No Better Place

Highly accredited care center eases fight against breast cancer.

What’s odd about the painting of a rustic canoe docked at a beach that hangs on the wall in Lisa Montanye’s office is that it’s one of the few that Lisa has painted and not given away to friends or admirers.

Photo by Jordan Pysz.

Painting seascapes, sea life and wildlife is Lisa’s hobby.

“I have a couple of others on the wall in my office, too, but if someone comes in and really likes a painting of mine, I’ll just turn around and give it to them,’’ Lisa says. “If it gives them a little bit of peace and happiness, I’m happy to do that.”

A native of Albany, New York, who works for the Manatee County School District, Lisa paints mostly in acrylics on canvas, and seascapes like the one in her office are what she paints most often. But she stretches her talents into other areas as well.

I’ve painted everything from a team of elephants in the wild to still life,” she says. “There was an employee that touched my heart that happened to be going through breast cancer herself, but much worse. I painted flowers in a breast cancer awareness symbol vase on canvas for her. It made her smile and that warmed my heart.

“That’s the part of my job that’s tough. I retire school district employees when they’re ready to retire, which is fun because the people I see are usually very happy they’re retiring. But sometimes, they have to retire because of illness. That part’s not fun.”

Lisa, 49, is no stranger to illness – or cancer, in particular. Her mother died from liver cancer at age 64; her father died from lung cancer at age 57; and her sister died from pancreatic cancer at age 52. She also has a niece who has fought brain cancer.

The disease has ravaged her family. It even took her ex-husband last October. And like the woman for whom she painted the still life, this mother of a 25-year-old son and 19-year-old daughter recently fought her own battle with breast cancer.

In November 2018, Lisa visited an area diagnostic center for her annual breast cancer screening. Lisa had no reason to feel anxious or concerned because she had not detected anything abnormal through self-examinations.

“As far as I could tell, I didn’t have any issues at all,’’ she relates. “I hadn’t felt any lumps or anything, so for me it was just a normal checkup. But then I got a notification that there was an abnormal sighting, so they asked me to come back and have the exam again.

“Even then, I still wasn’t that concerned, because that happens to a lot of people. I still didn’t think it was a big deal. But then I was told that something abnormal showed up in the second exam and was told to get a needle biopsy.”

Photo by Jordan Pysz.

In her spare time, Lisa paints seascapes and creates beach glass art like those shown here.

Needle biopsies are performed to obtain tissue for testing and can be completed in seconds. Lisa scheduled hers for January 4, 2019, at the Manatee Diagnostic Center, a member of the Manatee Healthcare System.

The timing of the biopsy made for an uneasy holiday season for Lisa, who chose not to tell her son and daughter about the issue because they had just lost their father to cancer three months earlier.

“My kids were already devastated by the loss of their dad, so I didn’t want to tell them about this until I knew for sure what was going on myself,” Lisa reasons. “So I dealt with this all through the holidays.

“Four days later, on January 8, the doctor called me at work and said she needed to see me right away. I ran over there, and that’s when she told me the bad news, which I presumed because if everything is clear they usually tell you over the phone.

“When I went back to work that day, I was in shock and nervous and scared just like anyone would be. The first thing I did was start looking up doctors that I was advised to see about getting whatever this was removed. I wanted to get this done quickly, so I did research on some of these names the doctor gave me. The more I talked to people, the more I heard that Dr. Erbella was the go-to guy, that he was the best.”

Standard of Excellence

Jose Erbella, MD, FACS, is a board-certified fellow of the American College of Surgeons who specializes in state-of-the-art, minimally invasive general surgery with an emphasis on cancer, laparoscopic and weight-loss surgery.

He is the medical director of breast surgery at the Manatee Memorial Hospital Breast Care Center, which recently earned a three-year accreditation from the National Accreditation Program for Breast Centers for its outstanding compliance with NAPBC standards.

Those criteria require centers to maintain levels of excellence in leadership, clinical services, research, community outreach, professional education and quality improvement, which are judged through on-site visits by NAPBC representatives over a three-year period.

