Patient Success Stories - Marra's Story
Doctor, Mother, and Breast Cancer Reconstruction Patient
My name is Marra Francis, a physician, and the mother of three young girls. I lost my mom to breast cancer when I was 24 years old. She was 47 when she was diagnosed and she died when she was only 49. In April of 2009, I underwent prophylactic double mastectomy surgery and tissue expanders were put in place to accommodate the implants I would get during the second surgery, scheduled to take place a mere two months later.
In June of 2009, the expanders were removed and my plastic and reconstructive surgeon, Dr. Sugene Kim, placed the silicone implants. Five months later, in November of 2009, I underwent the third and final surgery, and had nipple reconstruction. Afterwards, I found myself restored physically – looking and feeling wonderful.
The reality behind this may be shocking to some. I did not have breast cancer, nor did I have any outward indicators that pointed to early evidence of existing breast cancer. I chose to have my breasts removed because I didn’t want to develop the disease and in the back of my mind I had worried for years that it could happen to me. I lost my mother to the disease and then, over time, two of my mother’s cousins also developed breast cancer. Although I had gene testing done and the results came back negative, I did extensive research, which indicated that – given my family history – I had a 25-35% lifetime risk of developing the disease at some point.
“How could you make that decision?”
Some people who learned of my decision were shocked and asked, “How could you make that decision?” So, I said to them, “If you got on an airplane and it was announced that there was a 25-35% chance the plane was going to crash, would you get on that plane?” Then they got it. Others told me I was very brave, but I had kids who were 3, 4, & 5 years old at the time and bravery wasn’t the issue. There was no difficult decision to be made; I didn’t even give it a second thought. I wanted to raise my children. What could be more important than that?
I’m an OB-Gyn doctor with a busy practice and I worked throughout the entire process, taking very few days off after my surgeries. I had patients due to deliver their babies, and they depended on me. There’s never a good time to take off, so I just went to work and it worked out very well. I returned to work a week after my double mastectomy surgery and two days later, one of my patients came in crying. She’d just been diagnosed with breast cancer and told me that she just couldn’t deal with it. I told her that I’d just had the surgery she was facing 10 days prior to seeing her, and she was stunned. Then I showed her what I looked like. This woman has four little kids and she looked at me and said, “You came back to work right away?!” and I said, “Yes.” “And you feel good?” “Yes!” She was so heartened to see the actual result and to see me standing there, strong and smiling, that she booked her surgery, went through the entire process, and she’s just fine now.
Throughout the process, I was open with my children about what was going on. I didn’t want them to see me after each surgery without knowing why. I showed them what I looked like and normalized the whole thing for them. I wanted them to be a part of it, to know that their mom was strong and okay.
In fact, my 3-year-old came with me for my breast expansion appointments and I am convinced that the way I handled it with the kids has been great for them. A funny thing happened not long after my surgery, when my oldest daughter got up for show-and-tell and said to her classmates and teacher, “Hey, everyone, did you know that you can have your boobs cut off and not die?” That was really something, and said to me that she was able to talk about it without feeling something scary had taken place that she had to keep a secret.
I didn’t have any post-surgical emotional trauma, either…none whatsoever. I had witnessed what my mom went through when she was dying of breast cancer and it was just terribly difficult for everyone involved. I rationalized it like this: I can’t prevent a car accident or many other things that happen in life, but I can control this situation, so I’m going to. And if my kids had to watch me slowly die of breast cancer, I would never be able to forgive myself.
Meeting Dr. Sugene Kim
Dr. Sugene Kim, my surgeon, is wonderful. She’s brilliant, calming, and always positive. Throughout my surgeries and recovery times, she communicated with me in a way that made it clear that she knew exactly what she was doing and what she was going to do throughout the process. She also has a compassionate and wonderful staff. They went out of their way to work around my hectic work and parenting schedules and did it with warmth and efficiency. Technically, Dr. Kim is also a fantastic surgeon. During her training, she spent a year at the renowned M.D. Anderson Cancer Center in Houston doing nothing but breast surgeries so she knows what to do and how to do it.
