Brenda Welling recently purchased Tran-Siberian Orchestra tickets for her family. She used to think such an event was too expensive.

“You have to live your life every day,” she said.

Welling, 48, discovered a lump in her breast in September 2008. She had been lax in her yearly mammograms.

After her mammogram, the doctors saw calcifications and referred her to a general surgeon. Looking at the microscopic calcifications, Welling told her doctor, “That can’t be what I felt.”

The doctor did an ultrasound and found a mass. That afternoon, Welling had a biopsy that confirmed stage II lobular cancer. Her surgeon said the tumor had been growing about five years, Welling said.

While her tumor was 2.3 centimeters, almost half of Welling’s breast was infected with pre-cancer.

Although her grandmother and an aunt died of breast cancer, Welling said she never thought it would happen to her.

She has thought about genetic testing to see if she has cancer genes that could have been passed to her four children.

Welling is grateful for the support she received when she had a mastectomy earlier this year.

Her employer put her in touch with another survivor through the American Cancer Society’s Reach to Recovery program. Welling and her mentor live less than a mile from each other. She is looking forward to being a resource to other survivors.

Her strong team of doctors is “gonna be my best friends for many years,” she said.

Most of all, she said she is grateful for the support of her husband and children.

“You reevaluate,” she said. “It’s so clear now what’s important.”

With October marking Breast Cancer Awareness month, several local women are sharing their stories to encourage early detection and treatment.

Discovering the lump

When Diane Spino discovered a lump in her left breast in September 2005, she thought it would go away.

By October, she knew she was in trouble.

At 51, she had no children, drank and had smoked. She had been told those put her at a higher risk.

“I called my gynecologist and they squeezed me in within a half hour,” she said. “That day, I was seeing a plastic surgeon.”

Spino was diagnosed with stage 3 invasive ductal carcinoma. She consulted with an oncologist and a radiologist who told her if she had a mastectomy, she would not need radiation.

“I did not want to do radiation,” she said.

From left, Amy Brickner, Teresa Brickner and Jenny Sugg.

After consulting her doctors and friends in the medical field, Spino had her left breast removed.

“If [the cancer was] aggressive, I [was] gonna be aggressive right back,” she said. “You need to act quickly. A lot of people are in denial of their problems and wait too long — then it’s too late.”

Risk factors

Dr. Charu Trivedi, who practices oncology and hematology at the Toledo Clinic and the Monroe Cancer Center, specializes in breast cancer.

She said breast cancer is the most common cancer among women —194,000 cases a year are diagnosed.

Research has advanced in recent years, but has a long way to go, Trivedi said.

“We have good ways to prevent breast cancer and treat it effectively when diagnosed early,” Trivedi said. “Detection and prevention are the best treatments.”

Trivedi said women who are older and haven’t had children are at higher risk. Other risk factors include being female, of certain ethnicities like Hungarian and Swedish, and a family history of breast cancer. Trivedi said people with multiple first-degree relatives and male family members with breast cancer are more likely to develop the cancer. She said people who have had multiple or abnormal breast biopsies or ovarian, fallopian tube or peritoneal cancers are at high risk, as are people who drink a lot of alcohol, eat a high-fat diet or have been exposed to radiation. Women who started menstruating younger than 12 years old or have menopause after 55 are also at risk.

Early detection

Trivedi said women in their 20s or 30s should do monthly self breast examinations and get clinical breast exams every two to three years.

“Be vigilant,” she said. “We see cancer in younger women, too.

“Put your fingers together and examine your breast,” she said. “If you feel a lump, bring it to the attention of your doctor or gynecologist.”

A mammogram is one cheap screening tool, Trivedi said. Mammograms are recommended for women 40 years and older. Women with a family history of breast cancer should start getting mammograms at 10 years younger than the youngest family member was when diagnosed.

For women without health insurance, funds are available to help, Trivedi said. The American Cancer Society, Susan G. Komen Foundation and some pharmaceutical companies have programs to help with costs, said Gayle Young, marketing specialist for the Toledo Clinic.

“These foundations and drug companies are very generous,” Trivedi said.

Sue Whatley, 80, was diagnosed with stage zero breast cancer in 1999. She had no family history and had yearly mammograms since she was 25.

