After being diagnosed with breast cancer in September 2017, Teresa O’Malley, 63, of Mountainhome, Pa., is ready to put her cancer experience behind her. However as a surgical nurse at Lehigh Valley Hospital (LVH)–Pocono, O’Malley knows her experience can educate others. O’Malley, who has no family history of breast cancer, never imagined she would face a breast cancer diagnosis and credits her routine mammogram for finding the cancer early.
“That is what’s so important about this story,” O’Malley says. “They found my cancer using a routine screening mammogram. They were able to spot my small tumor from one year to the next.”
The tumor indicated early stage invasive ductal cancer of the right breast. The cancer had not spread to the lymph nodes. O’Malley immediately turned to the breast cancer team at the Dale and Frances Hughes Cancer Center, directly across the street from her workplace at LVH–Pocono.
Trusting in the team
“There’s a lot coming at you at once. The first day, when you meet the whole team, you’re still trying to get your head around the fact that you have cancer,” O’Malley says. “But I had to trust them. I’m in the health care business, but I’m not a cancer specialist.” The multidisciplinary breast cancer team that O’Malley met with included radiation oncologist Charles Andrews, MD, with Allentown Radiation Oncology Associates, medical oncologist Sonyo Shin, MD, with LVPG Hematology Oncology and surgical oncologist Lori Alfonse, DO, with LVPG Surgical Oncology. That collaborative team practice is one aspect of the comprehensive care offered at the Dale and Frances Hughes Cancer Center, which recently was extended membership in the Memorial Sloan Kettering Cancer Alliance.
The team concluded that the favorable characteristics of O’Malley’s cancer made her an ideal candidate for a breast conserving surgery. Alfonse performed the lumpectomy within the week, and although the tumor was small and hard to reach, the surgery was a success.
“Targeting the tumor was challenging, but our breast imagers provided appropriate pictures and targeting tools so that I could get the cancer out and still provide Teresa with a breast shape that is similar to what she had before surgery,” Alfonse says.
Guidance from genomic testing
The lumpectomy was the first step in O’Malley’s cancer treatment. To pinpoint the next move, Shin ordered a genomic test called Oncotype DX® which uses a sample of the breast tissue that was removed.
“The size and characteristics of Teresa’s cancer made her a perfect candidate for the Oncotype DX test, which predicts her breast cancer recurrence and helps us make a decision about whether or not to offer chemotherapy,” Shin says. With a low score on the test, the team decided against chemotherapy and proposed radiation therapy along with hormonal, or endocrine, therapy as preventative measures against breast cancer recurrence.
“There is no sign of any malignancy at this point, so the radiation is a preventative measure,” Andrews says.
“We treated Teresa using a 4-week course of treatment, and she did very well, finishing radiation treatment in December.”
O’Malley began hormonal therapy in November 2017 and was recommended to participate in the Breast Cancer Index test. This test analyzes the activity of seven genes to help predict the risk of breast cancer recurrence. It can help women, along with the recommendations from their doctors, decide if extending hormonal therapy another five years would be beneficial.
Regular mammogram = early stage diagnosis
“Teresa is the perfect example of early stage, standard of care breast cancer treatment, and it highlights the importance of screening and early treatment,” Shin says.
Looking back, O’Malley feels fortunate to have had her cancer diagnosed so early, and urges women to get their annual mammogram done. The early diagnosis allowed O’Malley to put things into perspective and remain positive throughout her journey.
“Teresa’s positive attitude is something that, no matter how great I am as a surgeon, Dr. Andrews is as a radiation oncologist, and Dr. Shin is as a medical oncologist, we can’t give that to a patient,” Alfonse says. “Teresa brought her positive attitude to the table and it made a big difference.”