Breast cancer in the bones: A mastectomy doesn’t end the threat of recurrence - The Explorer: News

Breast cancer in the bones: A mastectomy doesn’t end the threat of recurrence

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Posted: Wednesday, October 19, 2011 10:20 am | Updated: 4:46 pm, Wed Nov 2, 2011.

With a smile, Dorothy Nelson waited patiently on Oct. 7 to have an oncologist confirm what she already knew. She knew that recent back pain means she will have to go through more radiation treatments to stabilize the breast cancer running through her bones.

Dr. Rachel Swart, of the Arizona Oncology offices in the Northwest Medical Center, said Nelson has a condition known as metastic breast cancer, or breast cancer in the bone.  It has spread through Nelson’s spine, her skull and most of her body.

Nelson is in Stage 4, and Swart explained during the exam that cancer could cause bones to fracture or break without impact.

As she examined Nelson, Swart confirmed that while the back pains may not mean more cancer, it will likely require radiation treatments to keep the cancer cells neutralized.

As she pressed along Nelson’s body, Swart also found an area of pain in her abdomen that caused some concern.

After the hour-long appointment, Swart ordered the usual round of blood tests, medication and shots, but because of Nelson’s increased pain, she added orders for X-rays and a referral for her to see a radiologist.

With a positive attitude and a smile, Nelson takes the orders, endures the treatment and explains that she is getting treatment for something that she had never heard of until last year.

Nelson, an Oro Valley resident, was originally diagnosed with cancer nine years ago at age 72. After undergoing a mastectomy, Nelson said, by removing her breasts, she like many women, assumed she would be cancer free.

“I didn’t want a lumpectomy, I wanted a mastectomy to just remove the problem all at once,” she said. “Then, nine years later I go to the doctor with a pain in my side that doctors thought was just a muscle pull. Then, the pain switched to the other side, and before I knew it, they said I had breast cancer in my bones. This is something I have never even heard of.”

There is always a possibility of recurrence after the first diagnosis, according to Swart. However, there is not a lot of data to explain how a form of breast cancer can get into the bone and spread throughout the body.

One theory is that a breast cancer cell following a mastectomy can attach to a bone and lay dormant for an unknown amount of time until something triggers it.

“Unfortunately, it is just something that happens,” Swart said. “In Dorothy’s case, she did everything right. She got all the right treatments to prevent it from coming back, but it just happened.”

One of the problems points to an issue with the health care system. Swart explained that once a woman has the mastectomy, the cancer threat is believed to be eliminated; insurance companies will no longer pay for full-body scans.

Nelson said the breast cancer cells were able to spread throughout her body for years without her suspecting a thing. Now that Nelson understands there is no cure, her goal is to educate other women not to be complacent about preventative care, even after having a mastectomy.

“I just don’t want people to ignore the signs,” she said. “This has been really scary for me. My husband and I thought I was going to die. I was in so much pain. I had the first pains in February of this year, and by March, I was told I had cancer.”

Nelson has a positive attitude, and believes with proper treatment the cancer can be neutralized. But, with very little information about her disease and X-rays showing cancer throughout her entire body, she said at times she is, “scared because it’s just everywhere.”

“Women just need to always have in the back for their minds that the cancer could always come back,” she said. “I feel I’ve lived my life and done a lot of things. It’s not as much a tragedy for me to get this diagnosis as it would be for a younger person.”

Nelson said she will continue getting treated, living her life and being proud of what she has accomplished over the years, no matter what the future brings.

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