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Things Early Stage Breast Cancer Patients Should Know About Metastatic Breast Cancer Warning Signs

Susan G. Komen recently talked with Teri Pollastro, who has been living with metastatic breast cancer since 2003. Pollastro, a Susan G. Komen Advocate in Science, shares her experience going through early stage breast cancer, having a recurrence, and what developments she’s the most excited about in breast cancer care.

Helpful definitions:

Liquid biopsy:  a blood test the looks for cancer cells or pieces of DNA from cancer cells that are circulating in the blood.

Komen: We talk a lot about the warning signs of breast cancer and the importance of knowing what is normal. Did you notice any signs of a recurrence or metastasis? 

Pollastro: I was a young mom with small children and I just totally dismissed that I was losing weight. At the end of the day, I remember thinking, ‘Gosh, did I eat today?’ I love to eat, so that should have been a cause for some concern for me.

I had more fatigue than was probably normal. Again, I just attributed it to my having young children.  My breast cancer metastasized to my liver, and by the time I would have had glaring symptoms, it may have been too late for my liver to metabolize the chemotherapy.

Komen: Do you have any advice for early stage breast cancer patients about the warning signs of metastatic breast cancer?

Pollastro: I think it’s important for early stage patients to know the warning signs of metastatic disease. It’s not like, ‘Oh, I have a headache for one day,’ but if you have a headache for two weeks straight, you might want to mention that to someone. If you bring this up to your primary care doctor, you want to mention that you have had early stage breast cancer. If the symptoms do not go away, and you do not feel your concerns are being addressed, don’t be afraid to go to another provider or your oncologist if you have one. 

Komen: Is there anything on the horizon in breast cancer care that makes you excited?

Pollastro: Liquid biopsies. With accurate liquid biopsies, doctors would be able to determine sooner that there’s progression without having to rely upon a CT or PET scan. I’m also hoping that a liquid biopsy will be developed for early stage patients to determine if there could possibly be a local recurrence or distant progression. There are really no good tools out there right now for early stage patients.  I know when I was an early stage patient, that it is anxiety provoking when you have some unexplained pain. You often ask yourself, ‘Is this a pulled muscle, or has my breast cancer metastasized?’ With liquid biopsies, we could get a blood test to eliminate the cancer concern and focus on what else is going on.

Komen: How could a liquid biopsy (or blood test) improve your quality of life?

Pollastro: When you have metastatic or stage IV breast cancer, or when you’re starting a new treatment, they use either a CT or a PET scan (or both) to monitor your disease. I cannot tell you how important it would be to a patient to not have to have those scans. You have to wait a couple of days for the results to come back, and then you meet with your care team. It is just an overwhelming amount of anxiety during that time; we call it scanxiety. It is my hope that we could use liquid biopsy instead of using a CT or PET scan. And, we could run that blood test on a regular basis instead of using expensive scans that are spaced out at specific intervals.

Komen: You are currently serving as an Advocate in Science for Komen. How did you come to be such a strong breast cancer advocate?

Pollastro: I was nudged into advocacy by my oncologist. With my metastatic breast cancer, I spent a lot of time in the clinic. I would say, ‘You know, you could do this better if you did X, Y, and Z, or instead of in the infusion room doing A, B and C, you could do this.’ She told me she’d like me to start meeting with newly diagnosed patients, and that’s how I started my advocacy career.

Then I became a research advocate for my local cancer center, which is one of nineteen comprehensive cancer centers involved with the Translational Breast Cancer Research Consortium (TBCRC). We have monthly calls within each breast cancer subtype and we meet twice a year to discuss and design phase 1 and 2 clinical trials for breast cancer. I have learned so much from being involved in that group. Susan G. Komen is a sponsor for the TBCRC, which is how I connected with Komen and the Advocates in Science program. I am also the Research Task Force co-chair for the Metastatic Breast Cancer Alliance, of which Komen is a founding member. 

Now as an Advocate in Science, I have enjoyed attending conferences, reviewing grants, and being a part of the Metastatic Breast Cancer Advocacy Committee. Komen has a great program for advocates to get involved.