A Pre-Op Mammogram Saved Her Life: Why One 39-Year-Old Woman Urges Screening

In 2023, Jenna Werner of Middletown, N.J., met plastic surgeon Fares Samra, M.D., FACS, after her oldest son was under his care following an accident. The positive experience left a lasting impression on the family. Fast forward to September 2025: the healthy 38-year-old registered dietitian and mother of three felt the time was right to undergo a breast augmentation. Confident in her choice of surgeon, she called Dr. Samra’s office and scheduled the procedure for Feb. 2026.

Little did she know, a routine preoperative appointment shortly before the surgery would change the course of her life. The plastic surgeon noted that Jenna did not have a baseline mammogram on file. Despite being under 40 and having no family history of breast cancer, Samra required her to get one before proceeding with the surgery. 

"Whether I’m addressing a cosmetic or reconstructive surgery patient, my number one priority is always the patient's overall health and safety," explains Samra, who is affiliated with a number of Hackensack Meridian Health hospitals. "I take care of a lot of patients with breast cancer, and as a result I have long had a policy of requiring mammograms on any patients undergoing any form of breast surgery over the age of 35. Breast augmentations, lifts, and reductions can all change the architecture of the breast, so having a good baseline beforehand ensures we aren't masking an underlying issue." In Jenna’s case, this precaution was life-saving.  After taking care of Jenna, and discussing this further with our multidisciplinary breast team, I’ve now changed that threshold to any patient above 30." Jenna received her mammogram that same day. The initial screening revealed she had very dense breast tissue, but she was not considered high-risk.

Jenna's medical situation rapidly evolved. Within just a few days from that initial screening, she was called back for a follow-up mammogram and an ultrasound – and then was told she needed a biopsy. Before that procedure, Harriet Borofsky, M.D., medical director of breast imaging at RMC, pointed out three concerning spots on her scans, which were confirmed by the biopsy to be ductal carcinoma in situ (DCIS), a highly treatable, non-invasive form of breast cancer that starts inside the milk ducts. According to the ACS, DCIS accounts for about 20% of all new breast cancer diagnoses.

"Jenna had very dense breast tissue, which can sometimes mask early cancers on a standard mammogram, making additional imaging crucial," explains Dr. Borofsky. "Screening guidelines have recently shifted, with organizations like the USPSTF now recommending women start biennial screening at age 40, while others suggest 45. Because of these differences, and because breast density plays such a huge role in cancer detection, it is imperative for women to have a conversation with their doctor to determine a personalized screening cadence that is right for them."

After cancelling the breast augmentation surgery, Samra immediately referred Jenna to surgical oncologist Roshani Patel, M.D., FACS, medical director of breast surgical oncology at Jersey Shore University Medical Center. Jenna’s initial meeting with Dr. Patel was emotionally challenging.  "While DCIS is technically considered an early-stage cancer, Jenna's case was quite extensive," says Patel. "Given the extent of disease relative to her breast size, a mastectomy was the most effective course of action to ensure we removed all the disease and mitigated her future risk."

Before surgery, Jenna also underwent genetic testing. Between 5 and 10% of all breast cancers are caused by hereditary factors – genetic abnormalities or mutations passed from parent to child. The results revealed a mutation in the CHEK2 gene, a gene that increases the risk of developing breast cancer. This discovery prompted her mother and cousins to get tested as well; her mother's positive result meant her father was spared from unnecessary testing.

“The BRCA 1 and 2 genes are the ones most people associate with breast cancer, but there are other gene mutations that increase the risk of breast cancer including CHEK2,” notes Patel.  Just sixteen days after her diagnosis, Jenna underwent a double mastectomy with immediate reconstruction. Prior to surgery, Patel reviewed the breast imaging in detail with Borofsky and Samra. As there was disease close to the chest wall and skin, Patel was able to map out the area successfully to achieve clean margins. Thanks to the seamless, collaborative care within the HMH ecosystem, Jenna underwent a successful procedure and spent just one night in the hospital before being discharged home. After a six-week healing period, Jenna's second-stage breast reconstruction was scheduled. To learn more about breast cancer screening, risk factors, and treatment options, visit https://www.hackensackmeridianhealth.org/en/services/cancer-care/breast-cancer.