Knowledge Is Power: Fight Breast Cancer with Awareness
- Amy Isidoro, a 29-year-old Welsh mother and teacher, was diagnosed with triple-negative breast cancer six months after giving birth and now shares her story to raise awareness and support research through Cancer Research Wales.
- “Triple-negative” means the cancer is not fueled by any of the three main types of receptors: estrogen, progesterone, or the HER2 protein. Because of this, the cancer won’t respond to certain common therapies.
- The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) says that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
- For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
- Women who have a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
The school teacher, of Cwmbran, Wales, was 29 years old when she received her diagnosis during the COVID pandemic, and has chosen to share her story with Cancer Research Wales to help spread awareness and raise funds for pioneering studies.
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She urged others, “If you think something is not right, no matter how small it is, no matter how you try and explain it away, no matter what Google says, just go and get it checked out.”
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Isidoro’s care involved chemotherapy and a mastectomy. Fortunately, her surgeons discovered her lymph nodes were healthy, so radiation wasn’t required.
She then completed six additional cycles of chemotherapy to ensure no cancer remained.
Expert Resources for Breast Cancer Screening
- Mammograms Are Still the Best Tool for Detecting Breast Cancer — A Warning About Thermography
- Free Mammograms And Increased Access To Cancer Screenings Focus Of New Bills Promoting Early Detection
- New Guidelines Say Many Women Under 50 Can Skip Mammograms. That May Not Be The Best Advice
- 6 Common Excuses for Skipping a Mammogram That You Need to Stop Using!
- Earlier Mammograms for Black Women May Reduce Breast Cancer Mortality Disparity Rates By 57%; How to Screen for this Disease
- I Have Dense Breasts. Do I Need a 3D Mammogram?
To inspire other women to prioritize early detection, she and her family shared their journey in Cancer Research Wales’ first television ad, promoting donations to the charity’s Gift of Time campaign.
“We all wish for a little more time at Christmas,” Isidor says during the charity’s video ad. “But for families like ours, time isn’t guaranteed.”
She continues, “Thanks to pioneering research, more families in Wales are surviving cancer. Give families like mine the gift of time.”
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Further sharing her story and her new outlook on life with South Wales Argus, Isidoro said, “I’m really big on the need to make memories because you just don’t know what’s going to happen.
“You just don’t know if this is your last Christmas or your last birthday. I just want them to have these amazing Christmas memories in case we don’t get another one as a family.”
She acknowledges that her treatment highlighted just how close she came to a worse outcome. Now, she hopes her experience will encourage others to seek answers and prioritize early detection.
All About Breast Cancer Screenings
The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women who have a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
Genetic Testing for Breast Cancer: What is This Type of Test? And What Do My Results Mean?
Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:
- Older age
- Having a gene mutation such as the BRCA1 or BRCA2
- Added exposure to estrogen
- Having children after the age of 30
- Exposure to radiation early in life
- Family history of the disease
About ten percent of breast cancers are hereditary, says Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.
“We encourage only those who have a family history to really get [genetic testing],” Dr. Ginsburg previously told SurvivorNet.
“I would say that if you have anyone in your family who was diagnosed with a very rare cancer. Or if you have a strong family history of one or two kinds of cancer, particularly breast and ovarian, but also colon, rectal, uterine, and ovarian cancer, that goes together in another cancer syndrome called the Lynch Syndrome,” Dr. Ginsburg adds.
Understanding Triple Negative Breast Cancer
Triple-negative breast cancer is one of the most aggressive forms of the disease and makes up for approximately 20 percent of all breast cancers. The treatment approach varies from patient to patient and may include a combination of different treatments.
Early-stage triple-negative breast cancer (TNBC) treatments may use a combination of chemotherapy drugs.
For example, a CMF regimen is an abbreviation for combining chemotherapy drugs cyclophosphamide, methotrexate, and fluorouracil. AC stands for doxorubicin (Adriamycin) with cyclophosphamide, and ACT just indicates that a taxane drug is added to the regimen. Likewise, TC is an abbreviation for a regimen of Taxotere and cyclophosphamide.
In 2021, the FDA approved the immunotherapy drug pembrolizumab for the treatment of early-stage triple-negative breast cancer (TNBC). Pembrolizumab (Keytruda) is already used to treat other cancers, including melanoma and non-small cell lung cancer. Doctors heralded the FDA’s approval of pembrolizumab as a potentially paradigm-shifting advancement in breast cancer treatment.
For patients with stage 2 or 3 TNBC, adding the immune-boosting medication pembrolizumab to combination chemotherapy before surgery increases chances of living free of breast cancer, explains oncologist Dr. Sylvia Adams, director of the Breast Cancer Center at NYU Langone’s Perlmutter Cancer Center.
