>> You're watching Hope and Courage, a tribute to breast health on ABC 27, brought to you
by Penn State Milton S. Hershey Medical Center.
>> Welcome back.
We know the statistics; one in eight women will get breast cancer.
A Daughin County woman never expected to become part of that number.
[ Inaudible ]
Chris and Howie Smith's world revolves around 19 month old Josh, he's their first grandchild.
>> Who's there?
Mr. Bear, what's he say?
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>> Chris embraces these precious moments because there was a time she wasn't sure she would
ever experience this.
>> I was doing a self-breast exam, notice that I had a lump, went in for my mammogram
and on my mammogram, they said oh, you know, we need to an ultrasound and I said okay,
that's fine, I've had that done before.
I really thought I had a cyst.
>> But doctors weren't sure.
>> They said, no, I think we need to biopsy it so I said okay, I -- they did a biopsy
before and no issue with that.
>> I keep thinking well, when you have a lump, it could be it and she wasn't worried, I was
a little worried.
>> A few days later, Chris found out the results of the biopsy.
>> The biopsy showed that she had a cancer in her breast, the upper right part of right
breast.
You can see in the area that we were concerned about up in this area where the circle is
and so on, you have this bump that doesn't belong there, it's rather dense and it's asymmetric
compared to the other side.
>> I was pretty much shocked because that wasn't at all what I thought.
>> Around that same time, Chris found out her daughter was pregnant.
>> One of my biggest fears in the beginning was, you know, when I was first diagnosed,
I -- here I am going to have my first grandchild and I'm not going to be around.
>> It's probably the only time during the whole process that she really broke down one
day.
>> Chris' fears were put to rest once a plan was put into place.
>> I recommended a lumpectomy, I thought it would be easy to do based upon her MRI.
It looked as though the size of the tumor was about an inch, maybe a little bit larger
than an inch at the -- from the MRI.
>> I was really pretty set like, okay, they found cancer, you take this out and I'll be
fine.
Whatever else has to happen is what happens.
>> The surgery itself I don't think was the big concern.
My real worry was did you get it all?
>> Part of getting it all involved more tests.
>> Since 2005, we've been using a test called the oncotype which develops a recurrent score
or risk of recurrence.
>> The oncotype test looks at the actual genes in the tumor and can predict not only the
chance of recurrence but also whether there's going to be a benefit to chemotherapy.
>> She went onto get a oncotype recurrence score and her score came back at 27.
>> Chris had a test result that was kind of in the middle to high range so when I met
with her, I told her that there's probably a benefit to chemotherapy.
>> I was like, well, it's on the higher end of the middle, I'm thinking that means the
chemotherapy is where I'm headed.
>> So Chris underwent four chemotherapy treatments.
Dr. Cream [assumed spelling] told her what to expect.
>> You're going to go through your first course of chemotherapy and probably within three
weeks, you'll start to lose your hair and you're going to be really tired.
>> Everything held true.
>> Chris' daughter is a hairstylist and she knew what her mom needed.
>> She said here's a wig I think would look really cute and we're going to cut your hair
to that style and then once you end up losing your hair, we'll -- it's going to look just
like your wig and it's going to be fine.
>> There's his phone.
[ Background noise ]
>> With months of chemotherapy and radiation behind her, Chris has a new look and a new
outlook.
>> Where's a piggy?
There's a piggy.
I feel great, I really don't even think about it anymore.
We had a grandchild, we've been busy, we're very active with him.
I think life is good.
>> As you can see, Chris does feel great.
Now a year later, Chris' sister was diagnosed with breast cancer, she took the oncotype
test and it was determined that chemotherapy would not benefit her.
Alisha?
>> All right, Deborah, thanks a lot.
Joining us now is Oncologist Dr. Cristina Truica, thank you for being here.
>> Thank you [inaudible].
>> Let's talk more about this test, this oncotype DX test.
Go through, what is this again and how is this done?
>> So the oncotype is a genomic test that looks at about 21 genes in the tissue of the
patient with breast cancer and has the ability to predict the risk of the cancer recurrence
and the overall survival for that specific patient.
In addition, a more powerful tool is that it allows it to predict whether there is a
benefit from chemotherapy or hormonal therapy.
>> And talk more about how this helps women, you know, make decisions, important decisions
that they need to make.
>> It does, the oncotype basically gives us a recurrence score, the recurrence score can
be low and in that situation, we have a lot of evidence that there is no benefit from
getting chemotherapy that basically saves the patient the chemotherapy treatment.
The oncotype, if it comes back as a recurrence score that is in the high range, then there
is strong evidence that there is a lot of benefit from giving the patient chemotherapy.
The more difficult situation is when the oncotype recurrence score comes back in an intermediate
range.
For those patients, we do not have a lot of research and a lot of data as to whether they
should get chemotherapy or hormonal therapy.
We have clinical trials that have been completed and we are waiting those results.
>> Okay.
Very good.
And look, you do feel like there are certain patients who should get this test, who are
they?
>> This test right now is only being done in patients who have [inaudible] positive
breast cancer.
Also, for the time being, we have a lot of data only for patients whose cancer is not
in the lymph nodes.
We are working, however, on taking this test for the patients who [inaudible] positive
and the cancer is also in the lymph node in the hope of saving some of those patients
the chemotherapy as well.
>> And are there some other options for women when it comes to, you know, chemotherapy or
these hormone blocking agents, what else?
>> We do, so there is another type of breast cancer if you've heard called the [inaudible]
positive breast cancer and for that cancer, actually we have a lot of tools nowadays,
we have a drug called [inaudible] that has been shown to decrease the risk of the cancer
recurrence by about 50% so it is approved for the [inaudible] treatment of those patients.
>> Dr. Truica, thank you so you much, and we'll be back with more questions right after
this.