To Life!

Targeted Treatments Aim to Beat Breast Cancer

To Life!When they were out together, it was easy to see that Beulah Stephens and daughters Penny (above left) and Robbin (above right) were family. People often mistook the girls – nine months apart in age – for twins. But as years passed, a more troubling relationship arose. All three were diagnosed with breast cancer. Separated by decades, the experiences of Beulah, Penny (now Myers) and Robbin (now Jones) chart great strides in treatment and hope.

1970s

Breast cancer struck Beulah in her early 30s. Rarely done today, the treatment of choice then was a radical mastectomy.

A surgeon removed the breast, underlying chest muscle and nearby lymph nodes. Chemotherapy and radiation followed. She survived the cancer, although Robbin recalls heart muscle damage from the radiation.

Still, Beulah was a strong woman. Her four children didn’t see what she was going through. “She didn’t share that,” Robbin recalls.

1990s

Both girls had been having regular annual mammograms when Robbin’s breast cancer surfaced in her early 30s. It was 1996. “I looked at mom, thinking, ‘I’ll make it through.’” Robbin had a breast-sparing lumpectomy with chemo after radiation.

She was overwhelmed with printed material about the disease. “You had to read it all to try to understand what was going on with you,” Robbin says.

Mom was her entire support group. “I let her guide me in prayer and trust in the Lord.” To be strong for her own daughter, Robbin didn’t deal with the emotional and physical changes. Those hit her hard a few years after she finished treatment.

2011

Penny was used to re-screenings after her annual mammogram, so the call from the Breast Center in late 2011 didn’t worry her. “This time they saw two small spots on my right breast,” she says.

The breast care team quickly went to work. At the Center, a doctor inserted a thin needle to remove a tiny sample of breast tissue for study under a microscope. The test revealed the presence of cancer cells.

Breast Care Coordinator Ann Lensch, RN, accompanied Penny to her first meeting with surgeon Jennifer Wu, MD. Together, they weighed Penny’s options. She chose a lumpectomy, but during the procedure, Dr. Wu biopsied the other suspicious spot. Fortunately, there was no cancer. Ann visited Penny the day of her surgery and brought “A Woman’s Journey Toward Healing,” a guidebook for all aspects of breast cancer. “She called a couple days later to check on me, too,” Penny remembers.

Next, medical oncologist John Haluschak, MD, who would coordinate Penny’s post-surgery care, sent tissue samples from Penny’s surgery for laboratory analysis. The results would help define which treatment would most benefit Penny. The answer was hormone manipulation, enabling Penny to escape the chemotherapy Robbin had. “They don’t put you through unnecessary treatment,” she says.

Penny completed radiation treatments with Rebecca Paessun, MD, at Miami Valley Hospital North and then started on hormone therapy with tamoxifen.

Science Enables Personalized Treatment

“When Penny’s mom was diagnosed, we didn’t know about the action of hormones. We didn’t know which drugs could reduce the chance of the cancer returning. We looked at cancer cells under a microscope to determine if chemotherapy was needed. Now we can look at 21 different genes in a cancer cell and see who needs to worry about another breast cancer years later,” Dr. Haluschak says. “Now we can personalize our treatment. Our ability to improve outcomes is so much better than it was for Penny’s mom.”

Digital mammography and needle biopsies have made detection less traumatic and invasive. “One of our greatest advances is identifying risk,” says surgeon Thomas Heck, MD, Co-Medical Director of the Breast Center. “We started our High Risk Program to identify women with a positive BRCA gene test indicating a very high risk of developing breast and ovarian cancer.”

On the long survivorship road, cancer patients today don’t have to journey alone. “Support groups are out there in full force,” Robbin says. “There’s someone going through the same things you are. They help you know you can survive.”

Breast Cancer Care Then and Now: A World of Difference

Surgery

Surgeons can identify and remove only lymph nodes that need to be removed, reducing the risk of swollen arms. New reconstruction techniques offer improved cosmetic results.

Radiation

Improved radiation delivery does less damage to healthy tissue. For some patients, treatment can be tightly targeted through a balloon inserted into the lumpectomy cavity. Another benefit: treatment is five days, not six weeks.

Chemotherapy

Drugs are more effective in fighting cancer and in helping patients tolerate treatment. “Our goal is to give people great benefit with minimal side effects. We keep getting better at it,” Dr. Haluschak says.

Genetic Counseling

Today’s sophisticated testing can rule out many genetic concerns. Women who received genetic counseling years ago should return for a re-evaluation.

For more on the Sharing Our Strength breast cancer support group, call (937) 734-6117(937) 734-6117.