Breast Cancer Survivor - A Grandmother Shares her Story

One breast-cancer survivor is doing all she can to prevent her granddaughters from facing the same battle.

"I was bald, but my hair was slowly inching back," says Eileen Clark, who in August 2006 was diagnosed with breast cancer. "I would take off my cap and my granddaughter would say, 'Nunu, it's growing! It’s growing!"

Without the support of her family, says Eileen, she couldn't have pulled through the surgery, the radiation…the chemotherapy. "The acceptance of little ones when you feel physically depleted is amazing. My husband and I truly love our grandchildren and spend tons of time with them," she says. "They saw me when I was down and were so loving and kind. We grew back together."

Eileen's mother had been diagnosed at 65. In her early 30s, Eileen had two lumpectomies, both of which showed no malignancy. "I knew then to become pro-active. I had dense breasts and a family history," says the grandmother of four from Rehoboth Beach, Del. After going under the knife that first time, she contacted the Betty Lou Ourisman Breast Health Center at Georgetown University Hospital and began routine six-month checkups.

When Eileen was 63, her doctor found a suspicious lump. Within two weeks, she had 19 nodes removed (one of which was a cancerous sentinel node). Three weeks after surgery, Eileen started chemotherapy, which was immediately followed up by radiation. "I was deflated and exhausted," says Eileen of her battle with the disease. "The chemo was very tough, a real roller coaster. I had no strength to even pick up my granddaughters. All I wanted to do was sleep."

Eileen's mother had had one breast completely removed. Eileen had a lumpectomy with chemo and radiation. She's hoping that that by the time her three granddaughters are older, there will be a cure for breast cancer.

Just more than one year post-diagnosis, Eileen has made her comeback. She can finally swoop up her granddaughters again and give them hugs. On this November morning, she's taking off on a 12-mile walk. The day before, she clocked 10 miles. She's gearing up for the 60-mile Susan G. Komen 3-Day Breast Cancer Walk for the Cure in San Diego, Calif., Nov. 9-11.

Team Palm Springs, comprising Eileen, her 33-year-old daughter, Blair (daughter Stephanie is pregnant), and two other women, will strut their stuff in white T-shirts stamped with palm-trees wrapped in pink ribbons. There to cheer them on will be Eileen and Blair's husbands, and two of Eileen's grandgirls, Milligan, 1-½, and Barlow, 3. Eileen raised more than $7,000 of Team Palm Springs' $12,600 total which will go toward breast-cancer research.

"I am a hands-on grandmother," says Eileen."I get down on the floor and play with them. I participate in their activities. They are young now. But I hope they will remember me getting out there and demonstrating how thankful I am to have pulled through this. I want to do everything in my power – raising money, getting involved – so that when the girls are my age, they won’t have to face this. I have faith that actively raising money and awareness is going to be very beneficial for our grandchildren."

Still, Eileen says she fears that her daughters, who are in their 30s and granddaughters may one day have breast cancer and knows they are at higher-than-normal risk. Eileen wants to make her message to her granddaughters clear, though, "we do not want to frighten them. My daughters and I want to educate and encourage them to be aware and pro-active."

Is a Survivor's Grandchild at Higher Risk?

"Granddaughters of women with breast cancer do have higher than average risk of developing breast cancer," says Michael Naughton, M.D., a breast cancer oncologist at the Siteman Cancer Center of Washington University School of Medicine in St. Louis. "In general, though, this would be considered only a small increase in risk."

For a woman with breast cancer, the risk her granddaughter faces ultimately depends on:

* Whether other relatives have been affected (such as a grandchild's mother)

* The grandmother's age of diagnosis (pre- or post-menopausal)

* The type of diagnosis

* Whether a grandparent or parent is a BRCA1 or BRCA2 carrier

If a grandmother was diagnosed after age 50, and no other relatives were affected, says Naughton, general screening would be recommended (including annual mammogram beginning at age 40 and self and physician examinations). If, however, other risk factors are involved, a modified screening regimen may be required, says Naughton.

The good news for granddaughters: Screening technologies allow breast cancer to be detected at very early stages now, maximizing the possibility of survival. "The current imagining modalities – mammogram, ultrasound, MRI – allow for accurate localization, making biopsies easier and more accurate," says Naughton. A granddaughter's treatment will more likely be lumpectomy and sentinel-lymph-node biopsy rather than mastectomy and lymph-node dissection.

New Advances: Breast MRI

In March 2007, breast magnetic resonance imaging (MRI) got a boost when an article appeared in the March 29 issue of The New England Journal of Medicine that concluded that an MRI can detect cancer in the contralateral breast that is missed by mammography and clinical imagining. Approved by the FDA in 2004, it was just in 2007 that the American Cancer Society updated its guidelines to include the recommendation that high-risk women have annual breast-cancer screening with an MRI in addition to a mammogram.

Still, mammography remains the primary screening tool for early detection, says Elizabeth Jekot, M.D., founder of a Texas-based breast imaging center. "MRI is really something that should be reserved for recently diagnosed women or women who are at high risk, meaning they have a personal history or one or more family members was diagnosed with breast cancer, depending on age of diagnosis." Naughton agrees that a breast MRI, as a screening tool, is only appropriate for young women at especially high risk, i.e., those who are BRCA1 or BRCA2 carriers.

Because MRI screening works in tandem with a contrast agent that is injected into the vein and visually lights up lesions and suspect tissue areas, it is considered more sensitive than a mammogram.

Jekot suggests that women undergoing a breast MRI seek a screening center that has an integrated system that can perform MRI-directed biopsies and where the interpreting radiologist will correlate the MRI findings with the mammogram and sonogram. "If a relative was diagnosed at 42, then start screening 10 years before, at age 32. The thing about breast cancer is that it is age-dependent and absolute risk increases with age," says Jekot.

According to the American Cancer Society's 2006-2007 Breast Facts and Figures, the absolute risk of a woman developing breast cancer when she is 20 years old is one in 1,837; the risk of a woman who is 70 years old is one in 26. Genetic cancers, however (those discovered by BRCA1 and BRCA2 mutation carriers) behave differently and are usually diagnosed at an earlier age, says Jekot.

An MRI costs substantially more than a mammogram and is still not widely available (or covered easily by insurance). "Comparing mammography to breast MRI is comparing apples to oranges," says Barbara Ossias, a reimbursement specialist of the Aurora Breast MRI Reimbursement Hotline. "Mammo is a simple, quick first-step screening procedure. Breast MRI is a complex screening and diagnostic tool that involves many steps. Most breast MRIs involve several series of "pictures" - with and without contrast media - as well as extensive 3-D reconstruction and computer aided detection to enhance the usefulness of the procedures."

What You Can Do Right Now

If walking just isn't your thing, consider the Celebration Chain. It's a fun and free way to donate money from someone else's pocket to the cause. On the site, it takes three minutes to create a virtual animated doll in honor a breast cancer patient or survivor (pick from a list of adjectives — beautiful to brilliant — to describe the honoree). For every doll named now through year 2008, AstraZeneca, a London-based pharmaceutical company, will donate $1 (up to $25,000) to Living Beyond Breast Cancer, a Pennsylvania-based non-profit dedicated to empowering women affected by breast cancer. In this case, every click really can make a difference.