Maria Merino, M.D.

Director, Clinical Pathology
National Institutes of Health
Bethesda, Maryland

My e-mail to the chief of pathology at NIH had a subject line: Metastatic Cancer in DCiS. I was desperate for valid information, to back up my own limited knowledge of cellular biology, family history, and terror. I had breast cancer! The nodes were positive, with cytokeratin staining, a new pathology technique to identify malignant cells in lymph nodes. Not only that, I knew in my heart of hearts, without the mets, that node positive patients may be facing a serious future; I did not trust an archaic cell (malignant) to stay in one place! I truly felt that breast cancer was multi-centric, would most probably be in the same or opposite breast other than that originally found, and that it was a surgical disease. I never appreciated my education as much before I had breast cancer.

Having gone through the "lumpectomy" expecting a mastectomy and Sentinel Lymph Node Dissection (SLND) because I had Stage III comedo carcinoma, two sites of longitudinal calcifications, I awoke without any node exploration at a prestigious medical school (or they think it is). My second surgeon told me that I was " above the Van Nuy's Index." Thank God that surgeon was knowledgeable, assertive even informing me, "I am going to compromise your arm...if you don't want this, you'll have to see another surgeon." Want it? I had begged for it, before. However, the pathologist at that hospital I had contacted before the 2nd surgery attended my surgery, recommending that all the nodes be removed, and to not perform the SLND. Both my oncologist and surgeon were shocked, concerned and did not hesitate to take my case to the gurus of this new methodology.

I was not going to leave any variables this time - however, I trusted my surgeon, oncologist and physician friends implicitly. But this was my life- we were an agreed upon team, together. That did not mean that I didn't have a right to investigate as well. And, in the long run, it is a much better way for physicians and patient.

Almost immediately, I received a return e-mail from Dr. Liotta at NIH, telling me that the finest pathologist in breast cancer was out of the county but she would contact me as soon as she returned. She must have flown in on the Concorde because I heard from Dr. Merino, and her kind caring she informed me that she would like my oncologist to have my tissue blocks and slides sent to her ASAP. Needless to say, my oncologist moved on that immediately, but his ability to obtain them from my partial mastectomy performed 'back home' were not as successful, until Dr. Liotta took over.

Since that time in 1999, Dr. Merino and NIH have helped countless women with second opinions on their pathology at no cost, giving them hope, accuracy, and gratitude. During some of my own worst days during treatments, Dr. Merino e-mailed me to tell me that "everyone here" is cheering for you, during the Race for the Cure in D.C. I collapsed in tears of gratitude. . . the personification of prayer!

Dr. Merino has worked with me helping many women, and their families. Often, at times, overcome with the amount of e-mail requests I receive, I think of the work that she is doing, and pray to God that everyone keeps buying the Breast Cancer U.S. postal stamps, to help fund their work. During this time, Dr. Merino has become like a sister to me, and one I not only love, but admire, have sincere gratitude, and for whom I hold the highest respect. The emails I've received from women, so grateful for her help, cannot be imagined. Many have been shocked that ". . .the Government would do this for me!" It is only fitting that this wonderful physician from the lovely country of Spain, be among our first honored group of advisors. We thank the U.S. Government for letting us pass the stringent ethics tests and permitting Dr. Merino's seat on our Grand Rounds.

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