Amy's Story (Breast Cancer)
Breast cancer - for many women those are two of the most feared words in the English language. For Amy, knowing her grandmother had died of untreated breast cancer meant the disease was part of her history, but it never weighed heavily on her mind. She routinely scheduled annual mammograms and periodically performed breast self-exams. Every year she was rewarded with reassuring results from her doctor and went on with her busy life as a music producer.
This year was different. Her routine mammogram triggered a four-month, high-speed medical journey. Just two weeks after her screening mammogram, Amy was sitting in a medical office at the Cherry Hill Campus of Swedish Medical Center listening to a doctor tell her she needed a biopsy. The lump, which was detected on the mammogram and confirmed by the ultrasound, was very small - so small that even the well-trained, sensitive fingers of several physicians could not detect it.
All Amy remembers of the call she received the day after her biopsy was hearing the word "unfortunately." The remainder of the conversation was a blur as she was already wondering, "What do I do next?"
Throughout the next several months, Amy had one guiding principle. She was determined her surgery and post-surgical treatment would be the most effective and the least invasive. Along the way, she asked each of her physicians to embrace that principle.
"The goal with any breast cancer surgery is to balance what is medically appropriate with the patient's desire to conserve her breast," says Patricia Dawson, M.D., Amy's surgeon at Swedish Medical Center. "In Amy's case, the size of the cancer relative to the size of her breast, as well as its location and Amy's overall medical history, worked to her benefit. I was able to remove the cancer and obtain clear margins without leaving a significant cavity that would contribute to a visually deformed breast."
Discovering a genetic predisposition
Shortly after her surgery, genetic testing provided Amy much more information about her familial risk factors. Growing up, she had known very little about her father's mother who had died of breast cancer. The genetic test results provided proof that Amy was positive for the BRCA1 gene, a gene mutation that significantly increases a woman's risk of breast cancer. The BRCA1 and BRCA2 genes are commonly found in women of Ashkanazic Jewish heritage, such as Amy and her grandmother. Because her grandmother only had male offspring, awareness of abnormal BRCA1 and BRCA2 genes skipped a generation.
The next step in Amy's medical journey was to meet with Sandra Vermeulen, M.D., a radiation oncologist at Swedish and co-director of the Seattle CyberKnife Center at Swedish Medical Center. Vermeulen discussed conventional radiation therapy options, as well as newer options that would be in keeping with Amy's most-effective, least-intrusive guiding principle. Amy chose CyberKnife for her treatment.
CyberKnife treatment begins
Because CyberKnife is such a new treatment option for breast cancer, Vermeulen offered to write a letter to Amy's insurance company advocating for the use of this new technology. Within two days she had received approval.
About a month after a second surgery to clean up the margins and place gold fiducials, Amy was ready to begin her five days of CyberKnife treatment at the Seattle CyberKnife Center at Swedish.
"I am so grateful CyberKnife was available and Dr. Vermeulen was willing to make me one of the first beneficiaries of this new technology," says Amy. "I had none of the side effects of regular radiation. No super-sensitive skin. No burning. My heart rate and blood pressure were super low. I never felt tired. And, I still have all of my really thick hair. "
Although Amy's medical journey has not ended, she retains a positive outlook. Her ongoing treatment includes intravenous Vitamin C and Herceptin, a relatively new drug that targets cells in early-stage HER2 tumors. As she takes each step, she is reminded of the value of researching treatments and finding doctors who will work closely with you and listen to your goals.
Learn more about CyberKnife treatment
Read Amy's story and case report (PDF)