She was one of several researchers involved with the pembrolizumab trials. “It changes the standard of care and should be discussed with all patients diagnosed with stage 2-3 TNBC,” she adds. “Yes, it’s a game-changer, though there is much more to be learned.”
RELATED: New Study Identifies Genes Linked to Increased Risk for Triple-Negative Breast Cancer
Is Your Cancer Really Triple-Negative?
Dr. Heather McArthur, Clinical Director of the Breast Cancer Program at Simmons Cancer Center at UT Southwestern Medical Center, has spoken with SurvivorNet on this relevant topic.
You might be told you have triple-negative breast cancer, that means that your cancer is not being fueled by any of the three main types of receptors: estrogen, progesterone nor the HER2 protein. But now you could be categorized as HER2 low instead of HER2 negative.
Breast cancer cells with higher-than-normal levels of HER2 are called HER2-positive, those with low levels of HER2 are (or were) called HER2 negative. Recently, however, researchers have looked to further expand this definition to include patients that have a minimal amount of HER2 expression but do not meet the classic definition for HER2-positive tumors. This group has been called HER2 “low” and is very important as it represents almost 50% of all patients with breast cancer.
This excitement stems from the fact that HER2-low breast cancers are targetable with a recently new FDA-approved Enhertu (Fam-trastuzumab deruxtecan-nxki). It appears that Enhertu is extremely effective for appropriate patients and can greatly improve their quality of life and help them live longer.
Therefore, it is exceedingly important to discuss with your physician about your HER2 status.
Battling Cancer as a Parent
Talking to children about a cancer diagnosis can be extremely challenging. Parents often want to be truthful and help their children prepare for what may come, while also shielding them from unnecessary fear and delivering the information gently.
John Duberstein, who lost his wife Nina to cancer, shares that he and Nina tried to adopt a gradual, transparent approach with their children. Despite their honesty, they encountered difficulties with the kids’ understanding of the illness. For instance, when Nina appeared to be improving, the children assumed she was getting better, which wasn’t actually the case.
Talking to Kids About Cancer: Be Open as Much as You Can
“It was a real eye-opening moment for two people who felt like they were dealing really head-on with this stuff, talking to the kids,” Duberstein told SurvivorNet in an earlier interview.
“So I think it’s important to be open with the kids as much as you can, as much as you feel like they can handle. But it’s also important to revisit it and not make assumptions. At the end of the night, what Nina had to tell them was, ‘I’m not ever going to get better. My cancer is not ever going to go away,’ it was hard for them to hear even though they’d already been prepared.”
Meanwhile, breast cancer survivor Gina de Givenchy previously spoke with SurvivorNet about going through cancer treatment as the mother of a 12-year-old girl.
“I felt it was important to mask it because I really wanted her to know that I was going to be OK. I didn’t want her to see me weak and sickly,” she said. “When it comes to your kids, I think you always want to sort of protect them.”
RELATED: Telling Your Kids You Have Cancer ‘When it Comes to Your Kids, You Want to Protect Them’
Facing cancer while raising children can feel overwhelming, yet having young ones who rely on you can also serve as a powerful reason to keep fighting.
Jovannie Lorenzo experienced this firsthand. Diagnosed with colon cancer at the age of 32, she was struck by fear, particularly as a single mother of three. From the start of her treatment, she was determined to do everything possible to be there for her children and continue raising them.
“I knew that I had to do everything possible to be here for my children,” Lorenzo told SurvivorNet. “They are my saving grace. They are the reason I wake up every morning. They are the reason why I fight every single day and I make a choice to be positive, to be happy, and to move forward.”
Obviously, not every parent feels comfortable sharing so much about their diagnosis with their children. Some survivors have even told us that they were afraid to tell their family members, but as for Duberstein, de Givenchy, and Lorenzo, honesty was the best policy.
Licensed clinical psychologist Dr. Marianna Strongin encourages people with sick parents “to talk about your feelings with your immediate family as well as your parents.” She’s previously talked about the importance of expressing your feelings in her advice column for SurvivorNet.
“Talking about difficult things does not cause more anxiety,” Dr. Strongin said. “It is NOT talking about the very thing that we are all afraid or worried about that causes our body to feel dysregulated (unable to manage emotional responses or keep them within an acceptable range of typical emotional reactions) and anxious.”
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Specifically, with patients who may be scared to talk to their children about a diagnosis, Strongin said children can pick up on their emotions, so it may help to check in with yourself beforehand.
“Having these conversations may bring up deep emotions you may have stowed away. There is nothing wrong with showing our emotions to children as long as we can remain calm and give them a sense of safety,” Dr. Strongin said.
Contributing: SurvivorNet Staff
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