Despite the fact that there is no history of breast cancer in my family, I didn’t take that good fortune for granted and was diligent about getting my regularly scheduled mammograms and clinical breast exams, which never found any hint of disease. So, it was especially frightening when, while on a family vacation in the winter of 2020, I noticed an unusual dimpling and thickening in the skin between my right armpit and upper breast, and I could feel a mass both under my arm and in my breast. I was young, just 41, exercised regularly, and ate a healthy diet. Cancer was not on my radar.
Christine D’Addario
Worried and in a panic, I immediately called my gynecologist, who said to see her as soon as I returned from vacation. After that, events moved very quickly. A breast sonogram confirmed a mass under my right armpit and in my breast, and tissue samples were taken for a pathology examination. A few days later, I got the call we all dread. My doctor said to come to her office for the diagnosis, and I knew the news couldn’t be good. Once there, she didn’t sugarcoat the information. I had stage IIB triple-negative breast cancer and would need to see an oncologist right away for treatment.
I wish there was a guidebook for what you’re supposed to do when you get such a life-threatening diagnosis. I had no idea how to find an oncologist who specialized in this type of cancer. Fortunately, I had done some graphic design work for the Manhasset Women’s Coalition Against Breast Cancer (manhassetbreastcancer.org), an all-volunteer, charitable organization on Long Island that provides resources for newly diagnosed patients with breast cancer and grants for innovative research.
There I found invaluable information about my next crucial steps and, most importantly, suggestions on how to find and select a physician. After meeting with four highly qualified breast cancer specialists, I chose Douglas K. Marks, MD, Associate Professor, Department of Medicine at NYU Grossman Long Island School of Medicine and Medical Director, Clinical Trials Office at Perlmutter Cancer Center, Long Island, who, coincidentally, had received research funding from the organization.
Maintaining a Healthy Appearance While Undergoing Treatment
By the time I met with Dr. Marks, I had resigned myself to the fact that I would most likely lose my right breast and undergo months-long chemotherapy and radiation treatments, and in the process lose my thick, long hair, which I had always considered among my most prized assets. But my concern was not just about vanity. I didn’t want my young children to witness the obvious effects of my illness and possibly have that vision be their last memory of me.
Once again, the Manhasset Women’s Coalition Against Breast Cancer came to my rescue with information about the cold cap scalp cooling system, which helps reduce hair loss during chemotherapy. The device was expensive, more than $12,000, and not covered by insurance, but it was worth it for me to keep most of my hair and maintain a healthy appearance throughout my treatment.
Saving My Breast and My Life
All the oncologists I had consulted with while deciding the best treatment plan for the cancer, including Dr. Marks, had made similar recommendations for my care: neoadjuvant chemotherapy to reduce the size of the tumors and complete surgical removal of my right breast, followed by weeks of adjuvant radiation therapy to kill any remaining renegade cancer cells. However, it was Dr. Marks’ last-minute treatment suggestion that I credit with giving me the best shot at a durable remission and that also allowed me to keep my breast.
Dr. Marks had just read about a randomized phase III clinical trial investigating neoadjuvant pembrolizumab plus paclitaxel and carboplatin chemotherapy in previously untreated patients with stage II or III triple-negative breast cancer, and he thought the combination therapy could be effective for me. The findings from the study showed that among patients with early-stage triple-negative breast cancer, the percentage with a pathologic complete response was significantly higher among those who received pembrolizumab plus neoadjuvant chemotherapy than among those patients who received a placebo plus neoadjuvant pembrolizumab.1
The combination treatment reduced the size of the tumor in my breast enough, so I only needed a lumpectomy. Most important, it put me in remission, and today I remain cancer-free.
(Editor’s Note: Following the U.S. Food and Drug Administration (FDA) approval in 2020 of the combination of pembrolizumab and chemotherapy for advanced triple-negative breast cancer, in 2021, the FDA approved the combination therapy for patients with early-stage disease.2)
Living My Best Life
Although I’m nearing that coveted 5-year milestone of remaining cancer-free, recurrence is never far from my mind. But rather than letting cancer limit my life, I’m determined to let it be a motivating force that propels me to living my best life every day.
As I am an artist, my paintings, most of which represent the majesty and power of the ocean, give me strength and joy. Through my art, I hope to bring that same sense of strength and joy to others facing a life-threatening disease or another life difficulty.
Having survived cancer, every morning, I ask myself, how can I make this day better, not just for me and my family but for everyone I meet? That was cancer’s gift.
REFERENCES
1. Schmid P, Cortes J, Pusztai L, et al: Pembrolizumab for early triple-negative breast cancer. N Engl J Med 382:810-821,
2020.
2. Winstead E: Pembrolizumab improves survival in advanced triple-negative breast cancer. August 9, 2022. Available at www.cancer.gov/news-events/cancer-currents-blog/2022/pembrolizumab-triple-negative-breast-cancer-improves-survival#:~:text=After%20the%202020%20approval%20of,different%20trial%2C%20KEYNOTE%2D522. Accessed August 5, 2024.
Ms. D’Addario, an artist specializing in fine art oil paintings, lives in Locust Valley, New York. Some of her works are shown on these pages. Visit christinedaddario.com for more on her paintings.
Editor’s Note: Columns in the Patient’s Corner are based solely on information The ASCO Post received from patients and should be considered anecdotal.
