When Past Meets Present: Confronting a Family History of Breast Cancer

Imagine the impact of those words when you’ve already lost your mother and your sister to the disease.

“I was only 12 when my mother passed away,” says Cheryl Mitchell, a 43-year-old middle school math educator and community service coordinator from Kenilworth. We had just moved from New York City to New Jersey, where we transitioned mom’s care to Overlook. I vividly recall driving there at night to visit her and counting the lights on the homes leading to the hospital.”

Losing her 44-year-old mother, and subsequently her 29-year-old sister in 2008, to breast cancer prompted Cheryl to be both fearful and vigilant about her own health. For more than a decade, Cheryl had annual mammogram screenings, periodic ultrasounds and MRIs, and numerous breast biopsies under the care of Marc Mandel, M.D., a senior member of the Carol G. Simon Cancer Center/Atlantic Cancer Care team and surgical representative to its Breast Leadership Program.

“Dr. Mandel suggested BRCA testing each time we met, but I resisted,” remarks Cheryl. “I wasn’t emotionally ready to know my genetic risk and he was completely understanding and patient.”

In June 2018, Cheryl’s past and present fears collided when she was diagnosed with Stage 2 breast cancer following a routine mammogram.

“Based upon my family history, many physicians would have pushed me to get a mastectomy, but Dr. Mandel understood I wasn’t comfortable with that at the outset,” admits Cheryl. “He gave me the option of a nipple-sparing lumpectomy and reconstruction with his colleague Dr. Jim Gardner, chief of plastic surgery.

“After reviewing my history with Dr. Mandel, Dr. Gardner spent a considerable amount of time educating me about different types of reconstruction procedures. He understood the need to preserve my self-image and spoke to me in a kind, personal human-to-human way.”

Following the lumpectomy on her 42^nd birthday, Cheryl underwent four rounds of chemotherapy under the care of Bonni Guerin, M.D., director of breast cancer treatment and prevention at Overlook’s Carol G. Simon Cancer Center. Thanks to the use of cold cap therapy, funded in part by the Overlook Foundation, she was able to minimize hair loss and soften the visible impact of her cancer treatment for her students in the Bedminster Township School.

“Sandra Wrigley, the nurse navigator, was another godsend,” observes Cheryl. “She sat with me during chemo, and she offered helpful advice and numerous holistic strategies throughout my treatment.”

Recognizing that there was a deeper emotional component to Cheryl’s care, Dr. Mandel encouraged her to explore her apprehensions and fears through counseling. Ultimately, Cheryl also agreed to BRCA testing, and when she tested positive for BRCA1, which put her at risk for both breast and ovarian cancer, she was better prepared to take additional proactive lifesaving measures.

Cheryl had her ovaries and fallopian tubes removed (her aunt succumbed to ovarian cancer at age 50) and in January 2019, Drs. Mandel and Gardner teamed up again to perform a bilateral nipple sparing mastectomy and reconstruction.

“I’m pleased that Cheryl agreed to BRCA testing,” points out Dr. Mandel. “Our genetic counselors are terrific assets to our cancer center and an integral part of our program. They can perform a wide panel of tests – based on family history – to determine your risk of developing a range of cancers and help guide treatment options.

“By proactively getting a bilateral mastectomy, Cheryl has significantly reduced her risk of local breast cancer recurrence and new disease developing on the other side.”

“I’m grateful for the outcome – physically and emotionally,” says Cheryl. “There have been tremendous advancements in diagnosing and treating breast cancer since my mother and sister were diagnosed. I feel fortunate to have access to that leading-edge technology as well as compassionate healthcare professionals who are equipped to treat the total patient, not just the disease.

“Dr. Mandel, Dr. Gardner, and the whole team knew and understood my fears. They were patient. They were supportive; and they gave me a voice throughout the whole process.”