Woman, interrupted
Enhancing care for young women
with breast cancer
By Christine Cleary
For Donna Ashton-Panas, becoming a cancer patient added another role to those of wife, mother, and attorney.
To a 33-year-old new mother on maternity leave from her job as an attorney, cancer seems as remote an event as the son she is nursing growing old. When she discovers a lump in her breast, she assumes it is a clogged milk duct or a trivial complication of breastfeeding.
For Donna Ashton-Panas, the lump turned out to be Stage I invasive ductal carcinoma; two centimeters wide, it was almost large enough to be classified as Stage II. Suddenly, she learned the breast that nourished her baby contained a tumor that threatened her life, and four-month-old Nicholas had to be weaned as his mother prepared for surgery. "This was more physically and emotionally painful than all the cancer Woman, interrupted treatments," says Ashton-Panas. She underwent a lumpectomy, surgery to remove 18 lymph nodes, and chemotherapy.
Similarly, Hally Steiner, 34, knows all too well how breast cancer can disrupt young women's lives: She was diagnosed a year after her younger sister was treated for the same disease and 14 years after their mother was also affected by breast cancer. Her mother and sister are in remission, but Steiner is receiving investigational treatment at Dana-Farber for a recurrence. This, she says, was harder to face than the original diagnosis. "The first time, I did what I had to do and thought I was fine," she says. "I put it behind me. Now, the cancer is back. Not an hour goes by that I don't think about it."
With women like Ashton-Panas and Steiner in mind, Dana-Farber is introducing in summer 2005 a Program for Young Women with Breast Cancer, made possible by an anonymous gift and a gift from Rob Adler and Carie Capossela Adler, to enhance comprehensive care and expand research opportunities.
Cancer interrupted the lives of Ashton-Panas and Steiner just when they were on the rise of life's curve, starting families and careers. Ashton- Panas says at first she worried that she would be unable to have more children, but soon concentrated on staying alive for her son. "This goal keeps me focused on what I have to do." Steiner worries that her plans to start a family with her husband, Michael, may be derailed by cancer. Already booking events in 2006 and 2007 for the party-decorating company she owns, she wonders, "Will I be alive then?"
Although the median age for a breast cancer diagnosis is 65, more than 12,000 of the nearly 216,000 American women who receive this diagnosis in a given year are 40 or younger. For them, breast cancer tends to be more aggressive than it is in older women. Although most women will survive their disease, a younger woman who is diagnosed with breast cancer is more likely to suffer a recurrence and die from her cancer than is an older woman. This means that further research is needed to help explain what is different about the breast cancers that develop in young women, so that they can be treated more effectively.
Modeled after the multidisciplinary approach practiced throughout the Women's Cancers Program at Dana-Farber, the new program will offer an enlarged team dedicated to caring for women under 40. They will receive treatment planning, psychosocial assessment, and support during and after cancer treatment, which is specifically tailored for their needs. Plans also include more help for their families.
"We already provide excellent care to young women with breast cancer," says Eric Winer, MD, director of the Breast Oncology Center in the Gillette Center for Women's Cancers at Dana-Farber. "With this program in place, we'll be able to do it just a little better. We will also be able to help these women connect to their counterparts, since they often feel quite isolated."
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