Paula Haney is all too familiar with breast cancer and its impact on a family. Nearly 35 years ago, Paula's sister, Suzanne, was diagnosed with breast cancer when she was just 29. She passed away six years later at 35.
When her sister was first diagnosed, Paula began having annual mammograms even though she was only 21. She admits she was hesitant to have genetic testing at that point – despite being at a higher risk of breast cancer because of her sister.
"I figured I was young, and it had only been my sister who had breast cancer at that point," she admits. "I didn't have any children, so I just didn't worry about it."
That mindset began to change in 2002 when Paula's mother was diagnosed with breast cancer. Fifteen years later, Paula's mother's cancer returned.
"I had two young daughters when my mother was first diagnosed," Paula says. "I wanted to get tested for them and our family."
It was then that Paula began working to better understand her risk of developing breast cancer – and what she could do to prevent it or catch it early.
Knowledge is power
It can be scary and overwhelming to learn about your risk of developing serious illnesses, like cancer. Tiffany Kocher, APRN, from The Christ Hospital Physicians - Surgical Oncology team, has a different perspective.
"The more information you have, the more empowered you can be to be proactive for your health," she firmly states.
Paula agrees. "Knowledge is power. You can't fight something if you don't know it's there."
And that's exactly what Paula did. Her first visit to a high-risk cancer screening clinic found that while she tested negative for any known breast cancer mutation, she was still at a 42% risk of developing breast cancer. The average women's risk is just 13%. So, in 2002, Paula began having yearly breast MRIs with yearly mammograms; each six six months apart.
For 17 years, scans were all clear. She had a mammogram in October 2020, as scheduled. That mammogram also came back clean. Six months later, in March 2021, she had a breast MRI. It was that MRI that detected a suspicious growth in her breast. A biopsy confirmed it was cancer.
"Being with the High Risk Cancer Screening Clinic saved my life," Paula says. "The mammogram never found it. If I hadn't had that MRI, who knows what would have happened had I waited another year. Instead, we found it when it was so small my doctors could go in and take it all out."
Paula opted for a bilateral mastectomy during her surgery.
"I have been dealing with this for 35 years. I was done," she admits with a laugh. "I just told my surgeon – take them both! I'm done."
She never needed chemotherapy or radiation because the cancer was caught so early.
Understanding cancer risk
Three women in Paula's immediate family have been diagnosed with breast cancer. While family history is a risk factor for breast cancer, it's not the only one.
"Many people aren't aware of all the risk factors outside of family history," explains Tiffany. "At the High Risk Cancer Screening Clinic, we work closely with men and women to help them understand their risk of cancer and work together to find ways to reduce that risk and create a more aggressive screening schedule that would allow us to catch cancer in its early stages – much like we were able to do with Paula."
When it comes to breast cancer, Tiffany encourages women to keep the following risk factors in mind:
- Family history
- Age of first menstrual cycle
- Age of first pregnancy and birth
- Age of menopause
- Weight
- Body Mass Index (BMI)
"Most people know that being overweight or obese, or having a high BMI puts them at a higher risk of certain illnesses, like high blood pressure or diabetes," explains Tiffany. "But, women aren't always aware of the impact weight can have on their cancer risk."
It's also important to remember that women aren't the only ones affected by breast cancer.
"Men can also have risk factors that place them at a high risk for breast cancer," Tiffany says. "Often this may not be recognized. If a male is found to have a BRCA mutation, this mutation can increase their risk for developing a breast cancer as well as other cancers, including prostate cancer."
Unwavering support, education that empowers
Learning you have breast cancer – or even at a higher risk of developing it – is an emotional and overwhelming experience.
"A cancer diagnosis changes a person's life. I still remember the telephone call when my mom found out she had breast cancer," Tiffany shares. "We were sitting in the living room, and it was after hours. At the time, I didn't realize that was odd the doctor was calling in the evening. That one phone call changed everything."
Tiffany brings that empathy to every patient she sees. Paula is the first to admit she didn't react politely when she was first told she had cancer.
"I never thought I would get cancer," Paula admits. "My mom had it. My sister had it – no way would I get it, too.
"Tiffany called me to tell me it was cancer and told me 'The good news is, Paula, that we caught it early'," Paula continues. "I just snapped to her, 'Tell that to my dead sister.'"
After Paula had a chance to process the diagnosis and her emotions, she quickly called Tiffany back to apologize.
"Tiffany just told me – 'It's okay, Paula. You can react any way and we will always be here for you. You're allowed to be angry'," Paula says. "That was something I really needed to hear."
It wasn't just the unconditional support that helped Paula on her journey. Throughout every step – before, during and after her cancer diagnosis – she knew she could rely on the team at the High Risk Cancer Clinic.
"You start to consider these people your friends," Paula says. "They know so much about you and are helping you through some really tough and scary things. These are the people you want by your side. They are just so informative. They know all the latest recommendations, guidance and advice. You can be confident that they will get you where you need to be."
It's that combination of educating and supporting patients that drew Tiffany to her role at The Christ Hospital.
"Finding out you're at a significant, increased risk of developing breast cancer can bring many reactions – including feeling anxious or depressed," she says. "Those are all perfectly normal responses. We're able to help you learn to live with that knowledge and feel good about taking the steps available to reduce your risk."
Take the first step
If you're interested in learning more about your risk of breast cancer or any other chronic health condition, Tiffany encourages you to talk to your provider.
"Everyone has someone they are seeing – whether it's a primary care doctor they've had for years or the provider at a walk-in clinic," she says. "If you know you have a strong family history of cardiovascular disease, cancer or any other serious conditions, start the conversation today with your doctor."
The High Risk Cancer Screening Clinic provides genetic risk evaluation and advanced screening and imaging for individuals at an increased risk of cancer. For more information or to schedule an appointment, call 513-585-3275.