As Amber Pritchett was doing a breast self-examination in early spring, she found a lump.
The 33-year-old human resources employee at Mercer University didn’t think much of it since no one in her family had breast cancer.
She decided to wait to mention it to her gynecologist at her regular exam in May.
“It’s probably nothing to worry about. Probably just dense breast tissue,” the doctor told her.
Pritchett was decades away from the median age of 62 for breast cancer diagnoses in women.
To be safe, Dr. Kerry Holliman ordered an ultrasound in June, but Pritchett wasn’t worried.
“I was expecting them to say, ‘Oh, you’re fine,’ ” Prichett said. “When they pulled me into a consultation room and asked if I had anyone with me, I knew it wasn’t good.”
Forty-one-year-old Robin Cross, whose family farms 1,800 acres in Unadilla, noticed a cyst on her breast early this summer.
The busy mother of three boys aged 16 to 20 had similar ones before that her gynecologist removed.
In the throes of a membership drive for the Big Red Booster Club of Hawkinsville High School and managing their rental condo near Savannah, she decided to put off going to the doctor.
She increased her intake of Vitamin E and cut back on coffee, as her doctor previously suggested.
Her malignant tumor was four to five centimeters, or nearly two inches in diameter, when she was diagnosed Aug. 28.
“I had no family history or any kind of risk factors, just a little overweight,” Cross said. “You don’t expect something like this to be the worst.”
Although having a close relative with breast cancer can double or triple your risk, Dr. Paul Dale, a cancer researcher and surgical oncologist, warns against discounting your chance of developing the deadly disease.
“Most women who have breast cancer don’t have a family history,” said Dale, cancer director of the Peyton Anderson Cancer Center, Navicent Health, in Macon.
About 70 percent of women diagnosed have no significant family risk factors, he said.
Dale recommends regular mammograms for women beginning at age 40, unless there is a significant family history of a mother or sister being diagnosed before that age.
He has noticed a shift to younger women developing cancer, but breast tissue in most women in their 20s and 30s is too dense for effective mammography.
“Screening a 20-year-old with a mammogram would be useless,” Dale said. “Knowing more about genetic history and markers will help us more.”
Genetic testing becoming invaluable
Angelina Jolie’s startling double-mastectomy revelation published in The New York Times in May 2013 shined the spotlight on the role genetics plays in assessing breast cancer risk.
Jolie’s mother died at age 56 after fighting cancer for almost a decade.
The Hollywood actor and humanitarian carries a “faulty” BRCA1 gene that gave her an 87 percent chance of developing breast cancer and a 50 percent risk of ovarian cancer, her doctors said.
“Less than 10 percent of women with breast cancer are of this genetic makeup,” Dale said.
Genetic testing currently costs upward of $2,000, which makes it cost prohibitive for widespread use, he said.
Perhaps in the next decade it will be more prevalent as prices decline, he said.
Genetics also plays a role after diagnosis.
Tumor samples are studied to determine if any genetic mutations are influencing the cancer cells.
In Pritchett’s case, she had a lumpectomy this summer to remove the tumor and save her breast.
She thought she could bypass chemotherapy and follow up with radiation therapy, but she tested positive for the HER2 gene that triggers more aggressive growth.
Her cancer also is hormone-receptor positive, which means her breast cells feed on estrogen and progesterone signals that hasten growth.
Pritchett has had three of eight rounds of chemotherapy before she begins radiation treatments.
“Because I’m very young, they thought they’d throw the book at me,” she said.
Breast removal not the only option
In the past century, breast cancer treatment has changed dramatically.
When a woman was diagnosed 100 years ago, doctors surgically removed the breast, chest wall, muscles and lymph nodes.
“We’re making advances to try to offer women less invasive ways to treat their tumors,” Dale said.
Radical mastectomies eventually moderated to where only the breast and lymph nodes were removed.
Nowadays in a lumpectomy, only the tumor is removed and sentinel lymph nodes.
“The sentinel node is the first node,” Dale said. “A sentinel is the first guard that gets shot.”
While Dale was at the John Wayne Cancer Institute in California in the ‘90s, sentinel lymph node biopsies were first performed on breast cancer patients.
Doctors inject dye into the cancer and track it as it goes to the first lymph node. If that node is cancer free, it indicates the cancer has not spread.
Dale also reports radical improvements in radiation therapy since the advent of partial breast irradiation in 2004.
When a tumor is removed, a balloon-like device with a tail is inserted.
Beads of radiation are inserted through the tail to target where the tumor had been.
Doctors are beginning to experiment with using radiation during a lumpectomy, which would further shorten recovery time.
“Every time we make a step we move in a more positive direction,” Dale said. “Research allows us to make changes.”
Breakthroughs also are coming where women can opt for new alternatives to chemotherapy.
“They are developing immunoreceptors to fight cancer instead of injecting your body with poison,” he said.
For example, the drug Herceptin is a type of antidote for HER2. It attaches itself to the breast cancer cells, blocks growth signals and stops the spread of cancer.
Fighting for life
Robin Cross’s mother-in-law is now cancer free after battling breast cancer in recent years.
Watching the mother of her husband of 22 years go through treatment, she never thought she would be next.
“You never really expect it to be that bad news,” she said.
As Cross began considering her options with the help of nurse Kim Lewis at Georgia Cancer Specialists in Macon, she opted to have a double mastectomy.
“I have tumors on one side, but I just decided to do the double mastectomy to lesson the risk factors,” Cross said.
The American Cancer Society reports a woman with cancer in one breast has a higher risk of developing cancer in the other breast. The overall risk is low, but it’s higher the younger you are.
Over the next year or so, Cross will have six chemotherapy treatments, a double mastectomy and radiation.
She chopped off her long, strawberry blonde hair to prepare herself for the loss of locks to come.
“My boys are like, ‘We’re going to shave our heads, too,’ ” she said.
Her husband, Todd, is busy in the fields this time of year, but he hasn’t missed an appointment with her.
“I couldn’t do this without him,” she said of her husband, who also survived mouth cancer two years ago.
“I’m determined to keep my sense of humor through this and my positive spirit,” Cross said. “I could be miserable every day and say, ‘Why me?’ but what good would that do me?”
Amber Pritchett bought a wig before her hair began to fall out. She learned how to tie headscarves by watching YouTube videos.
As she sits for three hours of chemotherapy, husband Rhett Pritchett is by her side.
He is a youth pastor at Strong Tower Fellowship in Macon.
“It really is a beautiful thing to see the body of Christ come together when one of their members is struggling,” she said.
She’s battling with occasional tears, nausea, fatigue and loss of appetite but feels blessed she caught her tumor when she did.
“I had no signs this would ever happen to me,” Pritchett said.
She stands on faith that she will survive.
“Had it been a few months longer, or a year longer, it may not be the same story,” she said.
Cross, too, has all her friends praying and is advocating for regular breast self-exams and seeking care immediately.
“Don’t be too busy to go to the doctor because it is a priority,” she said. “I felt I haphazardly found it. If I was doing self exams every month, I might have found it sooner.”
Breast cancer warning signs
▪ Lump, hard knot or thickening inside the breast or underarm area
▪ Swelling, warmth, redness or darkening of the breast
▪ Change in the size or shape of the breast
▪ Dimpling or puckering of the skin
▪ Itchy, scaly sore or rash on the nipple
▪ Pulling in of the nipple or other parts of the breast
▪ Nipple discharge that starts suddenly
▪ New pain in one spot that does not go away
If you notice any of these symptoms, please see your doctor.
Source: Susan G. Komen