Mulic chose the type of surgery that preserves the outer shell of the
breast and, after post-surgical preparation, allows the most
normal-looking reconstructed breast possible. "But the main goal
is to give Lindsay protection from having another major health
problem," Wapnir said. "Breast cancer in any young woman is
tragic. In Lindsay, it would have presented some specific problems and
limitations in how we would have been able to treat her. Our
overwhelming concern was that giving her chemotherapy, for instance,
might take her off balance on a multitude of other issues involving
The transplant team monitored Mulic's lungs closely before, during
and after the surgery. "We look at chest X-rays, lung function
analysis, oxygen saturation and the blood levels of the
immunosuppressant drugs," Weill said. Mulic's recovery, he said,
"was beautiful and the health of her transplant lungs is very
good. Here was a young lady facing a very difficult choice,"
Weill said. "It's very inspiring to see someone confront that
directly and make such an informed and inspired choice."
As the days passed after her surgery, Mulic realized that for her,
coping with another major physical alteration in her body was not as
difficult as her emotional journey, something she had not expected at
all. "All over the world, you hear about people going through
transplants, but not most people talk about having a double mastectomy.
"There were times when I just cried and thought, 'Will I ever get
through this?' From a woman's perspective, you're taking away
something that means a lot. That's hard."
But she was heartened by the support she felt throughout from her
Stanford team. "They said, 'You have the strength to be able to
have this surgery. It's the perfect time to do this.' I just trusted them."
Mulic has helped teach Weill and his team more about the longer-term
health of people with transplants who are living "longer and
longer, developing all the usual health problems that all of us
develop as we get older. And as they do that, we're wholly reliant on
other teams in other specialties to help us care for them—and that
makes our job of keeping lung transplant patients as healthy as
possible that much easier."
Wapnir looks at Mulic and sees a young woman whose natural appearing
mastectomies have not changed her natural figure—and as someone
"who has been released from the burden of yearly MRIs, mammograms
or ultrasounds, as well as potential biopsies," she said.
"Women like Lindsay now have choices which include prophylactic,
risk-reducing operations in order to prevent breast cancer, while
preserving at the same time a near-normal body image."
Years ago, Wapnir said, patients like Mulic "would not be here
with us. By helping her the way we did, we make it possible for
Lindsay to live a long, long time without facing treatment for breast