Patients receiving care at an NAPBC-accredited center have access to information on clinical trials and new treatments, genetic counseling and patient-centered services, including psycho-social support and survivorship care plans.

“What the accreditation means is that we have been recognized as a Breast Cancer Center of Excellence, and that’s a really big deal because there are only a few hundred such centers in the world,” Dr. Erbella states.

“In fact, Manatee Memorial is the first hospital in Manatee and Sarasota counties to earn this accreditation. The next closest hospitals with this accreditation are in Fort Myers and north of Tampa. Being accredited highlights our commitment to quality care for breast cancer patients.”

As Lisa soon learned, the Manatee Memorial Hospital Breast Care Center delivers that care through a team of medical professionals that includes Jenny Brown, RN, BSN, an oncology nurse navigator at the hospital and Manatee Diagnostic Center who helps guide patients and their families through their health care decisions.

“My role is to follow patients from diagnosis into survivorship – or end of life, if that’s the case – and be an extra resource for them because this is a very difficult time for both the patients and their families,” Jenny explains.

“When someone is diagnosed with breast cancer, they’re scared and often confused, and there are a lot of decisions that have to be made. It’s my job to make sure they have a clear understanding of what’s going on and what their options are.

“For example, when someone is diagnosed, they need to see a surgeon, a medical oncologist and a radiation oncologist. They may even need to see a plastic surgeon and a cardiologist if they’re going to be doing chemotherapy. They’re bombarded with this all at once, and it can be quite overwhelming. Sometimes there are communication barriers, financial issues, even religious issues that need to be dealt with, and it’s my job to help them get through all that.”

Lisa met Jenny shortly before her first visit with Dr. Erbella on January 14, 2019. By the end of that meeting, Lisa discovered just how valuable a resource Jenny is.

“When I first went to see Dr. Erbella, all I knew was what I learned from the doctor at the diagnostic center, who told me that there was a lump in my right breast that was about the size of a black olive,” Lisa states. “Other than that, I didn’t know anything else. I didn’t know what a nurse navigator does or anything like that, and to be honest with you, I was adamant about getting a double mastectomy and just being done with it.

“Dr. Erbella and Jenny are just awesome. Without them, this would have been a lot harder.” – Lisa

“But I thank God that Jenny was there because after I stated that, Dr. Erbella explained the kind of cancer I had and started talking about doing a lumpectomy instead. Jenny asked him a lot of questions about lumpectomy versus mastectomy.

“She was asking far more detailed questions about things that I hadn’t even thought of. Afterward, I really had to thank her for being there to help me, because between her and Dr. Erbella, they really allowed me to better understand what my options were.”

A Better Option

What Lisa came to understand was that, while she did have breast cancer, her situation was not as dire as she initially feared. As Dr. Erbella explained, she most likely had stage 1 breast cancer, meaning her cancer was small and had likely not spread beyond the breast.

“When someone has that profile, we can save the breast by doing a lumpectomy, where we only remove a small portion of breast tissue, and the outcome is just as good as it would be if we had done a more radical surgery or a mastectomy,’’ Dr. Erbella explains.

“That’s why I recommended the lumpectomy. But I understood Lisa’s desire to do the double mastectomy. A lot of women come in requesting that. But once we present the details and explain all the pros and cons, they realize they have other choices.”

One of those choices is to seek a second opinion, and Lisa did that.

“On the way home from getting that second opinion, I called Dr. Erbella’s office and told them I wanted to do the lumpectomy with Dr. Erbella,” Lisa remembers. “I asked them, When can I have the surgery done? and they said, How about the 24th of January? That was less than a week later, so I said, I’ll take it.

“I went to Manatee Memorial for my pre-op the day before the surgery and the next morning, I went back, and my brother, my boyfriend, my kids, and a cousin and his girlfriend were all there to root me on.”

Prior to surgery, Dr. Erbella explained that there was a low chance that Lisa’s cancer had traveled to a lymph node under her arm. During surgery, however, he discovered that cancer cells were indeed present in one such lymph node.

