Fighting The Good Fight

When a little voice spoke to Janet Phillips, she listened, and it may have saved her life.

In 2006, the then-44-year-old Phillips went to her doctor for a routine well woman check. The doctor found some thickening in her right breast. Her mammogram came back clear, so Phillips was sent for an ultrasound.

“The radiologist said it was just fibrocystic thickening, it was something I’d always had,” says Phillips. “[The radiologist] started to put the wand away when I heard a little voice say, ‘You need to check the left side.’

“I looked at the doctor and said, ‘I really feel like we need to check the left side.’ Within seconds they found something that worried them.”

The Best Advice

The worrisome spot in Phillips’ ultrasound turned out to be early stage invasive lobular carcinoma, a less common form of breast cancer. The majority of breast cancer cases – 80 percent – involve invasive ductal carcinoma.

“Invasive ductal carcinoma is by far the most common type of invasive breast cancer,” says Dr. Chad Johnson, a physician with Warren Clinic Breast Specialists. “It gets its name from the fact that it begins in the cells that line the ‘tubing,’ or the ducts that deliver milk to the nipple. This is in contrast to invasive lobular carcinoma, which begins in the milk-producing glands and causes about 10 percent of breast cancers. The final 10 percent of breast cancers encompass a wide array of various types.”

It’s important that women pay attention to all signs of potential breast cancer when performing self-exams and not just feel for lumps. Invasive ductal carcinoma often presents as a lump; invasive lobular carcinoma, Phillips’ cancer type, often presents as a thickening of tissue and, in early stages, may go undetected on mammograms. For Phillips, the fact that she could not detect her cancer during self-exams was unsettling. “It was weird because I felt a real uneasiness that it wasn’t anything that was detectable by hand,” she says.

Phillips says she was glad she followed her instinct because, had she waited until the following year, the cancer could have been more advanced. “My mammogram came back clear,” she says. “Without the ultrasound, it would have been at a much greater stage. When we caught it, it was in a very early stage and hadn’t moved to lymph nodes. I was blessed to hear that little voice in my heart.”

“The two most common ways breast cancer is discovered is either by the patient feeling a lump or by a yearly mammogram,” says Johnson. “However, there are other symptoms that can be concerning for cancer. Bloody nipple discharge, nipple retraction, skin dimpling or skin color changes are all potential signs of a cancer and need to be thoroughly examined.

“I cannot stress enough the importance of regular self-exams and yearly mammograms along with an annual exam by a physician,” he continues. “Most breast cancers – more than 90 percent – can be located with these three steps. But it is also important to know what to look for on a self-exam. Of course, there is the exam of the breast tissue for lumps, but it is also important to examine the skin for any changes. Looking for skin color changes or dimpling of the skin and nipple are concerning signs that need to be examined by a physician. Many women are concerned that they don’t do their breast exam ‘the right way.’ I stress that there is no right way; what is important is to perform the exam regularly so that each woman knows what her normal tissue looks and feels like. That way, she can call the doctor any time there is something that strays from the normal exam.”

What Is And What Will Be

One in eight women will develop breast cancer. Unfortunately, the biggest risk factor is one that we cannot control: age. “If you live to be 110, you have an 80 percent chance of developing breast cancer,” says Dr. Shubham Pant, assistant professor of medicine and director of clinical trials in the hematology/oncology section of the Peggy and Charles Stephenson Oklahoma Cancer Center. The good news is that research is constantly yielding new information that aids in the treatment of breast cancer and brings researchers closer to finding the cause and subsequent cure.

Pant says developments in the last decade point to more personalized care that is tailored to each breast cancer patient.

“Just as all of us have a different fingerprint, every breast cancer has a different fingerprint,” Pant says. “There are now tests that evaluate the genes in cancer, and based on that, we can tell if the patient will need chemotherapy or hormonal therapy to treat the cancer. The cool thing about that is that we can select a group of patients that doesn’t need chemo, which has lots of side effects both physically and psychologically. (The test) improves the morbidity. A woman who comes in at early stage, I can look at her tumor and test her tumor and say, ‘This treatment is for you.’ That’s what we’re going towards in breast cancer.”

Pant sees tremendous growth in breast cancer treatment in the next decade, as well. Researchers have determined that identifying the “driver” mutation, the one responsible for producing cancer cells, can lead to a customized treatment plan to target that small group of cells and, ideally, stop the mutation.

“There may be 10 different mutations in the tumor, but there are only a few that are causing the cancer cell to grow,” Pant says. “The basic thing (about cancer) is that something goes rogue. The body has mechanisms to kill these rogue cells or put them back in line. Most of the time the body can identify those cells and throw them out; but mechanisms get worse with age, and these cells keep dividing and develop mutations. If we can identify the driver mutation, we can turn the switch off, find the Achilles heel in the tumor and target drugs toward this mutation.”

Sassy Survivor

Phillips is cancer-free for seven years now. She credits her faith, along with support from friends and family, with helping her through her cancer diagnosis and subsequent treatment. She has extended her circle of friends since her diagnosis by starting a support group for breast cancer survivors called Sassy Sisters In Christ.

“I knew how hard it was for me to get through,” Phillips says. “With the support group we do, we try not to focus on the thing, but instead, we focus on how we’ve healed. I’m not nearly the person I was seven years ago.”

It’s the small survivor groups like Sassy Sisters as well as large, national breast cancer organizations that continue to drive awareness and research efforts of the disease.

“The survivors have done a lot of work in improving the science in the disease,” Pant says. “That’s very unique to breast cancer and has led to a lot of discoveries. We are further ahead in breast cancer than in a lot of other cancers.”