Singular Sensation

A leading surgeon works to keep a woman’s body intact after breast surgery, while creating products to provide greater comfort.

by Alicia Di Rado

When Gail Lebovic sees a problem that keeps women from getting the most out of their health care, she does more than just complain: She invents a gadget, widget or gizmo to fix it.

Part physician, part scientist and part Thomas Edison, Lebovic has never seen an obstacle that can’t be hurdled by using her ingenuity.

Though she has reached her station as a leading breast surgeon at the Keck School of Medicine of USC through rigorous study and training, it is the hours she spends with breast cancer patients—and the ways she has improved their lives by listening to their stories and trying to meet their needs—that distinguishes her as an innovator.

“When I was first going into surgery, there was no subspecialty in breast surgery. When I saw how women were treated, I thought, ‘There has to be a better way,’” says Lebovic, M.D., associate director of the Harold E. and Henrietta C. Lee Breast Center at USC/Norris Comprehensive Cancer Center and Hospital. “So much more could be done to improve their care.”

Lebovic has never been the type of person to punch a time clock. Her days are jam-packed with meetings, new projects and phone calls from longtime and far-away patients. She has started four new medical device companies—is working on her fifth—and already has sold one.

“I’ve got others percolating, too,” she says. “But I can’t really talk about them yet.”

On top of that, she spreads the word to women about health in an understandable, friendly way. So friendly, in fact, the Internet portal Yahoo-Health! signed Lebovic on as its breast health expert. Lebovic has authored various columns on women’s health for popular magazines, has been featured on numerous television and radio shows, and she plans to keep going. She has a passion for community education: “It all starts by helping women understand what to look for.”

Others may simply get an idea and stop there. Lebovic grabs onto a concept and refuses to slow down until she makes it happen.

Surgical start

Born in Los Angeles of hard-working Czech immigrants, Lebovic spent her teen years doing more than just studying; she trained for hours on bars, beams and mats to be a gymnast. Her injured knee refused to cooperate, though, which set her on her way toward her future career.

“I had three knee surgeries,” Lebovic says. “I was so inspired, that by age 14, I decided to be a doctor.”

After high school, she moved north to UC Berkeley and earned her degree in physiology and anatomy, followed by a master of science in endocrinology. Then she headed to George Washington University School of Medicine in Washington, D.C., studying the clinical aspects of medicine while continuing her research on the relationship between hormones and the regulation of tumor growth.

As she deliberated her choice of internships in the mid-1980s, Lebovic heard the same message again and again from those around her. Despite her interests in surgery, the experts advised her that as a woman, she should choose the female-friendly field of obstetrics and gynecology.

She gave it a try, but “it just wasn’t for me,” she says.

So in 1987, she took a fellowship at the National Cancer Institute, studying under prominent breast cancer expert Marc Lippman, M.D., then head of the Breast Cancer Section. She learned about the molecular genetics of tumor growth, refueling her interest in breast cancer, an area close to her heart.

Lebovic had seen the effects of breast cancer firsthand: A dear family friend who had helped her parents immigrate to the United States died of the malignancy. “That had a large influence on what I did,” Lebovic says. When an opening came up in the surgical residency program at Stanford University Hospital, Lebovic did not hesitate. The dreams of being a surgeon working with breast cancer patients, once just a whisper in her mind, took voice and became real.

Balanced belief

Ask Lebovic to recall the state of breast cancer surgery in the 1980s, and she almost gives a shudder.

With the central goal of helping a woman survive the disease, surgeons focused their efforts on removing the cancer from a woman’s body to ensure the best chance at blocking the cancer’s recurrence, she says. While cleared of the tumors, many women were left with dramatic scars, altered form and sometimes even more disfigured self-images and emotions.

“Standard surgery skills were just not enough for these patients,” Lebovic says. So she demanded more.

She pursued a fellowship in cosmetic and reconstructive surgery of the breast, with Donald Laub, M.D., former chair of plastic and reconstructive surgery at Stanford University Medical Center. There, Lebovic honed her expert surgical skills while learning the latest techniques and applying them to breast reconstruction. The goal: minimize scarring and the amount of tissue to remove, without compromising cancer principles, along with trying to keep women as intact after surgery as possible. With plastic surgery skills, a breast surgeon could better restore a woman’s shape and leave her looking and feeling balanced, feminine and whole.

“It just reinforced the belief that you can take a tumor out effectively, using an aesthetic approach. In Europe they use the term oncoplastic surgery,” Lebovic says. “It’s all about planning ahead.”

Lebovic has not been alone in this belief. Since 1987, surgical treatments for breast cancer have changed dramatically. Today, more surgeons strive to perform their breast cancer surgeries in a way that protects the patient’s appearance, offering breast conserving surgery (lumpectomy), skin-sparing mastectomies and immediate reconstructions whenever possible. Lebovic states, “We try to preserve as much of the skin as possible, which helps give a better shape and results in less scarring.”

It makes sense, then, that USC/Norris leaders drew Lebovic away from her established Stanford-area practice to join them in 2003. USC/Norris is home to Keck School breast surgeon Melvin J. Silverstein, M.D., the Henrietta C. Lee Professor of Breast Cancer Research, who is an outspoken proponent of oncoplastic surgical techniques. Lebovic has followed Silverstein’s career closely, and almost joined the surgeon’s practice in the early 1990s when Silverstein was medical director at his pioneering Van Nuys Breast Center.

“We have always shared the same views on treating women with breast cancer through these less-invasive techniques,” she says.

Deceptively simple

Although her car’s license plate reads “OPR8N,” surgery is hardly all Lebovic does.

When Lebovic heard scores of women complaining about the pinching, squeezing pain involved in getting a mammogram, she set her mind on making the process softer and gentler.

So began the Woman’s Touch MammoPad, a disposable cushion placed on the mammography equipment before a woman has the test. The MammoPad cushions the breast during compression, reducing the pain.

“This looks deceivingly simple, like a mousepad,” she says, holding up a thin, rectangular slice of foam. “But the foam is incredibly complex. The key was to develop a product that decreased pain, but didn’t affect the X-ray image. It took two years to create it.”

Lebovic and the product’s maker, BioLucent Inc., took the MammoPad to Laszlo Tabar, M.D., at Falun Central Hospital in Sweden to perform intense clinical trials. Almost 1,000 Swedish women had mammograms either with or without the MammoPad, and Tabar—whom Lebovic dubs the “granddaddy of mammography” for his pioneering work in the field—could not see any adverse effects between mammograms done either way, even when examining the images with a magnifying glass. In the study, a majority of the women reported that the MammoPad cut the pain of mammography in half.

“Our hope is that by decreasing pain, we can increase compliance with mammography screenings,” Lebovic says. Today, USC/Norris and about 1,500 other mammography centers are using MammoPads, which cost about $4 each.

But there is more. Lebovic also created the Expand-a-Band Breast Binder, which is used to help women recovering from any invasive breast procedure. The binder is a stretchy elastic bandage, much like a tube top, available in various patterns and colors.

“Before, several people would lift the patient after surgery and wrap an Ace bandage around her chest,” an unwieldy proposition, Lebovic says. Now, nurses can open the Velcro fastener, slip the binder behind a patient’s back and refasten it in front. The dressing compresses the breast area after surgery so that patients go home with less swelling and bruising—and “patients feel like they got a little gift after surgery,” she says.

Today, Lebovic is where she wants to be—contributing locally and globally to women’s health. By performing surgeries and following up with patients, she can help women one at a time. “And when you invent something that will potentially touch millions of people,” she says, “that takes patient care to a whole new level.”