Health & Fitness
Breast cancer battle
By Anna Lamy | Hernando Today
Published: May 2, 2011
Several weeks ago in a recent article about organ donation with Steve Davey, his wife, Davey was present, she advised me of her recent diagnosis of breast cancer.Published: May 2, 2011
Becky Davey of Brooksville, at the age of 49, was diagnosed with breast cancer. She has worked in the medical community for more than 22 years.
Her story begins as it does for many women, going to a local hospital for her regular mammogram screening.
She went to Brooksville Regional Hospital for a digital mammography.
Patti Robbins, director of diagnostic imaging at Spring Hill Regional Hospital mentioned digital mammography is faster than the traditional film version, because there is no film to develop.
"The image is sent immediately to a radiologist for review," Robbins said, "it is a benefit to the patient because it is a better image quality, which is impressive compared to traditional mammograms."
Should the image be unclear, the image can be retaken immediately, Robbins added.
Amy Moore, director of diagnostic imaging at Brooksville Regional Hospital advised, the hospital's technologists are specially trained and state certified in mammography.
"They are able to view an image and immediately retake an unclear image," Moore said, "reducing the patient's amount of time in compression and ensuring that the radiologist will have the best image to read."
This helps to eliminate the need for callbacks and added stress on patients, she added.
According to the National Cancer Institute, in comparing results of traditional mammography to digital, there was greater accuracy with digital for diagnosing patients who are younger than age 50 with cancer.
"The digital mammography image displayed an area of concern on my left side," said Davey.
This is significant, as women under the age of 50 and for those who have denser (not fatty) breast tissue.
The digital mammography offers less exposure to radiation, reducing a person's overall exposure during their lifetime.
"After the initial sighting, I needed to go for a spot compression," said Davey. "Due to having fibromyalgia, the 'squishing' from this procedure pulls on my nerves causing pain through my jaw, neck, shoulders, which can last for more than a couple of days."
In lieu of having spot compression, her physician ordered an MRI, which was done at Spring Hill Regional Hospital.
"A spot compression is used to get a better view of the tissue," said Robbins. "A spot compression and MRI are tools used to further determine the initial findings, to provide additional information for the patient and physicians in the diagnosis."
Sometimes having a spot compression can be difficult for a patient, Robbins added.
"The recommendation for an MRI can be done through the radiologist, patient or referring physician," said Robbins.
This procedure did provide a better image of my left side for the doctors, Davey added.
After being confirmed that there were tumors present in her left breast, Davey choose to have her procedures done at H. Lee Moffitt Cancer Center & Research Institute in Tampa.
From her appointment at Moffitt, she had to undergo a spot compression for the surgeons to map out where the tumors were located for the punch biopsy.
"The biopsy revealed I had two tumors in my left breast," Davey said, "One as an invasive ductal carcinoma, high grade and the other was a focal ductal carcinoma in situ, high grade, from the pathology report."
Invasive ductal carcinoma (IDC) is the most common form of invasive breast cancer that is diagnosed.
The prognosis of IDC depends upon the tumor, as it relates to its size, whether it is affecting the lymph nodes, histological grade, cancer presence in small vessels, hormone receptors and oncogenes, called HER2/neu. This stands for 'Human Epidermal growth factor Receptor 2'. HER2/neu is a protein which signifies a higher aggressiveness in breast cancers, found during lab testing.
For Davey, both the tumors found had these markers for being the aggressive types of cancers.
Ductal carcinomas are cancer tumors that develop within the milk ducts of the breast. The term 'in situ' means in place, as the tumor has not moved outside of the duct.
"I had to make a decision," said Davey, "I decided due to this diagnosis, I wanted to have a BRAC test done."
BRACAnalysis® is a genetic testing that determines the risk a person has to developing breast or ovarian cancer. It is not a test for cancer, but is a test for Hereditary Breast and Ovarian Cancer (HBOC) syndrome, done so by a simple blood test.
The testing is recommended for those who have had a diagnosis of breast cancer prior to the age of 50, ovarian cancer, two primary breast cancer diagnosis in an individual, both breast and ovarian cancers in an individual, male breast cancer at any age, two or more breast cancers in a family (one under age 50), Women of Ashkenazi Jewish descent with breast or ovarian cancer at any age, or with a previously identified BRCA mutation in the family.
This test is helpful for any woman who may be at risk for cancer by providing information to start screenings earlier, developing an action plan to minimize risks, preventing a second cancer diagnosis and to help educate relatives pertaining to the inherited risks in the family.
HBOC syndrome causes about 10 percent of the breast and ovarian cancers, according to Myriad Genetics Laboratories, Inc. They report that this can also increase the risk for these cancers in women under the age of 50, and can be inherited or passed on in a family.
This is most often seen in mutations or alterations of the BRCA1 and BRCA2 genes.
Davey's test results were positive for both these genes.
Prior to the surgery, and part of the staging process for a cancer diagnosis, she had a dye test done to check her lymph nodes under the arm. This is to check if the cancer has spread or is present in that area. This type of spreading is also known as regional spread.
"Because the two masses were within being an inch apart, located in separate ducts and being a candidate for developing breast and ovarian cancer," said Davey, "I chose to have a double mastectomy (removal of the breast) and an oophorectomy (removal of the ovaries)."
My surgeries lasted about six hours, she added.
"I wasn't sure initially if I wanted to have reconstructive surgery afterward, but because the plastic surgeon and oncology surgeon need to work together in where to place the incisions," said Davey, "I decided to go forward with the reconstructive surgery, which places the incisions closer to the underarm, where scarring is less visible.
Her follow-up treatment requires her to have eighteen weeks of chemotherapy. Because her cancer was aggressive and non-reactive to hormones, she is having a series of four types of chemo in two cycles.
This is to 'kill' any small pieces that may be remaining, to prevent a reoccurrence.
After her chemotherapy, she will undergo the procedure for reconstruction.
The process for her reconstruction involves expanders placed in the breast, called two-stage reconstruction. She has expanders placed under the skin and chest muscle, which has a small valve under the skin for the surgeon to inject saline solution in regular intervals to expand the skin. This process takes about four to six months, depending on whether the skin is stretched enough for the procedure.
The final procedure removes the expanders and the surgeon inserts the implants. This is delayed until after the chemotherapy is competed.
Her check-ups in the future will start with one every three months, with the oncologist, with it dropping to once every six months for five years.
"In amidst all that I am experiencing, I confess that my faith in God has helped and his healing plan has been the number one thing to get me through" said Davey.
I have always said 'faith, family and friends is what sustains us on this earth', Davey added.