Defense Attorney & Cancer Warrior Joins Clinical Trial, Discovers Previous Surgery Had Removed a Lymph Node Instead of Her Cancerous Tumor

Albi traveled to Boston in early 2020 to join a clinical trial for her breast cancer at the Susan F. Smith Center for Women's Cancers at Dana-Farber/Brigham and Women's Cancer Center. It was there that she discovered an earlier surgery for her breast cancer had not been as effective as it should have been: At the trial, they discovered a tumor in her breast that was missed during a previous surgery.

Joy’s Breast Cancer Journey

Albi was diagnosed with HER2-positive breast cancer, a type of breast cancer in which the tumors have higher levels of a protein known as HER2. HER2 is a growth-promoting protein on the outside of all breast cells, says the American Cancer Society (ACS).

Albi is grateful she took part in the trial, saying, “Thank goodness for that second look by Dr. Sara Tolaney. Every cancer patient has a ‘what if’ moment, and mine is ‘What if I had never come to Boston and said I wanted to join that trial?'”

Albi’s breast cancer was discovered when her oncologist in Cincinnati noticed a “blueberry-sized spot” on the attorney’s breast during a mammogram in November 2019. After a diagnosis of breast cancer, Albi then had a lumpectomy in which her tumor was removed. For the next phase of her treatment, Albi went to the Susan F. Smith Center in Boston, where she’d take part in a clinical trial.

“I was a good candidate for one of her upcoming studies, and we went home very excited about doing something that would help me and push the science forward,” says Albi.

Weeks later, Albi’s doctor, Dr. Tolaney, called her saying that the pathology slides from her lumpectomy showed that what had been removed from Albi’s breast was a lymph node, not a breast tumor. An MRI was ordered, and it showed a tumor. Due to dense breast tissue, the tumor had originally gone undetected. Albi then had a second lumpectomy to remove the tumor, followed by a year-long chemotherapy regimen. Today, she is in remission.

HER2-Positive Metastatic Breast Cancer Treatment Options Explained

Screening for Breast Cancer

Screening for breast cancer is done via mammogram, which looks for lumps in the breast tissue and signs of cancer. Women should have annual mammograms between the ages of 45 and 54.

Related: When You're Getting a Mammogram, Ask About Dense Breasts

Dr. Connie Lehman, the chief of the Breast Imaging Division at Massachusetts General Hospital, explains in an earlier interview the need for regular screenings.

“If you haven’t gone through menopause yet, I think it’s very important that you have a mammogram every year. We know that cancers grow more rapidly in our younger patients, and having that annual mammogram can be lifesaving,” she says.

“After menopause, it may be perfectly acceptable to reduce that frequency to every two years,” says Dr. Lehman. “But what I’m most concerned about is the women who haven’t been in for a mammogram for two, three, or four years, those women that have never had a mammogram. We all agree regular screening mammography saves lives.”

When Should I Get a Mammogram?

What Are Dense Breasts?

If you have dense breasts, it becomes more difficult to detect cancer with a regular mammogram. Unfortunately, there's no way to determine if you have dense breasts just by feeling them only a mammogram can determine if you have dense breast tissue. Bestselling author and breast cancer survivor Laura Morton learned a really important lesson about advocating for herself when she was getting a mammogram, and questioned her radiologist about dense breasts. The radiologist brushed her off.

RELATED: When You’re Getting a Mammogram Ask About Dense Breasts

"I waited until afterward to mention to her how I felt about her response to what is a really important question, you can not feel if you have dense breasts. You have to be told if you have dense breasts," Laura says. "…So when somebody walks through your door and says, 'Do I have dense breasts?' Answer their question, don't roll your eyes and make them feel small for asking something that we are entitled to know."

Dense breasts can increase the risk of breast cancer.

"Dense breast is considered a significant risk factor because of two reasons," according to Dr. Cindy Lee, a radiologist at NYU Langone Health. "First, it has a masking effect on how well we can perceive cancer and find cancer on mammograms. Second reason is that it means the patients have more fibroglandular breast tissue, which produced a density on the mammogram. When you have more breast tissue, your risk for breast cancer is significantly higher."

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