I was asked if I would do an interview for an article in the Memorial Herman Cancer Journal. It is published a few times a year.
At first, I was a bit hesitant about sharing so much of my story but then I decided maybe if I told my story it might help someone else.
I hope this gives every woman with breast cancer some insight on genetic testing and how important it is, after all, it saved me from having to do chemo and that is a really big deal. Most insurance will pay for this testing because if you do not need chemo it saves them a lot of money.
This article just went online Wednesday I have copy/pasted it below as well as put the link to the actual article on this page.
Thanks to Advanced Genomic Testing, Breast Cancer Survivor Skips Chemotherapy
Sonya Lira has a strong family history of multiple cancers, but when she was tested for genetic mutations that might be linked to her breast cancer, there were none.
“We did comprehensive genetic testing involving a complete gene sequencing of her DNA, testing for all known mutations,” says Anish Meerasahib, MD, a medical oncologist with Texas Oncology, who is affiliated with Memorial Hermann Southeast Hospital and Memorial Hermann Pearland Hospital. “None came back positive.”
Lira’s cancer experience began when she got a call back after a 3-D tomosynthesis mammogram at the Memorial Hermann Outpatient Imaging Center in Pearland. Her biopsy showed early-stage invasive ductal carcinoma of the breast.
At the Memorial Hermann Cancer Center-Southeast, she met with Oncology Nurse Navigator Krystie Fenton, BSN, RN, OCN.
“I wouldn’t have made it through without Krystie,” Lira says. “She provided enormous support and also connected me with my amazing treatment team – Dr. Meerasahib, Dr. Garner and Dr. Yang.”
Glen Garner, MD, a general surgeon affiliated with Memorial Hermann Southeast Hospital, scheduled her for surgery in December 2017. “Given the small size of the tumor, we thought it would be an uncomplicated lumpectomy,” he says. “We removed six sentinel lymph nodes, and when our pathology team examined them, one of the nodes was positive. The tumor biopsy came back with three margins positive for microscopic ductal carcinoma in situ. This was unusual and unexpected in Mrs. Lira’s case, because none of the evidence we had pointed to it.”
“Dr. Garner said we could go back to surgery and try to get clear margins, but if we didn’t get them, I would have to go back to the OR again for a mastectomy,” Lira says. “I said, ‘What if we just go ahead and do a mastectomy?’”
Dr. Garner removed her right breast in January 2018. “I was dreading it because I don’t like to take pain pills,” she says. “But to my surprise, I had no pain after surgery, which was wonderful.”
Her multidisciplinary treatment team recommended radiation to that area of the breast, and as soon as her scars had healed, Lira was scheduled for 33 radiation treatments with Ted Yang, MD, an affiliated radiation oncologist at the Memorial Hermann Cancer Center-Southeast.
“A few years ago we automatically gave patients like Mrs. Lira chemotherapy, hoping that the cancer wouldn’t return, but new data has given us a different perspective on treatment, which has evolved remarkably in the last few years,” Dr. Meerasahib says. “We did the Oncotype DX® test on the tumor sample, which calculates a breast recurrence score that quantifies the risk of recurrence and shows the potential benefit of chemotherapy.
Her score was low, which means she would not derive any significant benefit from chemotherapy. She was fortunate. If we had not ordered that test, reflexively we would have given her chemotherapy.”
Testing showed that her tumor was positive for estrogen and progesterone but negative for HER2/Neu. “When there are microscopic cells, they could evolve into cancer in the future. We started her on Letrozole®, an aromatase inhibitor and anti-estrogen medicine used in the treatment of hormonally responsive breast cancer.
Her chance of cure is in the range of the high 90th percentile. My plan is to keep her on Letrozole for at least five years, and we may extend it longer depending on her how well she does.
“Mrs. Lira’s case was unusual in that she presented with a small breast tumor that involved the lymph glands,” he adds.
“Generally when there is involvement of the lymph glands, the tumor is aggressive, but in her case it wasn’t, as confirmed by further testing that told us more about her very favorable tumor biology. These newer tests help us choose personally tailored treatments that are more effective.”
Lira says she knew she had cancer even before the biopsy. “I knew it from the time I got the call back from the Outpatient Imaging Center. But I was always positive about the outcome,“ she says.
“I’m really pleased with all my doctors. I couldn’t have gotten through my breast cancer diagnosis and treatment without them and without surrounding myself with supportive, positive family and friends – and most of all my husband, Jack, of almost 40 years.”
During the course of her treatment, Dr. Meerasahib ordered a bone density scan that revealed mild osteopenia. He prescribed a new medication delivered by injection every six months to prevent the disorder from progressing to osteoporosis.
Lira, who is 58 and a former smoker, also had a low-dose CT scan for lung cancer. She met the criteria: ages 55 to 77 years, asymptomatic of lung cancer, tobacco smoking history of at least 30 pack-years and a current smoker or one who has quit within the last 15 years.
The scan revealed a few spots that are too small for a PET scan or biopsy.
“It’s extremely unlikely that the spots are related to breast cancer, and most of the time lung nodules are benign,” Dr. Meerasahib says. Lira is seeing pulmonologist Mohammad F. Siddiqui, MD, also affiliated with the Memorial Hermann Cancer Center- Southeast, who will have the nodules rescanned at three months.
“Mrs. Lira has a comprehensive idea of her disease process and is always willing to take the extra step to improve her health,” Dr. Meerasahib adds. “She’s a joy to work with.”