As the daughter and great-grand-daughter of breast cancer survivors, I knew I was at increased risk of developing breast cancer. My Ashkenazi Jewish heritage also increased the likelihood that I would develop cancer in my lifetime. But I had heard once that breast cancer “skips” a generation, and I clung to that falsehood desperately. Still, when my physician Emad Mikhail, M.D., advised me to enroll in the Hoag Early Risk Assessment (HERA) program, I listened. I was slightly nervous about entering the program. Sometimes we think, “I’d rather not know,” but a program designed to inform and empower women doesn’t leave a lot of room for willful denial. HERA not only evaluates a woman’s lifetime breast cancer risk profile, but also provides support and resources to help women take control of their breast health. I tell everyone who will listen that HERA saved my life.
I discovered that I had an elevated risk, something I already knew. But then Hoag’s high risk breast cancer nurse practitioner, Karen Herold, DNP, WHCNP-BC, FNP-BC, called me in and told me that I was eligible for a breast MRI, which is recommended for high risk women as an adjunct to mammograms. I had never had this test, but I went ahead as recommended. I remember the MRI tech saying, “MRI’s are great for breast cancer detection. With the IV dye that’s used, anything cancerous lights up.” The following week I got a call from my doctor telling me that based on the results of the MRI, they wanted me to go in for follow-up. I went down to the Hoag Breast Center in Irvine for an ultrasound that ultimately led to a biopsy. I still wasn’t worried. I have had biopsies in the past, and they have been fine. I thought this would be the same because, I still had that “skip a generation” thing in my head.
I’m a commander with the Los Angeles County Sheriff’s Department, and a few days after my biopsy, I was in a meeting with my captain when my personal phone rang. I saw the area code and thought it was my kid’s school so I answered, but the voice on the other end was my doctor. As soon as I heard the tone of his voice, I knew. The MRI detected a small mass in my left breast that had been invisible on my standard mammogram. Following the biopsy with dedicated breast radiologist Dr. Jennifer Overstreet, the mass was found to be an invasive lobular carcinoma, notoriously difficult to detect until it grows much larger. I then met with Dr. Colleen Coleman, a surgeon who helped map out a course of treatment. She told me that the good news was my cancer was caught as early as possible, stage one. Had it not been for the MRI, my cancer would not have been detected probably for another year by mammogram, and who knows what stage the cancer would have been at that point?
I opted for a double mastectomy with reconstruction. During that surgery, Dr. Coleman discovered a tiny cancer deposit in one of my lymph nodes. If my diagnosis had been delayed any longer, it likely would have been spread outside the breast and come much more invasive and threatening. Instead, my most recent test results show I can avoid chemotherapy and will only require hormone therapy as follow-up treatment. It’s that simple. Early detection saved me from so much trauma and potential death. It’s nothing short of a miracle. Now I’m wearing expanders that make me look pretty normal. Dr. Tenley Lawton, who is doing the plastic surgery, is amazing. She is an artist in a way.
The whole situation – from entering the HERA program, to being given the MRI that found my tiny cancer, to being spared a more advanced disease, to my normal-looking body – is unbelievable to me. Sometimes I do think, “Why me,” but then I tell myself, “Stop whining.” If not for Hoag’s program, I would be in a much different position a year from now or two years from now. What is amazing to me is that everyone I have spoken to about HERA says they’ve never heard of such a program. I have made it my mission to change that. I’ve retweeted a link to HERA multiple times to my 450 Twitter followers and I have spoken about the program and about early detection to my colleagues at the Sheriff’s department and elsewhere in the community. If there is one thing that I can do, it’s to urge people to enroll in a program like HERA that can help detect cancer as early as possible. It has made all the difference to me, and I hope it can make the difference to other women, too.