The trip from Jacksonville, North Carolina to Chapel Hill is only about three hours, 148 miles of mostly highway across a landscape of pine trees and old oaks with towns dotting the horizon. It’s not a bad ride, but it does get monotonous and draining when you have to do it a few times a week for months, not to mention how exhausting it can be when you’ve just gone through a round of chemo therapy. “It’s worth it,” says Krystle Hensley, a 29 year old breast cancer survivor. “I could have gone somewhere much closer to my home but I trust my doctors at UNC Healthcare Medical Center. The fact that I drive three hours to get to Chapel Hill for my care says a lot.”
Krystle’s journey started in July of 2016, when she was a 27 year old graduate student at Tulane, and had her whole life ahead of her when she felt a bump during a breast self-examination. Based on her age, her gynecologist first suggested it was a cyst. But after hearing Krystle’s family history that included her maternal grandmother, great-grandmother, great-aunt and 26-year old second cousin had all passed away from breast cancer, he sent her to get a mammogram as well as testing for the BRCA1+ gene mutation. Everyone has the BRCA1 and BRCA2 genes that produce tumor-suppressing proteins. BRCA1+ is a mutation of the original gene, preventing it from being able to fight cancer cells and allowing for a greater risk for cancer to develop and spread.
When the results of her mammogram came in, Krystle was diagnosed with stage 1 invasive ductal carcinoma, more commonly known as stage 1 breast cancer. She packed up her belongings, left school behind in Louisiana, and headed back to her home state of North Carolina to begin treatment. Five days later she made the drive for the first time to Chapel Hill to meet with a surgical oncologist to discuss what steps she could now take in her fight for survival.
Krystle explains her first impression of sitting down with her UNC Breast Surgeon, Dr. Kristalyn K. Gallagher: “When we first sat down to discuss my options, she started off the conversation by asking me what I wanted to do. That was very powerful and I appreciated it because it was important to me to feel comfortable with whatever decision I was going to make. This is just as much my decision as it is the doctors. It was a scary time and they made me feel as comfortable as I could in the situation.”
“Today breast cancer treatment options are becoming more personalized,” says Dr. Gallagher. “What is best for one patient may not be what is best for another patient. As a breast surgeon, I present patients with surgical options and discuss the risks and benefits of each option to help them make the best decision for them. Surgical options for breast cancer include breast conservation (removing the cancer, but saving the remaining breast tissue) and mastectomy (removing the entire breast). Within these two options there are additional choices that we discuss in depth.”
Dr. Gallagher is on this journey with her patients from the very beginning; “for most patients, finding out they have a diagnosis of breast cancer comes as a shock and can be difficult to accept and understand. As several of my patients tell me, no one wants to hear that they have the “big C” word. As a breast surgeon, my job is to sit down with them and help them understand their diagnosis and formulate a treatment plan. Krystle had done a lot of research and asked a ton of questions. During our conversations we discussed her options including side effects and outcomes as well as who would be a part of her journey here. At UNC, we approach breast cancer in a multidisciplinary fashion and patients meet with their “team” from the beginning.”
After speaking with her team of doctors and having her options laid out, even though her BRCA1 test had not come back yet, Krystle felt her family history and current diagnosis were powerful enough reasons to move forward in the direction she felt was right for her. She decided to have a double mastectomy, meaning she was going to have both breasts removed with immediate reconstructive surgery. A few weeks later her BRAC1 test did come back positive for the mutated gene. Krystle underwent her surgery in August of 2016, exactly a month after she was diagnosed. Removing breasts and undergoing breast reconstruction is a major decision, one that she discussed with a member of her surgical team, Dr. Lynn Damitz.
“As a plastic surgeon, I chose this profession because of women like Krystle; for women who during their fight against cancer, describe losing a piece of themselves. I try and give them the power to decide if they want to have breast reconstruction. Many of my patients tell me after reconstruction that they feel whole again, they can wear clothes or step out of the shower and not be reminded every day of their diagnosis. When I spoke to Krystle she knew this was the right choice for her so we discussed her goals and how our part of the surgery would fit into her overall treatment plan.”
During her conversations with the doctors they explained to her possible side effects of the next step in her journey, chemo therapy. “I really appreciated how straightforward they were with me. They told me I could lose my hair as well as the ability to have children. Knowing what I would be facing and things I could do to help me prepare and have options for my future was important to me. During that time, I decided that I wanted to freeze my eggs.”
After her successful surgery, Krystle started the process of IVF, invitro fertilization, and about a month later had her eggs harvested so that if and when she wanted kids, it could be a possibility. She then started her first of many rounds of chemo. In December 2016, six months after her diagnosis, Krystle completed her final chemo visit and was pronounced cancer free, beautiful words that every cancer fighter longs to hear.
However, that is just the beginning of the next chapter in her life. Once the big ”C” has shown up it never just goes away. Survivors live with the fear of its return as well as the aftereffects of treatments used to destroy it. For Krystle that meant early menopause from her chemo and a worry that any new aches or pains she feels may mean the cancer has returned. Krystle is a true fighter though. She is looking to the future with hope, starting law school this fall where she will focus on Health Law. It’s been two years since her story began, “It all started because I knew my family history and conducted regular breast exams on myself. If I hadn’t been aware, I could have sat with a tumor growing untreated in my breast. Now I’m heading to Law School and it’s thanks to the care I received from my doctors at UNC.”
Breast cancer doesn’t just effect one person, especially in Krystle’s case. Her family was by her side during the entire experience from diagnosis through recovery. To hear about their journey, told from her mom’s perspective check out Brenda’s story here.