In recent years, breast cancer was never far from Tracy Shen’s mind. How could it be? After her mother was diagnosed with stage 3 breast cancer at age 75, there was always that lingering worry: Could I get it too?
So when Shen’s doctor found something on her yearly mammogram in 2020, she braced for the worst.
But Shen had something going for her: Her condition had been caught early, thanks to her annual routine screening.
An important decision
Shen, 50, had moved to Charlotte from Asheville in June, starting a new job in finance for Novant Health, all in the middle of the pandemic.
Not only was Shen leaving her home of 27 years, she was starting over from scratch with a new set of providers at Novant Health. In October 2020, Shen made sure to get her yearly mammogram, but with a whole new care team.
But this time, her screening results were not completely clear. The doctors had found something. They followed this first image up with a diagnostic mammogram, which targets certain areas of the breast to gather more detailed information and analyze any lumps or spots that show up on the initial screening.
The diagnostic mammogram showed that Shen had calcium deposits in her right breast, which could be an indicator of cancer. Calcifications are often so small that they cannot be felt on a clinical exam and are only detectable via screening.
Mammograms catch problems early. And early is good.
Her doctors recommended a biopsy. It showed that the lump was not cancerous but was a risk factor for potential future breast cancers.
Shen had an important decision to make: have surgery to remove the calcifications, or have doctors track it with twice-yearly diagnostic mammograms.
Shen’s surgeon Dr. Amelia Merrill, a breast surgical oncologist at Novant Health Cancer Institute - SouthPark, recommended that Shen have the surgery to get a better evaluation of the calcifications.
But it was all up to Shen.
Keeping family history in mind
The deciding factor for Shen to proceed with the surgery hinged on a single question: “In the back of my mind, I was asking myself, ‘Why do you want to keep a bomb in your body? When it explodes, I will have much more of a mess to deal with.’”
She thought about her mother’s experience. Her mom, who lives in China, was diagnosed with stage 3 breast cancer five years ago, meaning it had spread beyond the immediate region to nearby lymph nodes and muscles.
When looking in a mirror, her mother had noticed a lump in one breast. After her diagnosis, she had a mastectomy but was not a good candidate for chemotherapy. Instead, her mother takes medication, which has caused pain in her bones. Before, she was active and loved taking daily walks. Now, even though she’s learned to cope with the medicine, simply moving around the house causes pain.
Shen knew she didn’t want to end up in that situation someday.
She asked Merrill how long it might take for an area like hers to progress. It would likely grow slowly over time, Merrill said, “but certainly we know that breast cancer, when it is not treated, will grow and it will spread.”
In February 2021, she had breast surgery (in this case, a lumpectomy) to remove the calcifications.
And after hearing the results of the pathology report, Shen was grateful she’d had the surgery. The pathology report revealed that she did have cancerous cells, meaning Shen had been living with stage 0 breast cancer. Stage 0 means that the cancer had not spread beyond its place of origin.
After the surgery, she quickly returned to work and “normal” life —“I was able to go back to my yoga practice after like a week.” The lump was gone, and that was a huge relief.
Ensuring the cancer is gone
Because the cancer was in stage 0, Shen had options for her next steps. She could undergo radiation therapy and she could take hormonal treatment therapy to reduce the risk of cancer recurrence.
Shen chose to go through about two weeks of radiation therapy at Novant Health Cancer Institute - Elizabeth. Every day she went to the center, received the localized radiation treatment for about one minute, then went back to work.
“So the whole thing, plus driving, was maybe just 40 minutes,” Shen said. “It was very convenient to the patient.”
Shen is now cured from her breast cancer, Merrill said.
Mammograms save lives
As an Asian woman, Shen had always been told that while her mammograms may look completely normal, there was a caveat. Because Asian women tend to have more dense breast tissue, it can be difficult for a mammogram to detect any potential masses through that tissue.
Shen credits the mammogram with catching the calcium deposits that she would later learn was breast cancer. After she was told about the calcifications, she asked how long they had been there. The Novant Health physician on staff that day said that it had likely been there for several years, but apparently hadn’t been detected.
For Shen, this is all the more reason women should always get their yearly mammogram. Novant Health recommends that women 40 and older start their annual screening, even if they have no symptoms of breast cancer.
“Wherever you come from, do it,” Shen said. “Be brave, face it, and do it. And from the bottom of my heart, I hope you are 100% healthy. But just keep in mind, if you need any help, the help is here.”
Shen also said despite common fears that mammograms can be painful, that she felt no discomfort. But even if there is discomfort for some, she doesn’t want any woman to experience more serious pains later in life. She’s also aware that Asian women (and Latinas) have mammograms at lower rates than women of some other races.
“I don’t want to see what happened to my mom happen to another woman,” she said.