Continuity of Care is a Key Weapon in Becky Rennebaum’s Battle against Breast Cancer
By Stacie Jones
Sitting together at their dining room table, Becky and Fritz Rennebaum admired the view of lake Coeur d’Alene from their home near Worley, Idaho. It was a drizzly mid-February afternoon, but Becky was fantasizing about the warmer months ahead when she and Fritz could spend time kayaking the bay, one of their favorite pastimes.
“When I get all my strength back, I’ll be back out there,” Becky said, before the conversation shifts to a more serious tone.
“You’ll have to forgive us, we will probably get a little emotional as we talk about this,” Becky warned nervously as she and Fritz prepared to recount what have undoubtedly been the most traumatic five months of their 45-year marriage. “But I have my tissues ready.”
In April 2013, during her annual physical, Becky asked her primary care physician, Bradley Drury, M.D., of Family Health Associates in Coeur d’Alene, if she could forgo her annual mammogram.
“There had been a lot in the media about having mammograms every two years. I’ve had one every year since I was 45 years old, and the results were always negative,” explained Becky, now 67. “I asked if I could skip this year’s, but my doctor said ‘no,’ that I should have one yearly.”
However, feeling no sense of urgency, Becky delayed visiting Kootenai Imaging for the routine exam until September.
The initial screening mammogram revealed two lesions in Becky’s left breast. She returned for a second mammogram with ultrasound. David E. Moody, M.D., a Kootenai Imaging radiologist, read and confirmed the abnormal results.
Becky needed a biopsy.
A week later, the Rennebaums found themselves at Kootenai Clinic for a consultation with Marcus Torgenson, M.D., general surgeon.
Dr. Torgenson examined Becky before sending her back to Kootenai Imaging for an ultrasound-guided biopsy. Three days later, Becky received a call from Dr. Torgenson on her cell phone while she helped her four-year-old granddaughter hunt for pumpkins during her family’s annual October trip to Green Bluff.
“The biopsy was positive,” Becky said. “I had breast cancer.”
“Breast cancer happens to other people, not to me!” Becky said. “It wasn’t until the biopsy came back that it struck me that this is real.”
The couple met with Dr. Torgenson to discuss next steps. He put them in touch with Jodi Schmidt, RN, in Kootenai Clinic’s Cancer Services, a patient care coordinator who helped the Rennebaums navigate each step of Becky’s treatment at Kootenai.
“We trusted that we were in good hands at Kootenai,” Becky said. “We relied on everyone’s expertise and the knowledge they shared with us.”
The Kootenai Health Breast Cancer Tumor Board also got involved in Becky’s care. The board brings together oncologists, surgeons (including a plastic and reconstructive surgeon), pathologists, patient navigators, radiologists, and cancer center staff twice a month to discuss each active breast cancer case at Kootenai Health.
“This board is a critical component of breast cancer care at Kootenai Health,” Dr. Torgenson said. “It provides an invaluable opportunity for multiple specialists to share perspectives and offer recommendations, all in the name of giving breast cancer patients the best possible care.”
Soon after the biopsy, Dr. Torgenson ordered an MRI at Kootenai Imaging of both breasts so he could further evaluate the number and locations of the breast lesions. The right breast was clear of abnormalities, but the study found two separate tumors in Becky’s left breast—an indication that Becky was a likely candidate for a mastectomy.
Just weeks before Becky’s diagnosis, Benjamin Mandel, M.D., had joined Kootenai as its first resident plastic and reconstructive surgeon. Dr. Mandel holds his medical degree from Johns Hopkins University School of Medicine and is certified by the American Board of Surgery.
For Becky and Fritz, Dr. Mandel’s arrival could not have been timelier.
“Dr. Mandel is a wonderful asset…having him at Kootenai as part of the team that cared for Becky made a tremendous difference for us,” Fritz said.
The Rennebaums faced a difficult decision: Should they remove one breast or both?
They consulted with both Dr. Torgenson and Dr. Mandel about their surgical options. Although no lesions were found in the right breast, the couple decided on a double mastectomy.
“If there was cancer in one breast, what were the chances that eventually there would be cancer in the other breast, too?” Fritz said. “We didn’t want to go through this trauma for a second time, when Becky would be older. Opting for the double mastectomy gave us peace of mind that we wouldn’t have to go through this all over again.”
On Oct. 29, less than a month after she learned the results of the biopsy, Becky underwent a five-hour surgery at the state-of-the-art surgical center at Kootenai Health’s main campus. Dr. Torgenson began with the mastectomies, and Dr. Mandel finished the surgery by implanting expanders into Becky’s chest, the first phase of breast reconstruction.
“Dr. Torgenson and Dr. Mandel worked very well as a team,” Fritz said. “Had we had to face this earlier, without Dr. Mandel’s presence, Becky probably would have had to have two surgeries.”
Dr. Mandel said this type of teamwork and collaboration helps to ensure seamless, quality patient care.
Shortly after Becky’s surgery, the Rennabaums heard from Dr. Torgenson with good news.
“We rejoiced when he called us after hours to tell us the pathology results showed that the surgery had successfully removed the cancer and that it had not spread,” Becky said. “I was cancer-free!”
Road to Recovery
Becky did not need chemotherapy or radiation, but her treatment continues at Kootenai under the care of medical oncologist, Kevin Kim, M.D.
For the next five years, Dr. Kim will monitor Becky’s treatment with an aromatase inhibitor, a drug that lowers the body’s levels of estrogen that fuels tumors.Becky is also completing the final stages of breast reconstruction, along with physical therapy to redirect the flow of her lymph system, improve mobility, and rebuild strength. Dr. Kim, Dr. Torgenson, and Dr. Mandel continue to keep each other informed on Becky’s progress.
“As I continue on this journey of healing, I thank all of my doctors and other health care providers for the quality of life they have given me,” Becky said. “Kootenai Health has given me great care through imaging, surgery, hospitalization, reconstruction and oncology. We are fortunate to live in an area with such knowledgeable physicians and wonderful facilities.”
Stacie Jones is a writer in Spokane, Washington. For more information visit staciejoneswriting.com.