Angela K. Thomas turned to her faith, her family and the experts at Keck Medicine of USC to move beyond a breast cancer diagnosis.
While climbing into bed one night in 2016, Thomas felt something unexpected. Though she knew that fibrocystic breasts — a benign condition she had — feel lumpy to the touch, this time was different.
Her right breast had a lump.
Only 32 at the time, Thomas had no reason to think anything would be wrong. She was an otherwise healthy young woman enjoying a busy life in her adopted home of Los Angeles.
Breast cancer can affect women of any age
The aspiring actor was racking up credits on TV shows and in theater, worked in hospitality and was very involved in her church. She had no changes in the skin on her breasts, pain, or discharge from her nipples, which can be early warning signs of breast cancer.
Thomas called her doctor the morning after she felt the lump. Her doctor ordered an ultrasound and in the days that followed, she also had a mammogram and biopsies on both breasts. Within a week, she received the news that she had cancer in both of her breasts.
Though nearly 270,000 women will be diagnosed with breast cancer this year, most are older women, with the median age of diagnosis being 62. While it is rare in younger women, with fewer than 5% of new cases occurring in women under 40, breast cancer can strike at any age.
In the days before she got her results, Thomas says she prayed more often than normal. Through prayer, she came to believe two things.
“I knew it was going to be cancer and I knew I was going to fight it,” she says.
Early breast cancer diagnosis means more options for treatment
Thomas’ doctor referred her to the USC Norris Comprehensive Cancer Center. She saw Maria Nelson, MD, a surgical breast oncologist at Keck Medicine of USC, who would operate on her and guide her through treatment.
Dr. Nelson, who also is an assistant professor of clinical surgery at the Keck School of Medicine of USC, explained to Thomas that she had early-stage breast cancer. She specifically had ductal carcinoma in situ (DCIS) in her left breast and DCIS and invasive ductal carcinoma in her right.
Surgery is the mainstay for early-stage breast cancer but most patients also typically need some combination of radiation, chemotherapy and hormone therapy. It depends on factors such as whether the cancer has spread and what type of surgery is performed.
“I am so grateful Dr. Nelson entered my life. I am grateful that I have this story and I thank God I was able to survive it.”Angela K. Thomas, patient, USC Norris Comprehensive Cancer Center
As is the case with most patients, the first big decision Thomas had to make was whether to have a lumpectomy or mastectomy. Dr. Nelson says research has demonstrated that treating early-stage breast cancer with mastectomies versus lumpectomies plus radiation results in equivalent survival.
“There was really nothing to think about,” says Thomas, who chose to have a double mastectomy. “I have never been so sure about a decision as I was with that and it took me no time to make it.”
Research efforts have improved breast cancer survival rates
Thomas felt her choice would reduce her anxiety about the possibility of recurrence, which Dr. Nelson says is a fear that tends to be heightened among younger patients.
While recurrence is a concern most patients have, younger people have more years ahead of them — which also means more time for the cancer to stage a return, Dr. Nelson says.
Though fear of recurrence is a genuine concern for all patients, Dr. Nelson also points out that advances in breast cancer research have had a positive effect on survival rates. Genetic tests and genomic assessment have shed light on some patients’ ongoing risk profile and negates the need for chemotherapy in others.
New drugs are targeting certain cancers and preventing the recurrence of others. Doctors better understand which types of chemotherapy work best for specific cancer types. All of this work and the advances in understanding breast cancer have led to improved survival rates.
Emotional support and lifestyle changes after mastectomy
During the course of her treatment, which consisted of a mastectomy, reconstruction surgery and hormone therapy, Thomas received several pieces of good news about her prognosis.
The first came on the same day as her surgery in November 2016: Her cancer had not spread to her lymph nodes.
Genetic testing also showed that she does not have the BRCA genes, which raises the risk of developing breast and several other types of cancer. A genomic test showed that she would not need chemotherapy and determined that she has a relatively low chance of recurrence.
In spite of the good news, and her relatively straightforward treatment, Thomas says getting through it all has been challenging both emotionally and physically. Her close-knit family helped her stay strong and positive throughout treatment and recovery, both in-person and via video.
She had to make some difficult choices along the way, including deciding to freeze her eggs. Thomas has ongoing struggles with pain in her chest and has had to learn how to manage it with physical therapy.
She has made serious lifestyle changes, including changing her diet and getting more serious about working out to improve her chances of remaining healthy. She continues to see Dr. Nelson for follow-up appointments to make sure there are no subtle signs of recurrence.
In spite of the challenges, she says she has a lot to be grateful for. “I am aware that everyone’s story doesn’t end as well as mine,” she says.
“I am so grateful Dr. Nelson entered my life. I am grateful that I have this story and I thank God I was able to survive it.”