Not all lumps are cancerous.
When Andrea Winkler, 37, heard those words from her women’s health nurse practitioner, she felt a bit of hope. Lumps can be caused by cysts, normal changes in breast tissue, infections or injuries. Still, her physician needed further testing to find out what kind of lump Andrea had identified on her breast.
“It was on the side of my breast, fairly close to the surface – so it was pretty easy to find, and it was pretty large by the time I felt it. I knew right away that it didn’t feel normal,” Andrea said.
Andrea went to Brigham City Community Hospital to receive a 3D mammogram and ultrasound, in order to gather more information.
“Bridget is one of the mammography techs there, and she is fantastic,” Andrea recalled. “She’s gentle and nice, and not at all awkward about it.”
Using new 3D mammography technology, which offers more precise, accurate imaging with the same radiation dose as 2D mammography, radiologists at Brigham City Community Hospital identified an area on Andrea’s breast that did not look like normal breast tissue.
“Now I tell all of my friends to get their dang mammograms! It’s not that painful, it’s not uncomfortable, and if something is wrong, you want to know about it!” Andrea said.
Based on the images revealed in the mammogram, Andrea needed the next step: A biopsy. But even at this point, they weren’t sure what kind of lump it was.
“If the lump was a cyst, it would aspirate and collapse on itself – then they wouldn’t biopsy it. If the area was fibrous, and didn’t aspirate, they would take the sample. When they stuck the needle in, nothing happened. It wasn’t a cyst. At that point, I thought that I probably have cancer,” Andrea said.
Sadly, Andrea’s assessment proved correct. Andrea was diagnosed with breast cancer.
The silver lining? A team of compassionate, skilled healthcare professionals were prepared and ready to help her during each step of her journey.
“Everyone’s faces looked so concerned, for me,” Andrea remembered. “They were so caring and cute. I could tell that everyone wanted to hug me. My biggest thought was, ‘What do we next? What do we do to fix this? What are the next steps?’”
Andrea believes knowledge is power, and she was eager for more details on what she was up against.
She didn’t have to wait long. The very next day, Andrea met with Dr. Lance Bryce, general surgeon at Brigham City Community Hospital, and learned the specific type and details of her cancer.
Dr. Bryce told Andrea that she had stage 2, triple negative, invasive ductal carcinoma. That means Andrea’s cancer began in a milk duct and invaded tissue directly outside of her breast. By testing as triple negative, physicians knew that the three most common types of receptors that fuel breast cancer growth were not present in Andrea’s tumor, therefore, hormone treatments would be ineffective for Andrea’s tumor. Instead, her best treatment plan would involve surgery, chemotherapy and possibly radiation.
“Dr. Bryce met with me for 2.5 hours that day, explaining everything to us. He was super caring, and I could tell he really wanted to help me,” Andrea said. “He told me that as a surgeon, his job is to kill cancer with skill. That’s his job. The next person’s job is to kill cancer with chemicals. That’s their job. Then, if I need it, people will kill the cancer with radiation. He rallied me up and said we’d get it figured out.”
Dr. Bryce also explained that her specific tumor was growing with speed.
“Based on one report, Dr. Bryce described how fast growing it is. If the results were between 0 and 10 percent, it was slow growing … more than 20 percent, it was considered fast growing. Mine scored at 90 percent,” Andrea said.
Personal decisions and personal treatment plans: Mapping out steps to kicking cancer.
Armed with knowledge, Andrea faced her first big decision regarding treatment. Since surgical removal of the tumor would be the first strategic move, Andrea had the personal choice between a bilateral mastectomy or a double mastectomy (meaning remove the one breast with the tumor or remove both breasts).
“This was a little difficult to come a decision about,” Andrea said. “In my first reaction, I felt like I had a foreign alien in me, and I just wanted to get it all out. I didn’t want anything to come back again. Then, the more I thought about it, I felt like I didn’t need to take everything. I mean, if I had a bad infection in one hand, I wouldn’t chop off both hands.”
With that in mind, Andrea chose to have a bilateral mastectomy. Dr. Bryce successfully performed the surgery at Brigham City Community Hospital soon thereafter.
The next strategy in Andrea’s treatment focused on chemotherapy. Considering the stage and type of cancer, and the fact that her cancer was triple negative, physicians came up with a personalized chemotherapy plan.
“We started with what I call the Red Devil (it’s actually called doxorubicin). I had four rounds every two week. This was the hardest part of my treatment so far,” Andrea said.
The harsh chemotherapy produced fatigue, nausea and hair loss – and this was just phase one of chemotherapy.
Thankfully, she’s moved on from the “Red Devil.” Andrea now has chemotherapy with a drug called Taxtol. She recently completed her seventh out of twelve chemotherapy rounds with this drug.
“I only have five more rounds to go. I’m feeling great. It’s very exciting,” Andrea said. “I do get tired, but I’m still able to work, play pickleball once in a while and tennis once a week.”
More to come: A bright future
After Andrea’s chemotherapy wraps up, her physicians will determine if radiation is necessary. Then, the reconstructive surgery process will begin. Although there’s more to come in Andrea’s treatment, she says the future is bright and she knows what to focus on.
“Going through cancer makes it easier to prioritize which things are important,” Andera said. “There are a lot of things that just don’t really matter.”
What’s most important to Andrea, is spending time with her family. She’s the mother of three girls (ages 15, 13 and 10) and married to her best friend.