- 2017 Miles of Hope Community Walk for Breast Cancer.
As a dancer, Mary Ritter has always been in close conversation with her body. So, in the fall of 2010, when a lump developed in her right breast, she knew something was wrong. "I wear leotards and tights and all kinds of things that are close to my body," says Ritter, a dance instructor at Yanarella School of Dance in Beacon. "I was always very conscious of what was going on, so I knew this thing was happening. It just happened to be two weeks before my dance recital." Yet even her keener-than-average body awareness couldn't keep up with the speed of the tumor that was growing inside her. As recently as January, she'd had a clean mammogram—but in the space of ten months, a tumor had taken root and quickly claimed her entire right breast. "They brought me in and did another mammogram, and basically had the technician read it immediately because they suspected something," she says. "They did a biopsy, I had my dance recital, and two days later they called me with the news."
It was Stage 3 cancer and very aggressive, so the doctors had to work quickly. To get the tumor to stop growing, Ritter went through five rounds of chemotherapy. "I lost my hair right after Christmas," she recalls. "At one point I was hospitalized because I was so weak." By April she was ready for surgery, electing for a double mastectomy because even though her left breast was cancer-free, she knew she was susceptible. "I was close to 50 and didn't need my breasts anymore," says the mother of grown children. A plastic surgeon performed reconstruction the same day as her mastectomy. "I wanted to be able to put on a leotard and not have people say, 'Oh my god, what happened to that woman?'" Ritter also started radiation about a month after the surgery, because the doctors couldn't say for sure whether her lymph nodes were clear. She wasn't going to take any chances. Today she is a seven-year breast cancer survivor, a grandmother of two with a third on the way, and she's never stopped dancing.
The Rise of Tumor-Melting Smart Bombs
Gone are the days when a one-centimeter tumor automatically meant a total mastectomy. Gone as well is the assumption that a breast cancer patient will need chemotherapy in all scenarios. "Now we send a molecular test in most cases where we determine whether or not the patient will actually benefit from getting chemo," says Schaefer-Cutillo. With a test like Oncotype or MammaPrint, doctors can figure out what makes a tumor tick and match it with a medication designed to kick it where it counts. The de-escalation of chemotherapy, once considered unthinkable, is a new line of discussion that's only made possible by recent advances and new pharmaceuticals. "The science has advanced, and we're using more molecular, targeted treatments than ever before. This allows some patients to avoid a lot of the toxicity of chemotherapy, and also get them to the treatment they need faster. We do have to use chemotherapy in some situations, but we really try to use more targeted, less toxic drugs so we can help people maintain their quality of life and treat their cancer more effectively."
The transformation in breast cancer treatment started in the early 2000s with the FDA approval of a drug called Herceptin to treat HER2-positive breast cancer (that is, breast cancer that tests positive for a protein called human epidermal growth factor receptor 2). While HER2-positive accounts for just 25 to 30 percent of all breast cancers, historically it has had very poor outcomes with a high risk of the cancer coming back after surgery. Researchers found that adding Herceptin to chemotherapy resulted in a 50-percent reduction in the rate of the cancer's recurrence. Yet since the Herceptin-chemotherapy combo also increased the risk of heart failure, they took it one step further by reducing the amount of chemotherapy that patients needed—and in so doing, reducing the heart-failure risk.