Competitive Spirit Helps Breast Cancer Survivor

Mila Ellsworth is a fierce competitor. She earned softball pitching records galore in high school and college (many of which still stand). She played on a professional team in the Netherlands. She even had the guts to start her own training academy called Strictly Softball.

But in 2015, Mila was pitted against a formidable opponent that would test her in ways she never thought possible.

Staring down breast cancer

On the morning of March 4, Mila, of Olathe, stepped out of the shower and felt a lump in her left breast. She called her obstetrician-gynecologist and secured an appointment for the next day.

After a mammogram, ultrasound and biopsy, Mila was diagnosed with breast cancer. She had 2 tumors in 1 breast. She was only 36 years old.

Mila received her diagnosis at a nearby healthcare facility. But she didn’t get clear answers about her biopsy results. So she contacted medical oncologist and breast cancer specialist Priyanka Sharma, MD, at The University of Kansas Cancer Center.

Dr. Sharma explained her team’s approach. “When breast cancer is present at more than one site in the breast, many cancer treatment centers assume it’s all the same type of cancer,” she says. “We take the time to test each site so we can create a targeted treatment plan that attacks each type of cancer.”

Testing revealed Mila had an aggressive combination of cancer cells. Some parts of her cancer were estrogen and progesterone-receptor positive and some parts were triple-positive (breast cancer driven by estrogen, progesterone and HER2-positive proteins).

Knowing the score

“I didn’t think genetic testing was necessary because there is no history of cancer in my family,” Mila says. “But Dr. Sharma wanted to know everything about the cause of my cancer to treat it appropriately.”

Mila agreed to genetic testing and learned that she was positive for the BRCA1 gene mutation. Those who inherit the faulty gene are more likely to develop breast cancer, ovarian cancer and other cancers.

“The gene testing guided our decisions about treatment,” Dr. Sharma says. “Mila was also able to share that BRCA1 gene information with her relatives. Hereditary cancer impacts the entire family and provides opportunity to family members to seek preventive measures.”

Covering all the bases

At The University of Kansas Cancer Center, a multidisciplinary team of experts convenes weekly to discuss patients’ diagnoses and treatment plans. The breast cancer team includes medical oncologists, surgeons, pathologists, radiation oncologists, plastic surgeons and nurse navigators, all specialists in breast cancer.

Mila’s team planned to attack her cancer with multiple treatments. She would receive chemotherapy, anti-HER2 therapy, surgery and radiation, followed by anti-hormone therapy.

In April 2015, Mila began chemotherapy. She lost her hair. She was tired. But she continued to manage her business, coach players and attend her children’s sporting events.

“My kids were a huge blessing to me,” she says. “They were just 2, 4 and 7 when I was diagnosed. They kept me distracted from my own issues. I didn’t have time to feel sorry for myself. I tried to live every day to the best of my ability.”

When Mila needed extra support, her high school sweetheart and husband, Danny, stepped up to the plate.

“He did not miss a beat,” Mila says with a smile. “He took care of the kids, the house and his own job. He kept our family going. He has been absolutely amazing.”

Taking breast cancer treatment like a champ

In September 2015, Mila finally took time off from her coaching duties for surgery.

Because of the risks associated with a BRCA1 gene mutation, the cancer team recommended tumor removal and preventive surgeries for Mila. Breast surgical oncologist Jamie Wagner, DO, performed a double mastectomy and lymph node removal, while a gynecologic oncologist  did a bilateral oophorectomy (removing both ovaries).

“We are able to do all these surgeries at one time,” Dr. Sharma says. “That’s important for moms who have kids and jobs and busy lives.”

Breast cancer surgeons and plastic surgeons work side by side at the cancer center. Our expert surgical team manages some of the most rare and complex cancer cases.

Two months after surgery, Mila began radiation therapy to reduce her risk of recurrence. She had radiation 5 days a week for 6 weeks.

“Mila dealt very bravely with a difficult situation,” Dr. Sharma says.

As a pitcher, Mila developed a level of focus and mental toughness that helped get her through cancer.

“When I was playing professionally, I learned there’s a lot you can’t control,” Mila shares. “I tried to focus on what I could control – my attitude, my efforts.”

Staying positive

Long before Mila’s mastectomy, the breast cancer team outlined the advantages and disadvantages of creating new breasts.

