Thrive by IU Health

January 20, 2020

She Reconstructs Breasts After Cancer Destroys Them, In Honor Of Her Mom

IU Health Methodist Hospital

She Reconstructs Breasts After Cancer Destroys Them, In Honor Of Her Mom

As Dr. Mary Lester headed off to medical school, she always had plastic surgery in the back of her mind. How wonderful would it be to make women feel whole again, like her mother did? To make them forget they ever had breast cancer?

Mary Lester was 8 years old and she had a dance recital to perform. She remembers getting all dressed up with her 11-year-old sister, Susan.

But as they left to head to the recital, there was a stop they needed to make first – before there would be any dancing – a stop at the hospital.

Their mom, 37-year-old Nancy Lester, had been diagnosed with breast cancer and, almost immediately, had a mastectomy.

As her mom recuperated, Mary Lester’s dad, Charlie, brought his two little girls to the hospital – so Nancy could do their hair.

It’s the most vivid memory Mary Lester has of the breast cancer that attacked her mom. She remembers her being gone from home. And she remembers the name Dr. Hartrampf.

It was that Georgia plastic surgeon, Dr. Carl Hartrampf, who reconstructed her mom’s breast – with a groundbreaking procedure called the TRAM flap. Nancy Lester was one of the first in the nation to undergo the surgery.

The TRAM stands for transverse rectus abdominis, a muscle in the lower abdomen between the waist and pubic bone. A flap of that skin, fat, and all or part of the underlying rectus abdominus muscle are used to reconstruct the breast, called a TRAM flap procedure.

Unlike implants, the tissue was Nancy Lester’s own with its own circulation. It felt like a real breast.

“It made me feel whole again,” said Nancy Lester last week. “I came through that surgery just feeling great.”

And so, as Mary Lester headed off to college and then medical school and started thinking about what specialty she would go into, she always had plastic surgery in the back of her mind.

How wonderful would it be to make women feel whole again, like her mother did? To make them forget they ever had breast cancer?

That’s exactly what Dr. Lester does now as a plastic surgeon at IU Health Methodist Hospital. More than half of her surgeries are breast reconstruction, implants and flaps. She is performing the next generation of the same procedure her mom had in 1982.

“I am proud of my daughter,” Nancy Lester said.

She knows firsthand just how important it is what her daughter’s doing.

***

She thought she might like to be a lawyer. But when Dr. Lester hurt her knee playing powder puff football in high school, that changed. She had to have her ACL repaired and she had a dynamic woman doctor.

Dr. Lester decided she would be a doctor, too. She had grown up in a family of physicians. Her grandfather, on her mom’s side, was a doctor in a small town. Her dad had doctors in his family.

“It rubs off on you,” she says.

For two summers as a young woman, Dr. Lester worked alongside her dad’s first cousin, a general surgeon. Because he practiced in a small town, he did a little bit of everything.

One summer, they were doing a mastectomy on a patient. The next summer, that patient came back for an implant-related, touch-up surgery.

“That was my first real medical experience with breast cancer,” Dr. Lester says. “I was always interested in it, but I knew I wanted to be a surgeon as soon as I spent that time with him.”

After her undergrad at Auburn University and medical school at Emory University, Dr. Lester trained in general surgery at Emory in Atlanta.

She then moved to Charleston, S.C., for her plastic surgery residency at the Medical University of South Carolina. In 2008, she completed a microsurgical breast fellowship in Charleston with Dr. Bob Allen.

It was Dr. Allen who became a mentor to Dr. Lester. It was Dr. Allen who had taken Dr. Hartrampf’s procedure, that Nancy Lester had received, to the next level – a less invasive, muscle sparing, microsurgery version.

“That’s what sparked it for me,” Dr. Lester said. “I could be that surgeon who brought the positive back after such a scary time.”

***

Nancy Lester remembers that scary time. It was in June of 1982 and she was 37 years old when she found a lump in her breast during a self exam.

Her twin sister was a nurse practitioner. At their grandmother’s 100th birthday party, Nancy Lester told her sister about the lump.

“If you have a lump and you still have it a month later you need to have a biopsy,” her sister told her.

Nancy Lester got in to see a cancer specialist to have a biopsy. While in the operating room, he sent a piece of tissue off to be frozen and immediately looked at for cancer cells.

When Nancy Lester woke up, he told her she had cancer.

“He said, ‘In a couple of weeks, we will take off your breast,’” Nancy Lester says. “And I said, ‘No, no. If I have cancer, I want it off right away.”

Just days later, she was in surgery having her breast removed.

The surgeon removed 15 lymph nodes, which were all negative. Her breast cancer was Stage 1. The tumor was less than two centimeters with no evidence of metastasizing.

But Nancy Lester remembers feeling the need to replace that breast. She was still so young. She went to medical libraries and researched, looking at microfilm. She sought out Dr. Hartrampf for the new surgery, that TRAM flap.

Months later, at age 38, she became the 74th person in the nation to receive the tram flap.

And now Dr. Lester is doing the same for other women.

“I always tell my patients, ‘The goal is when you get up and put on a dress or put on a swimsuit, you’re not thinking about the fact you had breast cancer,’” she says. “That’s what I love doing for patients. We get to do the final part. We are the happy part of their journey.”

More with Dr. Lester

* She is married to Joel Corvera, M.D., a cardiac surgeon at Methodist. The two met during their general surgery residencies. They have two children, a 9-year-old girl and a 7-year-old boy.

* Dr. Lester joined the plastic surgery team at Methodist in 2010.

* Due to her family history of breast cancer, Dr. Lester started annual mammograms and MRIs at age 28, spaced six months apart – along with medical exams.

-- By Dana Benbow, Senior Journalist at IU Health.

Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

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