by Lauren Pope, Staff Writer
When you’re breastfeeding a baby, you expect to have some strange changes happening with your body. Everything from engorgement to leaking milk all over the bed to clogged ducts or even mastitis can be in the realm of, if not normal, then commonly expected. However, imagine if you finished nursing your baby and something just felt…off. Would you go to the doctor, and have it investigated, or just shrug it off under the chaos of trying to survive with an infant?
Nichole Lauer is alive because she refused to ignore the signs that something was wrong. She was 30 years old with a 6-month-old baby when she felt like she had some sort of thickening on one breast.
It wasn’t a lump, yet, but it was definitely noticeable. It wasn’t the first time that she’d had some concerns about her breast health. About 6 months before she’d gotten pregnant with her baby, she’d seen her doctor about the fact that she was still able to induce lactation even though her older daughter was seven years old.
The doctor had dismissed that symptom by telling her to just avoid the stimulation that triggered it, but in retrospect Nichole sees it as the first warning sign that something might have really been wrong. “You have to advocate for your health,” she says. She had also had a previous biopsy in her 20s that had come back benign, so she was familiar with the process that she’d need to go through to get this latest concern addressed. In the middle of the Covid pandemic, she learned that she had Stage 2 Triple Negative Breast Cancer.
From WebMD :
About 80% of all breast cancers are “ER-positive.” That means the cancer cells grow in response to the hormone estrogen. About 65% of these are also “PR-positive.” They grow in response to another hormone, progesterone.
If your breast cancer has a significant number of receptors for either estrogen or progesterone, it’s considered hormone-receptor positive.
Tumors that are ER/PR-positive are much more likely to respond to hormone therapy than tumors that are ER/PR-negative.
In about 20% of breast cancers, the cells make too much of a protein known as HER2. These cancers tend to be aggressive and fast-growing.
For women with HER2-positive breast cancers, the targeted drug trastuzumab (Herceptin) has been shown to dramatically reduce the risk of the cancer coming back.
Some breast cancers — between 10% and 20% — are known as “triple negative” because they don’t have estrogen and progesterone receptors and don’t overexpress the HER2 protein. Many breast cancers associated with the gene BRCA1 are triple negative. They are often treated with surgery, chemotherapy, and radiation.
Triple negative breast cancer has historically been very difficult to treat. Because it lacks hormone receptors or the targetable HER2 protein, there has been little that doctors could do outside of surgery, chemo, and radiation. Unlike the hormone receptor positive cancers that respond very well to various types of hormone blocking therapy, there was no drug that could help prevent a recurrence of this type of cancer. That meant that women diagnosed with triple negative breast cancer faced a higher chance that it would return. Because this type of breast cancer is often diagnosed in younger women, this meant a lifetime of worry and uncertainty.
Thankfully for Nichole, a new regimen of chemotherapy and immunotherapy has just been discovered that is extremely effective against these types of tumors. “I was actually the first person in my area to undergo the new treatment,” she says. “I had a cocktail of 4 different chemo meds plus a drug called Keytruda which is immunotherapy.” Treatment lasted a full year for Nichole, and though she avoided most of the most awful side effects due to careful symptom management, one of the drugs she was on is called the “red devil” because of its bright red color and terrible side effects.
“The hardest part was when I went in for an infusion and they measured my neutrophils and told me that they were zero point zero. I literally had no immune system at all at that point. They told me that a simple cold could kill me, which was really scary because it was right in the middle of the pandemic. Then, right after that, my daughter was diagnosed with Covid. We had to isolate her away from me and my husband was running back and forth trying to take care of us both. Thankfully, I avoided it then and my immune system was able to recover.”
As hard as treatment was though, it was incredibly successful. Remember earlier when I said that originally, she just felt a thickening, but no lump? Well, the lump came on very soon afterwards and it was the size of a golf ball. However, after only one single round of treatment, that tumor had already begun to shrink.
“My doctor didn’t believe me until he saw it for himself,” laughs Nichole. “It was really dramatic. It came on very quickly and was gone just as quickly.” Even so, after she completed her medical therapy, Nicole opted for a complete mastectomy to reduce any chance of recurrence or lingering cancerous cells. She is currently considered to have no evidence of disease, but she will have to wait until she has been cancer free for 5 years to be considered “clear.”
Nicole tells me that she had genetic testing done to see if she had the BRCA gene mutation that makes triple negative breast cancer more likely. She didn’t have it. Cancer, for her, was just a fluke. “1 in 8 women will be diagnosed with breast cancer in their lifetime and triple negative breast cancer is more common in younger women and for Black women,” she explains. Even if you don’t have a family history or the genetic predisposition for this type of cancer, it is just so incredibly common, especially here in Louisiana, that all women should be aware of the signs and symptoms.
The experience of having breast cancer clarified some things for Nichole and her family. They had always wanted to move south from Illinois to Louisiana, but it was a “someday” dream. “Life is short.” Nichole says, “Don’t wait around. Pray about it and go where God takes you. My husband got an opportunity to take over a business here in Louisiana, and we saw it as an opening. Just keep the faith.”