When I was searching for a surgeon, she was new to the community and I had considered a number of experienced surgeons. But when I met Dr. Kim, I knew she was the surgeon for me. She had the training and background to do excellent breast reconstruction work – the specific surgeries I would be having. I’d also seen her work on some of my own patients and every one of them loved her. She and I have developed a relationship of mutual respect over time and I had the privilege recently of delivering her baby, who’s now 9 months old. I just can’t say enough about her – as a woman and as a doctor.
My breasts actually look better!
As for my breast implants…well, I’m just doing great and I love them. Breastfeeding my girls wrecked my breasts and they actually look better now than they did even before I had kids!
My experience hasn’t been kept hidden from anyone; it’s not a secret. I’ve talked with quite a number of women about it, and many people in the community know what I’ve gone through – including a good number of physicians. They now refer their own patients facing prophylactic breast surgery to me and I meet with them, show them what I look like, offer comfort and support, and share my story with them. Every one of these women has left my office saying, “I can do this.” I feel so good about being able to give this to those facing this situation.
You know, I understand why so many are fearful. A lot of the women I’ve spoken to have heard horror stories about mastectomy surgery because years ago the techniques were very different than they are now. Consequently many older women who went through breast cancer and reconstructive surgery ended up disfigured. But surgical techniques have advanced tremendously over the years and it eases the minds of the women I meet with to see what can be achieved now by a highly experienced surgeon.
I’m so much better off, and I have peace of mind.
I feel incredibly fortunate to be healthy and strong – for my work, my children, and my friends – and to be able to share my story with women facing breast surgery. I’m grateful that they get a little bit of added strength when they talk to me.
I have so much living left to do, and so much I want to accomplish with my kids. I wouldn’t do it any differently than I did. I’m a whole woman – and my chances now of developing breast cancer are only 1% – far less than the average woman. I’m so much better off, and I have peace of mind. My biggest fear was that I would develop breast cancer and not live to raise my kids. It was one of those things I could control, so I did. I have a wonderful life and couldn’t be more thankful. Thank you so much for listening to my story.
Dr. Marra S. Francis is an Ob/Gyn doctor working in private practice with Dr. Clayton Young at Obstetrics and Gynecology of The Woodlands since 2004. She graduated from Occidental College in 1994, The University of Connecticut School of Medicine in 1999, and completed her residency in Obstetrics and Gynecology at NYU Downtown Hospital in New York City in 2003, where she was Chief Resident throughout her last year of training. Dr. Francis was Board Certified in 2007 by the American Board of Obstetrics and Gynecology.
She is a member of the Texas Medical Association, The North American Society of Pediatric and Adolescent Gynecology, and the American College of Obstetrics and Gynecology. Dr. Francis is also involved with Basic Health El Salvador, providing gynecologic medical care to the women of El Salvador. She is a National Speaker for Cord Blood Registry, Myriad Genetics, and a speaker for Worth The Wait. Marra Francis is a resident of The Woodlands, where she lives with her family.
A note from the author:
A writer of doctor and patient profiles by profession, I embarked on this interview with Dr. Marra Francis knowing nothing of her story – only that she had been a patient of Dr. Sugene Kim at The Institute of Advanced Breast Reconstruction and that Marra herself is a doctor. Everyone has a story to tell, and the stories of women who have undergone mastectomy surgery and subsequent breast reconstruction are always compelling. But Dr. Francis’ story is different from many, for she chose to undergo double mastectomy surgery and breast reconstruction without having breast cancer. She is one of the many individuals who, when tested, are found to be at high risk for developing the disease and who decide to take control of the situation. To elect mastectomy surgery when you are a young working mother of three small children is an act of incomprehensible courage and strength. To wait and take your chances was, for Marra, equally incomprehensible.
And then there’s Marra herself. What did I expect to encounter during our conversation – fear, depression, bitterness, relief? To negotiate three surgeries and the recovery periods in their wake would be daunting for anyone. I imagined a sobering, serious conversation, hushed tones, and fragility. Instead, I encountered a woman of tremendous optimism and joy – a young doctor and mother who is playful, open, and possessed of a voice that can only be described as filled with laughter and good cheer. Grateful to be healthy and eager to share her story with patients and friends undergoing mastectomy surgery and breast reconstruction, Marra Francis is a walking, talking inspiration. It is a privilege and an honor to share her story with you.
–Kate Altork, Ph.D.