'What's the best that can happen?' A sensational treatment for breast cancer
October 14, 2026
When Lindsey Johnson learned she had breast cancer, her first thought was simple and universal: "Get. It. Out."
She was 39, a wife, a mother of three busy boys, and a chiropractor with a lifelong passion for wellness and fitness. Then, in early 2022 she felt a lump in her left breast while showering.
“I remember saying to my husband, ‘Feel this. What is this?’” Lindsey recalled.
Being under 40 with no family history of breast cancer, she had not yet had a mammogram or developed a habit of doing self-exams. After inspecting the lump, her primary care doctor immediately ordered a mammogram and an ultrasound, which led to more testing.
A biopsy confirmed the lump was malignant. An MRI revealed the cancer had taken over much of her left breast and spread to six lymph nodes. Suddenly, Lindsey was facing a diagnosis she had never expected and treatment decisions that would change her body and her life.
From Lindsey Johnson on Instagram:
"My first surgical consultation was one that laid out my options or should I say option … the surgery would include an incision horizontally across the breast, and cut around the nipple to remove the cancer tissue and breast.
My heart dropped.
I’m 39. I understand that the most important thing is to get the cancer out, but surely there was a better option.
My mind was racing … What are my options? I hadn’t planned to get cancer. I had no idea where to go and what to do."
Then a physician friend told her about a new, developing surgical approach: single-port robotic nipple-sparing mastectomy (SPrNSM). Shortly after, Lindsey met Deborah Farr, M.D., the surgical oncologist with UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center who would not only help her become cancer-free but also preserve the look and sensation of her breasts.
A different kind of mastectomy
The idea of getting a traditional mastectomy, with incisions below the breasts and around the nipples, was difficult for Lindsey to accept. Determined not to be rushed into a care plan that didn't feel right, she found a UT Southwestern video explaining the SPrNSM procedure that her friend had mentioned.
She learned that SPrNSM is designed to remove tissue through a small incision in the armpit while preserving the skin and nipple-areolar complex. The primary goal is the same as traditional mastectomy: to remove the cancer.
But SPrNSM offered a benefit that Lindsey had neither considered nor heard from any other surgeon. It offered the possibility of preserving sensation and a more natural sense of her body after surgery. For the first time since her diagnosis, she felt hopeful.
The procedure that changed Lindsey’s outlook
Guided by high-definition 3D robotic visualization, Dr. Farr removes the cancerous breast tissue while protecting skin integrity, minimizing trauma, and sparing the natural nipple. The location also provides access to nearby lymph nodes when they need to be removed.
Dr. Farr has done hundreds of SPrNSM procedures – only a handful of U.S. surgeons have performed more than a few of these surgeries. To date, she is the only surgical oncologist who has published clinical trial data on the safety and effectiveness of the procedure.
UT Southwestern was the first hospital in the world to perform SPrNSM with profunda artery perforator (PAP) flap reconstruction, a breast reconstruction done by plastic surgeon Nicholas Haddock, M.D. This procedure uses the patient's own fat and skin to reshape the breast after mastectomy, either at the time of the initial surgery or at a later date.
This new approach minimizes trauma to nerves that support breast and nipple sensation. More than 80% of Dr. Farr's patients have retained breast sensation, and there have been no breast cancer recurrences after six years of performing SPrNSMs.
From Lindsey Johnson on Instagram:
"… Luck would have it a local surgeon and friend had heard about our situation and sent us to Dallas.
@debbfarrmd & @haddockmd were a team like I’ve never seen. They trained together in Milan, Italy and in 2019 brought a Single Port Robotic Nipple-Sparing Mastectomy technique to @utswnews.
This special technique is for breast cancer -OR- prophylactic #brca gene positive patients.
Highlights include:
🔬Small incision in the armpit
🔬Delayed-Immediate Reconstruction (Tissue expanders added during mastectomy)
🔬Option of immediate Reconstruction (Implants added during #mastectomy)
🔬~85% chance of regaining breast/nipple sensation (conventional mastectomies usually end with no tissue sensation)
🔬4-5 hour surgery with less damage to tissue = advanced recovery"
Feeling heard for the first time
From the moment Lindsey contacted Dr. Farr’s team, the experience was unlike her earlier consultations.
“The vibe there, the experience from making an appointment to walking in there to spending time with her, it's just different,” Lindsey said. “You feel very comfortable, and you feel that everybody is specialized.”
