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By Jacqueline Lisk
This article is a part of Studio/B’s Breast Cancer Explored series, exploring the state of breast cancer in 2020 through stories from survivors, loved ones, doctors, and researchers.
LaTonya Davis has faced heartache, but she is always able to find joy. She lost her mother, Gloria Davis, to metastatic triple-negative breast cancer in July 1993. Her sister, Yolonda Holmes, died from the same disease in May 2016, four years after her husband, Eric Holmes, had died in his sleep of a heart attack. This left their 11-year-old son, Jayden, an orphan. Soon after, LaTonya became his legal guardian.
“My number one goal was to be a ray of light and hope for my nephew,” she says.
In November 2016, LaTonya learned she, too, had breast cancer.
“It’s still mind-boggling to me that I was diagnosed six months after I buried my sister,” LaTonya says. “I literally held her hand while she took her last breath.”
LaTonya’s cancer was HER2-positive. She had a bilateral mastectomy and began chemotherapy in Miami, Florida, where she lived. But one oncologist, Dr. Sara Garrido, thought the diagnosis was curious since her mother and sister were both triple-negative. Garrido suggested two genomic tests by Agendia, a leading precision oncology company: MammaPrint, an FDA-cleared test to predict the risk of breast cancer recurrence, and BluePrint, a molecular subtyping test to predict likely tumor behavior.
LaTonya’s doctor’s hunch was right. Agendia testing showed LaTonya’s cancer was genomically High Risk and Basal Type, which acts like triple-negative breast cancer. LaTonya’s doctors switched to the type of chemotherapy most likely to be effective based on the tumor’s biology.
“If it weren’t for my oncologist being so proactive, and for MammaPrint and BluePrint, I probably wouldn’t be here,” LaTonya says.
A welcome change in plans
In August 2013, four days before her 33rd birthday, Aleseia Saunders got the best news and the worst news of her life. She was newly pregnant—and she had invasive ductal carcinoma in her right breast.
“The doctor told me that with me being early in the pregnancy, he thought it was best if I just go ahead and schedule to, you know, abort my child so we could get started with chemotherapy, radiation and hormonal treatment,” Aleseia remembers.
She describes the news as a “punch to the gut.” But something in her gut told her “to not be hasty.” She sought a second opinion, and this doctor told her about Agendia.
“It was reassuring to hear, ‘Before making a decision, let’s do this MammaPrint test,’” Aleseia explains.
Her results showed her cancer had a less than a 10% chance of recurrence. Based on this information, her care team decided chemotherapy would do more harm than good. Instead, they recommended a lumpectomy in her second trimester, and radiation and hormonal treatment after her daughter was born.
“We went from ‘You have to abort the baby’ to ‘Chemotherapy is not most beneficial.’ I was very fortunate,” Aleseia says.
Dr. Mohammad Jahanzeb, founder and managing partner at Florida Precision Oncology, a division of 21st Century Oncology, recommends Agendia testing to many of his breast cancer patients.
“Genomic testing allows us to assess the biological behavior of a tumor in terms of its aggressiveness, likelihood to spread, as well as likelihood of the patient benefitting from chemotherapy or not,” he explains. “It saves a good majority of patients from unnecessary chemotherapy while identifying some others who can benefit but would previously have not received it based on traditional pathology and anatomic staging criteria.”
The comfort of certainty
Cari Grundman was diagnosed with ER/PR-positive, HER2-negative breast cancer in July 2012, when she was 49. Agendia testing revealed her breast cancer was more aggressive than it looked. Prior to MammaPrint, her cancer was confusing. She had sought multiple opinions, but experts were torn on whether she needed chemo.
“Much to everyone’s utter shock, MammaPrint showed I was high risk,” she says. “So, based on the test, and in speaking with my oncologist and husband, we decided chemo was the best route.”
Nobody wants chemo, but Cari was “really very thankful to have had that decision basically made.”
“I don’t ever go to sleep wondering if I should have treated it differently,” she explains.
Trust your gut, trust in science
Today, Cari feels wonderful. Her hair has grown back. She is no longer on hormone therapy. And she has a job she loves: She is now a molecular oncology specialist for Agendia. She attests that one-size-fits-all does not work best in breast cancer treatment. Genomic testing enables doctors to better understand each patient’s cancer and treat it accordingly.
Jahanzeb notes it is all about “rightsizing,” which “really refers to judicious use of chemotherapy in those who really need it, and fine-tuning the timing of chemotherapy (either before or after surgery), which is increasingly based on genomic information.”
LaTonya is thriving, too. She was selected for the NPR How I Built This Fellowship program for her podcast idea, “The Breast Talk Ever,” in which she interviews cancer survivors who launched a business as a result of their diagnosis. The first episode will debut on October 7.
Aleseia doesn’t take a day for granted, either. Her baby, Julia, is six now and has a nearly-two-year-old sister, Ayla, and ten-month-old brother, Micah. She prays more doctors embrace the most informative genomic testing.
“I know what it did for me,” she says. “I am forever grateful to Agendia.”