That prompted Dr. Erbella to remove not only the tumor in Lisa’s right breast and the diseased lymph node, but also a cluster of lymph nodes behind the diseased lymph node to ensure he got all the cancer that might spread.

“Prior to surgery I knew I was going to need to undergo radiation therapy,’’ Lisa says. “But because the cancer cells showed up in the lymph node, Dr. Erbella explained that I might need chemotherapy, too.

“I was devastated by that news because I’ve seen family members go through chemo and I did not want to do that. But Dr. Erbella was great because he told me to ask my cancer doctor about something called a MammaPrint, which I did.”

A Predictive Test

A MammaPrint is a predictive diagnostic test given to patients with stage 1 or stage 2 breast cancer. Based on the patient’s genetic makeup, it is designed to determine the likelihood the cancer will metastasize to other parts of the body.

The test further determines whether a patient such as Lisa would benefit from chemotherapy.

“Dr. Erbella explained that the test provides you with a percentage of how much chemotherapy will actually help you,” Lisa says. “What he said to me was, Why go through chemo and get sick and lose your hair if it’s not going to help?

“So I asked about the test. The oncologist, who was on the medical staff at Manatee Memorial Hospital, said I was a perfect candidate. The only problem was you have to wait two weeks for the test results. That was hard because, as I said before, I’ve seen other people, mostly family members, go through chemo, and I was really hoping I could avoid that.

Photo by Manatee Memorial Hospital Breast Care Center.

In January, Manatee Memorial Hospital’s Breast Care Center received a three-year accreditation from The National Accreditation Program for Breast Centers for its outstanding compliance with NAPBC standards. Manatee Memorial Hospital is the first hospital in Manatee and Sarasota counties to receive this quality program recognition. Manatee Memorial Hospital congratulates its breast program leadership committee, led by Jose Erbella, MD, medical director of breast surgery (seated) for this outstanding accomplishment.

“Thankfully, about 10 days after I took the test, I got good news. It was on a Friday, and I wasn’t supposed to get those test results back until the following Wednesday. My oncologist called and let me know they got the test results back and said, You don’t have to do chemo. That was such great news.”

Lisa still had to undergo radiation, and after taking a few weeks off to heal from her surgery, she began those in mid-March. She eventually received 33 treatments, concluding the last week in April.

By May, Lisa’s journey from diagnosis to recovery from breast cancer was completed, and she began taking anastrozole, an endocrine therapy drug that can cut a woman’s risk of developing breast cancer by 50 percent, according to Dr. Erbella.

“Multiple trials have shown that it can cut your risk in half, because it blocks hormones from causing inflammation of the breast,” Dr. Erbella explains. “You need to take it for five years, but it works well.”

It’s working for Lisa. Her latest mammogram was clear, and while she admits her fight against breast cancer was difficult, she says that Dr. Erbella, Jenny and the staff at the Manatee Memorial Hospital Breast Care Center made it easier.

“Dr. Erbella and Jenny are just awesome,’’ Lisa exudes. “They’re the ones who referred me to my cancer doctor, my radiation doctor and the doctor who did my breast reconstruction. I know that without them, this would have been a lot harder.

“Jenny was such a great help through it all. I was fortunate because I had a lot of people to help me, but for someone who has no one and is trying to deal with all that you have to go through to fight this, she’s invaluable.

“And Dr. Erbella, well he’s just so nice and caring and professional. Everyone in his office is the same way. I recommend him and Manatee Memorial Hospital Breast Care Center to anyone who has to go through this. I don’t think you can find any place better.”

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    • Manatee Memorial Hospital

      When it comes to choosing a hospital, one thing is clear: quality counts. Manatee Memorial Hospital has a long tradition of providing medical care in a comfortable and convenient environment each year for thousands of patients... Read More

    • Jose Erbella, MD, FACS

      Jose Erbella, MD, FACS, is board-certified by the American Board of Surgery and a fellow of the American College of Surgeons. He earned a Bachelor of Science degree in biochemistry and molecular biology from the University of Miami and a m... Read More