Rays of Resilience

She Battled Two Types of Breast Cancer At The Same Time: The Most Common And One Of The Rarest

Rays of Resilience: 31 Stories in 31 Days. So many people around the world have been affected by breast cancer, yet no two breast cancer journeys are the same. This Breast Cancer Awareness Month, we’re celebrating a new survivor every day. Their resilience is an inspiration to us all.

My name is Laura.

This is my journey with battling breast cancer at age 34. I had two types of breast cancer: the most common, DCIS, AND the most rare, Paget’s disease of the breast.

Well, it’s become a passion of mine to spread the word and make Paget’s disease of the breast more known. I was misdiagnosed for a year. I had been seen by a dermatologist who performed a culture swab and skin shave biopsy. I was told that it was a rare bacterial infection, finegolda magna bacteria (f magna), that is usually found in the GI tract. I was treated with topical steroids and antibiotics.

Me before cancer. I was diagnosed about 2 months later.

It kept coming back, and had started to get to where I always had to keep my nipple covered due to the oozing and ulceration. I knew in my gut it was more serious. During the course of the nipple showing signs of changes, I found a lump. I had multiple mammograms and ultrasounds, all showed I had fibrocystic breast disease with microcalcifications; I was 33 at this time.

In December of 2016, I went to my GYN, because for over a year I had been battling the crusting oozing nipple. Two weeks later I was seen by a general surgeon for an excisional biopsy of the areola.

Me, my husband Nathan (in the DAV shirt), our oldest Ethan, our youngest Vincent, and Brantley Gilbert, who awarded my husband his companion dog

In January of 2017, the surgeon ordered a mammogram, ultrasound, and MRI with contras; he also ordered a u/s biopsy after the initial scans came back to see if the lump was DCIS. Between the time the excisional biopsy was performed and the ultrasound guided biopsy, the doctor called me and told me that it was Paget’s disease of the breast, it was very rare but fast developing, and the only treatment was a mastectomy. A few minutes later I received a second call from him stating that he “wasn’t sure what it was” and that I’d need further testing. At this point, I wanted a “yes” or “no” on the secondary type of cancer. I wanted a second opinion, something concrete, not an, “I think you have cancer.” At this point, I self-referred myself to Brown Cancer Center due to the fact I needed more answers and did not want to undergo any unnecessary testing.

In February of 2017, I met with Dr. Nicolas Ajkay, who went over my history and had all my scans and pathology reports looked at. He confirmed that it was Paget’s disease of the breast and DCIS without further testing. Dr. Ajkay had only seen one other Paget’s case in his long career, and that was of his 88-year-old grandmother! I was 34 at the time.

Our pitbull, Rico, from Brantley Gilbert; and our French Bulldog, Jax. He has helped me through some tough times.

I met with Dr. Bradon Wilhelmi for my plastics consult, and he is incredible. He could not be a more amazing physician! He gave me his personal cell phone number in case I had any problems during recovery or treatment, something he does for all his cancer patients.

On March 1, 2017, I had a radical mastectomy with one lymph node removed, and a tissue expander placed. I was ER- PR- HER2+ due to the Paget’s, with high grade DCIS. I did not have to go through chemo or radiation because my margins were clear.

The collage is of my stages of surgery. The first picture is the day of surgery when I had my mastectomy and lymph node removal; top right is after the expander to implant swap and implant placed on right; bottom left and middle is day of fat grafting; and bottom right is completed reconstructions.

The recovery for that surgery was horrible; the expander fills were probably the worst. On July 20, 2017, I had my first stage of reconstruction performed by Dr. Wilhelmi at Jewish downtown. He performed a tissue expander swap with capsulectomy and a breast implant placement on the left (my mastectomy side), and on the right he performed a lift and implant placement for symmetry. I went with Mentor memory gel silicone implants, 800cc on the left and 375cc on the right. I was left with no fat tissue and my skin was scraped so thin that you could see through it. During this reconstruction surgery, Alloderm had to be used because I did not have enough skin.

On October 5, 2017, I underwent fat grafting with Dr. Wilhelmi to fill in the depression areas left behind after my mastectomy. During the fat grafting procedure, I had liposuction done on my stomach; then the fat was emulsified and injected into my breast. On average only about 50%-60% of transferred fat takes to the new area.

Overall, my prognosis is very good, according to my medical oncologist Mounicka Mandadi. I have to get mammograms and MRI every six months to monitor to see if there are any changes in my right breast. I keep a check on my remaining nipple daily to make sure there are no changes.

My dad and I at my wedding in 2006.

Cancer not only affected me, but my whole family — my husband and two small children especially. My husband is a medically retired Army veteran who currently works at the post office. He has been my rock through this. My sons, Ethan, 10, and Vincent, 6, have each dealt with this in their own way. Ethan threw himself into school; he’s on the academic team, makes straight A’s, has had perfect attendance all but the day I had my mastectomy in March, and has wrestled for 5 years, so his focus is on that as well. Vincent is special needs. I’ve had to handle my cancer and take him to his therapists and specialists at Vanderbilt University throughout the course of everything. He only knows that, “Mommy had surgery.”

My dad and his grandsons at the local park.

My dad has been the biggest support other than my husband. By the time I was battling breast cancer, he had been battling bladder cancer for the previous six years. He is 85 now, and he still comes to see us, calls me daily, and tries to make it to my boys’ sporting events when he feels well enough.

If it weren’t for my husband, dad, and kids, I’m not sure I could have done this. Cancer doesn’t just affect the individual, it affects the family.

“I was given this journey because God knew I was strong enough to handle it.”

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