“I knew from my family doctor that I should be having them every year,” she said. “This is how it was discovered.”

Her mammogram showed abnormal cells and her doctor advised her to return in six months. Whatley said, “No.”

“If there’s anything in there that’s abnormal, I want it out,” she said. “I wouldn’t be able to sleep at night wondering: ‘Is it there? Is it growing? Even though I don’t feel anything, if I wait six months … it’ll get worse.’”

She had a lumpectomy to remove the abnormal cells and takes anti-cancer drugs.

Whatley’s strict mammogram schedule aided her diagnosis, she said: “They had all these pictures to go by and compare.”

Whatley’s cancer had not spread. After surgery, she said she experienced no pain, even though her doctor told her regaining mobility in her right arm would take time.

“Follow your doctor’s instructions to a T,” she said.

Genetic testing

“What I see day-to-day is women who have family members with breast cancer or an abnormal gene in family,” Trivedi said. “The majority of cancer is sporadic, but familial is what bothers people most.”

Genetic testing is another tool doctors can use for families with history of breast cancer.

Teresa Brickner had a mammogram in 2006 that showed an abnormality. Her doctor told her to come back in six months.

“I came back and what they saw prior had greatly increased,” she said. “I went immediately to my OBGYN … and was in the surgeon’s office in two days.”

During her lumpectomy, doctors found a second type of cancer. She underwent another surgery, chemotherapy and radiation.

Teresa had no family history of breast cancer.

Her daughter, Jenny Sugg, was diagnosed at 28, after the birth of her second child. Jenny’s cancer was stage IV and attacked her bones, liver and right breast.

After Teresa’s diagnosis, she had asked about genetic testing for her girls. Her husband Dave’s mother had died of breast cancer. The doctors said it wasn’t necessary.

“If we knew what we knew today, we would have been persistent,” she said.

Teresa carries the gene for the BRCA2 mutation and Dave carries the gene for the BRCA1 mutation.

Daughter Amy inherited neither mutation, son Ryan carries the BRCA1 mutation and has a 50 percent chance of passing it on to his children.

Jenny got both.

“My No. 1 advice to anyone [is] if you have a family history on either side, get the early testing done,” Theresa said. “It was devastating when I heard those words myself, but it was far worse when I heard them for my daughter.”

Teresa, a nurse, said doctors are getting better about getting complete family histories.

Jenny had had breast exams, Teresa said. Doctors thought abnormalities were because of her pregnancy.

“You can’t ask why now. You have to deal with it and make the best of it. We live each and every day to the fullest and the things that were important, or we thought were important, aren’t important,” she said.

In June 2008, Jenny’s cancer spread to her lungs and more of her liver and bones. Recent scans show no new cancer and the cancer she has is shrinking.

“She is not dying of cancer; she is living with cancer,” Teresa said. “I have my tests and wonder when it’s gonna come back. She has her tests and scans and wonders where it’s at and if she has any new spots. Whatever stage you’re at, you worry about different things.”

Treatment

Breast cancer is either invasive or non-invasive, Trivedi said.

Non-invasive is confined to the ducts and lobes of the breast and called stage zero breast cancer. Invasive has spread.

“If you discover a lump, immediately go to your doctor,” Trivedi said. “You don’t want to delay it. Your doctor will direct you appropriately.”

She said many biopsies are performed by radiologists, eliminating the wait for a surgeon and minimizing diagnostic time.

Treatment depends on the stage.

“When cancer is detected, we want to see it confined,” Trivedi said.

Doctors will remove a lump if they think the abnormality is confined. If not, a better choice is to remove the whole breast, Trivedi said.

After removal, doctors evaluate the risk of cancer returning. Drugs are available to prevent cancer recurrence. Chemotherapy drugs are used to treat breast cancer and radiation sterilizes the area surrounding a tumor or affected lymph nodes so abnormalities don’t grow back, Trivedi said. If cost is an issue, help is available.

“Talk to your doctor,” Trivedi said. “Don’t just stop taking the pills because you can’t afford them.”

Tags: breast cancer

This entry was posted on Thursday, October 15th, 2009 at 7:49 pm and is filed under Community, Featured, Health Care.
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