Triple negative breast cancer: Theresa’s story

Theresa Brandt, 69, has always made her health a priority. “I try to avoid processed food and maintain a healthy diet. I’ve run five marathons, exercise as often as I can, and my husband and I walk together frequently,” she says. Since age 40, Theresa has always had an annual mammogram with consistently normal results. But in September 2022, the day before her yearly screening, “my arm brushed against my right breast, and I was shocked to feel a large lump. I instinctively knew it was going to be a problem,” she recalls.

The next day, Theresa’s fears were confirmed. “My routine appointment was anything but routine. I spent three-and-a-half hours at the facility. They did two mammograms and an ultrasound, and then I took the dreaded walk to a private room where a very compassionate radiologist told me that he identified three lumps in my breast and one in my lymph nodes, which would all need to be biopsied.”

Two weeks later, Theresa’s general physician called with the biopsy results and immediately referred her to Roswell Park Comprehensive Cancer Center.

Tumor board + patient input = personalized treatment

A few days later, Theresa and her husband, Scott, met with Roswell Park surgical oncologist Jessica Young, MD, FACS and (now retired) medical oncologist Amy Early, MD, FACP. “I learned that I had stage 3 triple negative breast cancer, which is rare but aggressive. My case was even more rare in that triple negative breast cancer usually affects women who are younger than 40, African American, Hispanic and/or have a BRCA1 gene mutation, but I met none of those conditions.

“Prior to my appointment, both doctors reviewed my records and consulted with a team of other Roswell Park breast cancer experts to devise a recommended treatment plan: 12 consecutive weeks of chemotherapy along with an infusion of the immunotherapy drug pembrolizumab (brand name Keytruda), every three weeks. After successfully completing this regimen, I would start a final cycle of Keytruda along with ‘red devil’ chemotherapy – so named because of the drug’s red color and often harsh side effects. Then, if my body responded well to this regimen, Dr. Young would explore surgical options and then radiation,” Theresa says.

“Of course, I was nervous processing all of this, but they calmly and honestly answered every one of our questions and considered my input. I told Dr. Young that even though the cancer was only in my right breast, I preferred to have a bilateral mastectomy with no reconstruction, and she understood and agreed with me. Both doctors were compassionate and approachable, and I felt confident with their expertise and bedside manner.”

Coping and resources at Roswell Park

After hearing her diagnosis, one of the first things Theresa did was join an online support group for triple negative breast cancer patients. She also visited Roswell Park’s 11 Day Power Play Cancer Resource Center. “I borrowed Dr. Susan Love’s Breast Book from the Resource Center’s lending library. I also learned about Roswell Park’s complimentary Wig and Head Covering Program, and tried out several different beautiful headscarves and types of wigs and was surprised to learn that they even offered wigs with ear pieces to help assist with hearing issues. After deciding on a wig, the Resource Center staff suggested I visit the Elevate Salon before I lost my hair, so that they could help me match the wig to my hair color and style, and they did a wonderful job,” Theresa says.

Just before she started her treatment in November, Theresa’s son, daughter and grandkids sent a care package that included a gratitude journal. “That journal was one of the most cathartic things for me during treatment,” Theresa recalls with emotion. “Losing my hair was traumatic and I had many of the usual side effects of chemotherapy, including fatigue, dry mouth, bloody noses and fingernails turning black. But writing even one thing to be grateful for each day – feeling my tumors shrinking, seeing a beautiful cardinal perched on a snowy tree, watching a sunset, feeling better about myself after a visit to the Elevate Salon (you can see portraits of Theresa taken that day near the Elevate Salon), or getting a visit or food and support from friends, for example – helped remind me how good life can be and got me through the worst days.”

After completing her chemotherapy in April, Theresa underwent a bilateral mastectomy in May. “Compared to chemotherapy, this was a breeze,” she says. “Later that month, however, Dr. Young explained they had discovered some axillary lymph nodes deep in my armpit that would also need to be removed and biopsied to make sure that no traces of cancer remained, and I would need minor surgery. The great news is that all eight of these lymph nodes removed were negative for cancer, and I am healing well and continuing with the Keytruda.”

Theresa’s next step was to meet with Simon Fung-Kee-Fung, MD, Director of Breast Radiation. “After I heal a bit more from my surgeries, I will start radiation. Dr. Fung was wonderful in explaining everything about this process to me and my husband,” Theresa says. She recently met with Roswell Park’s lymphedema care team to address swelling due to removal of the additional lymph nodes.

Lessons learned along the way

Reflecting on her cancer journey, Theresa recounts some of the most valuable lessons she has learned. “Always get your annual mammograms. They are so important. And practice breast self-exams on a regular basis. I sometimes wonder if I would have detected my cancer earlier if I had been more diligent about performing breast self-exams more frequently.

“Reach out to really support others who are hurting. While I have sent cards to friends who were diagnosed with cancer, until I had cancer myself, I never understood how gestures like visiting, bringing food, offering to shop, and asking friends how you could help them really made a difference while they are going through treatment.

“Finally, even during the roughest times, try to find at least one thing to be grateful for each day. I will forever be grateful for so many things, including all of the compassion, care, and resources available to me at Roswell Park.”