Before talking about the surgery itself, Dr. Farr focused on whether the surgery would be appropriate for Lindsey's breast cancer. Candidates must meet standard criteria for a nipple-sparing mastectomy. There are also considerations for tumor location, breast size, prior surgeries, and history of radiation therapy.
Lindsey remembers that Dr. Farr spoke with the calm confidence of someone who had devoted herself to the field. “She believed in it,” Lindsey said. “She knew how great it was.”
Lindsey understood her cancer had to be treated aggressively. It had spread to the lymph nodes. But she also wanted to take into account her future quality of life.
Dr. Farr describes Lindsey as a wonderful patient, especially early in the surgical team’s clinical experience using the single-port robotic system to perform mastectomies.
“She is a very health-savvy and educated woman. She came with a whole bevy of questions, asking exactly what she was getting herself into,” said Dr. Farr, an Associate Professor of Surgery at UT Southwestern. “I was very honest with her that this was a new procedure. I told her what I thought the benefits could be, and she was all in from the beginning.”
"Once I found Dr. Farr and Dr. Haddock, I was like, 'I have found the right place with the right doctors. I felt so at peace with the decision and became hopeful and confident again,'” she said.
Related: Read “Cancer Answers: Taking Robotic Surgery to the Next Level”
Surgery and healing, one step at a time
During Lindsey’s double mastectomy in April 2022, Dr. Farr successfully removed the cancerous tissue and affected lymph nodes.
Dr. Haddock then inserted tissue expanders as part of the delayed breast reconstruction, giving Lindsey’s body time to heal through chemotherapy and radiation before final restoration.
After the SPrNSM, Lindsey returned home to Lubbock, Texas, where she received 16 rounds of chemotherapy from May through October 2022, then targeted radiation therapy in late 2022.
Her breast reconstruction was completed at UT Southwestern in May 2023.
Sharing her story through photos
Lindsey documented her journey under her Instagram handle @lovelifewellnesss to demystify cancer care, support other women, and spread a message of self-advocacy.
"I shared everything – every appointment, every moment," Lindsey said. "I was supported so much through doing that. I wanted to turn this into a positive experience and help other people."
For example, she showed images and videos of herself using cold capping, an approach that cools the blood vessels of the scalp to slow blood flow, which can help minimize hair loss during chemotherapy.
One of her most viewed Instagram posts was also one of her simplest: Research your options. That message has become part of what she hopes to give back. She encourages women to seek multiple consultations, ask questions, explore what treatments are available, and talk with their insurance companies.
From Lindsey Johnson on Instagram:
"During the mastectomy breast expanders are placed to keep skin stretched and to hold the place where the previous breast tissue was.
Radiation significantly tightens and changes skin where it is never the same. This causes potential issues with breast reconstruction.
This is why I had to wait for my reconstructive surgery. To let my skin heal as much as possible before going through another surgery.
Praying my body accepts the changes during surgery and heals properly and quickly.
This is one of the many stresses cancer patients have to think about and deal with.
The mental and physical challenges are unreal, but we GOT THIS!🩷👊
Mastectomy ➡️ April 2022
Chemo ➡️ May-Oct 2022
Radiation ➡️ Nov-Dec 2022
Breast Reconstruction ➡️ May 2023"
Preserved sensation 'means everything'
"Physically, I’m so comfortable — truly, so comfortable," Lindsey shared. "They did the most beautiful job. You can barely see my scarring because it's in the armpit."
Beyond the aesthetic success, Lindsey highlights the emotional and physical impact of retained nerve sensation. Her doctors told her that sensation could be different, not necessarily absent. Lindsey said that this expectation matters because the sensation is difficult to put into words.
"There is still a feeling there. It's not dead; it's alive," she explains. "There is still this connection to the rest of your body, and that means everything."
'What is the best that can happen?'
Today, Lindsey sees her UT Southwestern team every six months for follow-up imaging. She is approaching five years since her diagnosis and remains grateful for the choices she made along the way.
She still remembers a moment during her treatment when she saw a sign outside her Dallas hotel. It asked a deceptively simple question: “What’s the best that can happen?”
“I took that and ran with it,” she said. “What is the best that could happen?”
For Lindsey, it was finding Dr. Farr and the SPrNSM procedure along with Dr. Haddock and the specialized approach to breast reconstruction. It gave her something she desperately wanted: a choice in her future amid the uncertainty of breast cancer.
To talk with an expert about SPrNSM and other breast cancer treatments, make an appointment by calling 214-645-4673 or request an appointment online.