Mila chose reconstruction using implants rather than her own tissue. Her right side was a success. But the left implant had to be removed due to complications from her cancer treatments.

Breast cancer plastic surgeon James Butterworth, MD, helped Mila understand the next steps.

“When a breast implant fails, the only option is tissue-based reconstruction,” Dr. Butterworth says. “This approach uses skin and fat or skin, fat and muscle from the body to sculpt and shape new breasts.”

At the cancer center, experts offer many types of tissue-based reconstruction procedures:

• Diep flap: The surgeon uses excess belly skin and fat to reconstruct the breast.
• Latissimus dorsi flap: The surgeon moves skin, fat and muscle from the upper back to the chest.
• Profunda artery perforator flap: The surgeon transfers flaps from the upper thigh to the breast area.

The first 2 options weren’t possible because Mila was in excellent physical condition and had no excess tissue available. Additionally, she wanted to maintain whatever muscle mass and core body strength she had.

In August 2016, Dr. Butterworth performed the PAP flap surgery, an advanced technique that is available at only a few cancer centers. Because Mila is extremely lean, flaps from both thighs were needed to create one breast. Over the next few months, Dr. Butterworth added more thigh tissue and an implant to make her left breast symmetrical with her right.

“This technique was the best choice for Mila, given her cancer-related complications and her sports career,” Dr. Butterworth says.

Working through pain

While most of Mila’s cancer treatment did not affect her pitching arm, she experienced lymphedema and thoracic nerve complications on her left side. These are common side effects of cancer surgery and treatment.

After 5 months of physical therapy, the thoracic nerve issue resolved, giving Mila full range of motion with her left arm.

To address her lymphedema symptoms, Mila met with Sabrina Korentager, RN. Sabrina helps breast cancer patients manage the swelling and pain caused by lymphatic cording and an abnormal buildup of fluid.

“Many cancer centers take a wait-and-see attitude about lymphedema,” Sabrina says. “I saw Mila before her mastectomy to get a baseline study of her lymph system. As soon as we noticed changes, we offered interventions.”

Sabrina recommended a compression sleeve, massage, yoga and stretching exercises.

“By summer 2017, the swelling grew worse,” Mila recalls. “Even the compression sleeve was not working. Sabrina measured the fluid in my arm and it had drastically increased.”

About 6% of our lymphedema patients do not achieve relief with therapeutic treatments. It was time for Mila to consider a surgical option.

Seeking intervention

Lymphovenous bypass is a new outpatient microsurgery that shows promise for patients with lymphedema. The University of Kansas Health System is one of the few to offer this technique.

“We go into the arm and find lymphatic vessels. They’re less than half a millimeter in diameter. We reroute them around damaged areas and connect them with healthy veins to improve the flow of lymph fluid,” explains Dr. Butterworth.

The procedure does not cure lymphedema. But it can reduce swelling and the feeling of heaviness.

Mila had lymphovenous bypass surgery in October 2017. Today, she is back on the field, throwing heat with her right arm during batting practices. Her left arm, armpit and chest feel better. There is less muscle and skin tightness.

“Mila has gone through so many surgeries,” says Dr. Butterworth. “She's handled it all with so much strength and grace.”

Sabrina agrees. “Mila is really a fighter,” she says. “She’s a role model for her daughters and for all of us. She faced an aggressive cancer and many complications with a competitive attitude.”

Getting the win

Three years after her diagnosis, Mila remains cancer-free. She loves spending time with her kids, vacationing with her husband and coaching softball. She is also proud to have been honored at Kauffman Stadium as a 2018 Kansas City Royals Honorary Bat Girl.

Mila feels blessed she was diagnosed with a cancer the medical community knows so much about. “Research they did years ago led to better treatments for me today,” she says.

To show her appreciation, Mila has organized softball tournaments and 3 “pink out” games at her alma mater, St. Thomas Aquinas High School. She wants to continue raising money for breast cancer patients and Dr. Sharma’s BRCA testing efforts.

“The BRCA1 gene mutation really hit me hard,” says Mila. “I hope and pray a cure is figured out by the time my kids grow up. If reading my story causes one person to get tested, it’s all worth it.”

As with all treatments, individual patient results vary. It is important to discuss your treatment options with your healthcare provider.