Ultra Early Diagnosis for Breast Cancer

In what was to become a “surreal event”, Chris Knight had a laid-back attitude about responding to an invitation for a check-up at the High-Risk Breast Clinic in Jackson. Soon Henry Ford Health specialists would find two tiny spots with cancer cells that may have taken as long as two years to be seen on a mammogram.

School was out for the summer, and Chris, a teacher for 28 years, had plans to celebrate her 50th birthday with a trip to Ireland. Worldwide travel had influenced her history classes at East Jackson Secondary School, and for five summers she had traveled to Europe and Australia with students from Lansing. But that summer, she would be taking an unplanned trip to Henry Ford Health in downtown Detroit.

Although Chris had a normal mammogram earlier in the year, she had several risk factors for breast cancer. Her mom had the disease and her grandmother had ovarian cancer. Chris never gave birth, and she had dense breasts. So, mammogram technicians referred her to the High Risk Breast Clinic at Henry Ford Jackson Hospital as a precaution.

At the clinic, she received a unique offer: Four checkups each year for breast cancer. They included two clinical breast exams, plus an MRI and a mammogram alternating every six months. Also, genetic testing could be done for qualified patients.

Nonchalant, Chris agreed to the schedule. During her first MRI, something very small showed up. “They weren’t 100 percent sure about it, so they did an ultrasound,” says Chris. But doctors were still uncertain. So, using advanced technology, an MRI-guided biopsy was done at Henry Ford Health in downtown Detroit.

“I was really worried about the MRI-guided biopsy, but the people doing it were wonderful,” says Chris. Two days later, she received a phone call. Invasive ductal, hormone-receptor positive cancer cells had been found in two tiny spots.

“Life became dramatically different in a hurry,” she says. “I hated that this was happening, and life felt surreal.”

At Henry Ford Health in Jackson, she met surgeon Phillip Frantzis, M.D. He reviewed her case with the members of the breast cancer team at a tumor board meeting and determined that the cancer only required a lumpectomy and radiation therapy. Says Dr. Frantzis, if the cancer had been found a year later, it is likely that the two areas would have been bigger, and chemotherapy may have been needed also.

“Dr. Frantzis was kind and understanding. He gave the facts, and his bedside manner was wonderful. He was never condescending. Before the surgery, I was crying because I’d never look the same. He told me that tears were to be expected and things will be different now,” says Chris. Dr. Frantzis had also treated Chris’ mom for breast cancer 10 years earlier.

During the nearly two-hour surgery, a sentinel lymph node biopsy was done to determine if cancer cells had spread to the lymph nodes. It hadn’t. Only four lymph nodes were removed along with the two cancerous areas.

“I was beyond shocked how good I felt afterward. I expected a fair amount of pain, but I was just a bit sore,” says Chris. She went home a couple hours after the procedure and stopped taking pain medication after two days.

For Chris, the lumpectomy resulted in a visual change to her breast. “I had been really worried about how emotional that was going to be,” says Chris. “I’m still dating, and if some guy has a problem with it, well, that tells me everything I need to know about him.”

To boost her mood after the lumpectomy, Chris quickly returned to her routine activities, “When you have a black cloud over you and you can do your normal things, that cloud shrinks a lot,” she says. “I’m trying to do things that are important to me. That keeps me sane and happy.”

Using humor has also been helpful. “My parents and I have been cracking jokes about my breast, rather than taking this super seriously. That’s a big deal. It takes down the seriousness and sadness of this if you can joke about it,” says Chris.

To renew her energy, Chris visits many of the friends who sent her gifts and took her to dinners after surgery. Plus, she plays with her black Labrador, a happy dog that thumps her tail in her sleep. Chris also landscapes her yard with lots of flowers, then sits back and enjoys the work she’s done.

Soon she’ll start taking a drug to block female hormones and reduce the risk of cancer recurrence. In addition, she’ll receive radiation therapy for about four weeks.

Dr. Frantzis has some advice for women. Talk to your doctor about your risks for breast cancer. They include dense breasts, older age, genetic mutations, previous radiation therapy and a family history of breast or ovarian cancer.

Says Dr. Frantzis, breast cancer among women in their forties has increased, so mammograms are recommended every year starting at age 40. Women with a family history of early onset breast cancer should get their first mammogram 10 years before the age when their mother was diagnosed. If the mother was diagnosed at age 44, the daughter should have yearly mammograms starting at age 34. Mammograms are not recommended prior to age 30 because breast tissue is very dense and early cancers may be hidden.

For high-risk women living in rural areas, Dr. Frantzis advises them to obtain a referral to a high-risk breast clinic in surrounding counties – even if they have a negative mammogram.

He adds, “If you’re going to have breast cancer, it’s better to find it early. It takes about six years for typical breast cancer to grow to the size that it can be felt during an exam, and a mammogram can catch it a year or two before it can be felt."

To help protect against some cancers, it has been advised to stop smoking and get sufficient exercise.

Looking back, Chris says, “I’m so thankful Henry Ford started this High-Risk Breast Clinic. Had they not done it, the conversations would be very different in years from now.”

With an eye toward the future, Chris wants to finish seeing all of Europe. “When I retire from teaching, I want to start another career. I don’t know what lies ahead of me, but I’m excited to see what happens next.”