Meet Jessica

I am a pediatrician in Houston, Texas, and I was diagnosed with invasive lobular carcinoma at the age of 43 in March of 2024. In January of 2024 I was experiencing significant anxiety at work due to changes in management and increased patient load. During that time, I developed some changes in my menstrual cycle and left nipple pain and scheduled an appointment with my primary care provider (PCP). I have a lot of cancer in my family including my mother who was diagnosed with breast cancer two years ago, so I was worried I had some type of cancer but I was also having a lot of anxiety.

Luckily, my PCP took my concerns seriously. She ordered blood work which was normal and told me to see oncology to get recommendations on screening guidelines due to my family history of breast cancer. I had already been having mammograms for several years and they were always normal. I had Myriad genetic testing in 2022 which was negative. My PCP ordered a mammogram and diagnostic ultrasound due to the left nipple pain, which would be 10 months since my last normal mammogram. I had a virtual visit with oncology on March 19 and they told me I only have slightly above normal risk for breast cancer and did not recommend any other special screening besides yearly mammogram. I could have qualified for tamoxifen as a preventive medication but it wasn’t recommended.

But then on March 25 after I had the mammogram and the radiologist walked in afterwards and said my entire right breast was abnormal, most likely cancer. My left breast showed no signs of cancer, but later my pathology showed an intraductal papilloma of the left breast which is considered a benign finding, but may have caused the life saving nipple pain. I then had biopsies, MRI, and by April 8 I knew I had invasive lobular carcinoma of the right breast which was not seen on the last mammogram. I was told lobular carcinoma is rare and sneaky and does not always show up on any imaging in the early stages, and cannot be felt with your hand. The MRI showed the cancer was all the way up to my chest wall but not yet invading my muscle or lymph nodes. I was told I was only a few months away from metastasis at the time of surgery.

My breast surgeon also told me that she sees many young people coming in with cancer who had recently gone through an extremely stressful event, so I resigned from my job the next day.

I then underwent bilateral mastectomy April 26th including reconstruction, a six hour surgery, and came home with 4 drains in my body for 3 weeks. Expanders were placed which are to be switched with silicone implants in the future. I had 4 sentinel lymph nodes removed from my right axilla during surgery, with pathology showing some isolated tumor cells around 1 lymph node, but not yet invading.
Final pathology: T3N0 stage 1B invasive lobular carcinoma, 6 cm cancer mass, negative lymph nodes, negative margins but closest margin only 0.1mm from the chest wall, oncotype score 19, and RSClin score with 19% chance of reoccurrence.

The most difficult part of deciding the treatment plan was being told that chemotherapy is not recommended due to little benefit. With an oncotype score of 19, and the diagnosis of lobular carcinoma which historically does not respond well to chemo, the risks outweigh the benefits. I received a second opinion which confirmed that although my cancer is in a gray area which is currently being studied (oncotypes of 15-25), I would have very little benefit from chemotherapy. Although I am happy to not undergo chemo, the news does not bring a feeling of celebration, but rather fear that any wrong decision made now could lead to a recurrence in the future. Instead, my treatment plan consists of 5 weeks of radiation, ovary suppression with Zoladex injections every 28 days, and an aromatase inhibitor for 10 years of total hormone suppression. Furthermore, due to a family history of endometrial cancer, I have chosen to undergo ovarian removal and hysterectomy in a few months to decrease my risk of ovarian and endometrial cancer.

Once I became a breast cancer patient, I connected with several friends who also have breast cancer, but all with ductal carcinoma. Luckily, one survivor shared the Lobular Breast Cancer Alliance website with me, and reading all the stories of other women with lobular carcinoma made me feel hope, but also frustration that most of us are diagnosed with advanced cancer or large tumor size. I am confident the work being done by the LBCA will lead to both earlier detection and better treatment options for ILC.

I hope to enter a study that is tracking CTCs (circulating tumor cells) as a way to track and predict recurrence. Until a better way of tracking cancer recurrence is developed, and treatments that are specific for lobular breast cancer, our only option is to wait, live as healthy and low stress lifestyle as possible, and hope it does not return.

Are you interested in telling others about your own lobular breast cancer story? Please email communications@lobularbreastcancer.org to request more information on how to submit your story.