Treating Genetic Breast Cancer

Organization: Service: Story Topics:
Breast Cancer

With a maternal grandmother, mother and aunt who developed breast cancer at an early age, Tara Stein had been on the alert for the disease and received annual mammograms, monthly breast self-exams and regular checkups. But when Tara, a 49-year-old Rossmoor resident, discovered a small abnormality in her breast, she assumed it was a pulled muscle.

“It wasn’t even a lump,” says the physical fitness advocate. “It felt like a tiny flap of tissue.”

Detecting Breast Cancer

Four months later, while having her annual mammogram at the MemorialCare Breast Center in Long Beach, Tara casually mentioned her finding. Since she had dense breast tissue that could hide potentially dangerous growths, MemorialCare Todd Cancer Institute radiologists performed two mammograms and an ultrasound, which revealed a thin, flat tumor about three-quarters of an inch long. A biopsy identified the growth as an aggressive subtype of breast cancer that starts in the milk ducts and can quickly invade surrounding tissue and move to other parts of the body.

Advanced Treatment

Alarmed, Tara met with a nationally respected breast cancer specialist at the MemorialCare Breast Center to review her treatment options. An MRI showed that there were no additional tumors in her breast, but a biopsy of Tara’s sentinel node—the lymph node through which any cancer cells must first pass to other areas of the body—indicated the cancer had begun to spread. Tara’s form of the disease was called “triple negative,” meaning the tumor was not responsive to three common treatments including estrogen, progesterone or trastuzumab (Herceptin).

However, Tara qualified for a clinical trial that involved intensive dosages of epirubicin (Ellence) and docetaxel (Taxotere). After discussing the study and considering other options, Tara agreed to participate in the 12-week course of chemotherapy. “I always felt I was being taken care of by one of the best doctors in the world,” says Tara, who experienced minimal side effects from the treatment.

Genetic Testing

But Tara’s cancer journey wasn’t over. A multidisciplinary team of MemorialCare Todd Cancer Institute specialists who meet every week to discuss treatment plans for individual patients recommended that Tara undergo genetic testing. Women of Ashkenazi (Eastern European) Jewish heritage such as Tara are prone to inherited mutations on the BRCA1 and/or BRCA2 genes, significantly increasing their risk of breast and ovarian cancer.

A few days after having a DNA blood test, Tara learned she had the BRCA1 mutation. There were two treatment choices. The first was a program of frequent testing for breast and ovarian cancer. The second was preventive surgery—the removal of both breasts, several lymph nodes, uterus, ovaries and fallopian tubes. “I was aware of the high odds for developing future breast and ovarian cancer and decided surgery was the best option for me,” says Tara. 

She underwent a seven-and-a-half hour operation. Her surgery was followed by a rapid recovery. “I was in good physical condition and a laparoscopic hysterectomy was performed as a minimally invasive procedure, which made my recovery much easier,” says Tara. “It also helped that my husband was very supportive and my kids—David, who was 19 at the time, and Caryn, who was 13—handled it so well.” Soon after, she had reconstructive breast surgery at Long Beach Memorial.

Knowing there is Hope

Today, Tara is free of cancer. She’s also enjoying a newfound career as a volunteer, acting as a mentor in a Long Beach Memorial program called Women Guiding Women peer mentor program. The program matches newly diagnosed patients with breast cancer survivors who provide support, information, encouragement and friendship. She’s also active in another volunteer group at the hospital called Wings, which involves visiting patients in the oncology unit once a week. “I’ve had cancer and can relate to what patients are going through,” says Tara. “I want them to know there’s hope.”