After Her TNBC Diagnosis, Stephanie Made Life Affirming Choices
I have always been an optimist, a glass half-full type of person. So when I found a lump in my breast during a self-exam, I was sure that it was just a cyst. It couldn’t possibly be breast cancer, right? I was only 37 at the time and was not aware of any family history of breast cancer.
I made an appointment with my Ob/Gyn believing she would diagnose a cyst and life would move on as normal. In a very short time I would learn that my “cyst” was, in fact, a tumor. Even with the cancer diagnosis, I managed to maintain my positive outlook, was not overly concerned and certainly not panicked. I assumed that a quick lumpectomy and a few years of orally administered hormone therapy would take care of the issue.
Then came the biopsy, which revealed Invasive Ductal Carcinoma, negative for both estrogen and progesterone hormone receptors as well as HER2. The medical lingo the healthcare professionals used for this diagnosis was Triple Negative Breast Cancer (TNBC). This diagnosis shook my generally positive outlook because I associated the tag with the worst-case scenario in terms of breast cancer tumors. TNBC tends to be more aggressive and is more likely to metastasize.
Studies have shown that 77% of women with a TNBC diagnosis survive five years after treatment, compared to 93% of women with other types of breast cancer. As I learned these statistics, along with the probable need for a more aggressive and intrusive treatment plan, a gripping fear ensued. My family recalls that I “entered into a dark tunnel.” Instead of the assumed lumpectomy and hormone therapy, the recommended treatment protocol would now include two major surgeries, chemotherapy, and radiation.
The TNBC diagnosis, coupled with my young age, indicated to my breast surgeon that I should take the BRACAnalysis test. This seemed to be overkill to me because I was not aware of a family history of breast cancer, but, since it was covered by insurance, I agreed to take the test. A couple of weeks passed, then the results arrived and, surprisingly, confirmed that I have the BRCA1 mutation. This information further shook my optimistic attitude. I began to fear the worst – it seemed that the cards were now stacked against a positive outcome.
In retrospect, I now understand that having all of the information associated with my diagnosis, specifically the BRACAnalysis test result, was actually empowering as opposed to the frustration that I originally felt after the initial diagnosis. One in five women with TNBC is positive for the BRCA genetic mutation. After deeper research into my family’s health history, I confirmed that breast cancer was not on the maternal side of my family tree. However, the paternal side of the tree is a different story. I found out that my paternal great grandmother, paternal great aunts, and two paternal cousins had all been diagnosed with breast cancer in their 40s and 50s. From this history and the BRAC results, it was clear that the mutation was passed to me from my father. I was predisposed to breast cancer because of genetics, not because of something I could have controlled. What a relief!
The BRAC test result also gave me the power to avoid a future cancer diagnosis. The BRCA mutation increases the risk of breast cancer if breast tissue remains and also substantially increases the likelihood of ovarian cancer. With this knowledge I was empowered to make treatment choices to reduce future health risks related my genetic predisposition to certain types of cancer. I chose the most aggressive treatment: a bilateral mastectomy, chemotherapy and radiation. A prophylactic hysterectomy followed soon thereafter to proactively address the risk of ovarian cancer.
Maintaining my health is something I take very seriously, which includes eating well and exercising. They are no longer options but lifestyle choices. I am confident that this lifestyle approach and a fully restored sense of optimism will help me to remain cancer free. My three-year “Cancer-versary” is March 28, 2014. This is a significant milestone for a TNBC diagnosis. In addition to being focused on my personal health, I am committed to doing my part in educating medical providers and women with breast cancer diagnoses about the importance of BRAC testing. Knowledge really is power. Hereditary breast and ovarian cancers are passed down from both the maternal and paternal sides of the family and this information needs to resonate through the medical community.
Know more so that you can do more!