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Saturday, 01 August 2015 06:31

Rethinking breast cancer treatment: One patient's story.

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In the United States, one in five new breast cancer cases is stage 0 disease, but for Amy Thigpen, a mother of three who works in an oncology clinic, breast cancer is not a statistic; it is personal. After all, her mother is a breast cancer survivor, and later, she too faced-off with a similar diagnosis.
 
After Thigpen’s mother was diagnosed with early-stage invasive breast cancer, Thigpen was determined to be proactive about her breast health. She had a feeling something was not right and requested a mammogram from her doctors at the age of 34, even though guidelines do not recommend screening before the age of 50. The mammogram found a small tumor that was confined to the milk ducts; fortunately it had not spread to the surrounding tissue. At that point, Thigpen faced her diagnosis — stage 0 breast cancer known as Ductal Carcinoma in Situ, or DCIS.
 
An oncology nurse in the hematology oncology department at Physicians East in Greenville, North Carolina, Thigpen worked alongside a breast cancer specialist and had seen many patients battle the disease and struggle with the many decisions that had to be made, including whether or not to pursue post-surgery treatment. After caring for so many cancer patients over the years, Thigpen was now grappling with a difficult decision of her own; it was not clear whether her cancer would come back and if she needed radiation therapy.
 
Thigpen was familiar with genomic testing, a new tool doctors are using to guide treatment decisions. Her mother had received the Oncotype DX test for her invasive breast cancer and used the test results to determine whether she needed chemotherapy. Inspired by her mother’s experience, Thigpen talked to her doctor about genomic testing, and since the Oncotype DX test was now available and validated for DCIS patients, they decided to move forward. A recent study led by researchers from the University of California, San Francisco and published by The Journal of Clinical Oncology found that the Oncotype DX DCIS Score result has been shown to change treatment recommendations in 30 percent of patients and doctors rank it as the most important factor in treatment planning.
 
When Thigpen received her Oncotype DX results, her DCIS Score was zero.
 
“I was so excited, I carried my results to my doctor and knew we had our answer. I wouldn’t have radiation. The test probably saved me from having to go through six weeks of radiation that my body really did not need — and not having to go through all the side effects that radiation can cause,” Thigpen says.
 
“DCIS is pre-invasive, meaning that it can often be treated with surgery alone,” says Marisa Weiss, M.D., president and founder of Breastcancer.org. “Unfortunately not all patients are aware of the non-life-threatening nature of the disease. In fact, most women diagnosed with DCIS receive aggressive treatment, and many are receiving unnecessary treatments that have side effects and potential long-term complications.”
 
To encourage other women to pursue personalized treatment, Thigpen decided to share her story on www.MyBreastCancerTreatment.org , a patient education resource providing information around breast cancer and the benefits of genomic testing. The tools, resources and eligibility quiz offered on this website enable patients and their loved ones to empower themselves with information about their specific cancer and work with their doctor to confidently select a treatment plan that can guide personalized treatment decisions based on their individual tumor.
 
Thigpen says the best advice she can give to anyone is, “You have to be your own advocate and push for what you truly feel in your heart is right, because when the day is over, you have to be 100 percent comfortable with your treatment plan.”
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