver energy to these nerves in a way that restores sensation”? said Lindau. ” We’re having participants do that with us using very similar protocols that have been used in people with limb amputation to demonstrate that delivering electricity can indeed restore sensation”.
In order to aid in better design the device, the patients will provide a report back explaining the sensation, intensity, and whether the feeling is natural or painful. In addition, the electrical leads and electrodes would later be taken from the participants during breast reconstruction.
The team will later test the entire “bionic breast” device, which will involve placing a flexible sensor underneath the patient’s skin that can sense the sensation of a gentle touch or the pressure of a hug, according to Lindau.
The sensor would take in the mechanical information of touch and transmit it to a processor in the chest that can convert that information into electricity, which would then be delivered to the nerves, Lindau said.
This would all take place” through a closed system that’s implanted in the breast,” according to Lindau.
She stated that this implantable device would be made to be” compatible with the widest range of procedures” that mastectomy patients can choose from.
Some patients decide to undergo reconstruction with breast implants, some opt to remain flat with no reconstruction. Others opt for flap reconstruction, a procedure that reconstructs the breast’s shape using tissue from another area of the patient’s body.
In some cases, the device might be completely integrated with an implant, Lindau said. ” In another case, it might operate without any implant at all”.
Even with an “ambitious timeline,” Lindau predicted that the technology wouldn’t be accessible to the general public for at least five years, assuming the trials turn out as planned.
” But we are working with urgency, recognizing how many women experience sensation loss following a mastectomy,” she continued. ” And we are working with a big, bold vision”.
A need to feel the touch
According to Lindau, medical professionals who care for breast cancer patients frequently overlook breast sensory function. But she and her colleagues are trying to change that.
She launched the FEEL Project a few years ago in collaboration with the Bionic Breast research group to educate the public about the effects of mastectomy on sensation. The results of those interviews, which included interviews with breast cancer survivors and medical professionals about postoperative feelings, were captured on video.
These narratives were intended to give patients an idea of what to expect after mastectomy, as well as provide a guide for surgeons to discuss breast sensation with patients.
You may have heard the phrase “you know if you sit on your leg for too long and it eventually starts to hurt when you try to feel something,” but you can’t feel anything? One patient who underwent unilateral mastectomy said in the video,” That’s how it felt.” ” Around the nipple itself? Absolutely nothing. I believe I tried my hardest to pinched one day. Nothing”.
” You never consider, during sex, what your breast means to you. Another breast cancer survivor made the comment in the video,” It just happens.” ” But when you’re going to lose your breast, and you do, then you’re like yeah, that really was important to me”.
A psycho-oncologist explained in the video that losing breast sensation can be very agonizing, but it will vary from person to person.
We all have a need to feel touch, which can be both enjoyable and comforting, she said.
One of the patients interviewed was Tubigan, who described the change post-mastectomy.
She said in the video,” It’s just different now.” Even my son is aware that if we snuggle up and watch a movie, he’ll place his head on my right side rather than my left.
During the interview, Tubigan also expressed gratitude for her surgeon, Jaskowiak, who removed one breast to help save her life and encouraged her to keep the other one, preserving a sense of feeling on one side, a piece of her identity as a woman and her ability to breastfeed her daughter.
My surgeon simply provided space and was really open to hearing my concerns, Tubigan said in the video.” What helped me get through it was. And she didn’t consider me to be a number.
If she hadn’t gone to Jaskowiak, she wonders if she would have undergone a double mastectomy, losing all feeling in her chest as well as the chance to nurse her new baby.
She gave her daughter, Nora, the name of the surgeon.
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Chicago Tribune 2024
Distributed by , Tribune Content Agency, LLC.
