Amy, diagnosed at 24

My name is Amy Thomas. I am 38 years old, a wife, a mother and a 14 year breast cancer survivor. My husband, Jim Thomas, and I have been married for 19 years and have two great teenagers at home. Adam is 18 and a high school senior this year. Rachel is 15 and a high school sophomore this year.

In April of 1988, at 24 years of age, I was diagnosed with stage I breast cancer of the left breast. The palpable breast lump that had been surgically biopsied was a 1.4 cm high grade, infiltrating ductal carcinoma with some DCIS around the edges of the tumor. Adam and Rachel were two and four years old at the time.

I opted for breast conserving therapy and had a lumpectomy, axillary lymph node dissection and radiation therapy to my breast at Vanderbilt. The surgery showed that the tumor margins were clean and all 18 lymph nodes were negative for cancer. I had several weeks to heal, a couple of days of physical therapy and then started my radiation therapy. I had 28 total treatments; daily Monday through Friday. Even though I suffered from the skin effects of treatment, the daily trips were worse because I had to put my children in daycare. I had always been a stay at home mom and my heart broke to leave them every day!

When I got to the last week of radiation, my doctors told me that I should also have chemotherapy due to my young age and the type of cancer. I started what was supposed to be six rounds of CMF (cytoxan, methotrexate & 5-FU) chemotherapy, three weeks apart. I didn't do well with the side effects of chemo, but didn't lose my hair. After four treatments, I quit my chemo. due to my inability to handle it while taking care of the kids This was actually six months after my initial diagnosis and the help that was there in the beginning just wasn't there towards the end.

After treatment, I went back to college, commuting from Tullahoma to Columbia, Tennessee for 24 months. I received my AAS in Radiologic Technology, graduating from Columbia State Community College in 1991. I began work as a staff technologist as well as part-time mammographer at Harton Regional Medical Center in Tullahoma in the Fall of 1991. I quit to stay home with our children after the devastation of losing Jim's mother to a fatal car accident in 1995.

Then, eight years after my first diagnosis, my only sister was diagnosed with breast cancer (DCIS) in 1996, at the age of 38. She underwent a mastectomy and reconstruction in Louisville, KY where she lives and she came to Nashville to have a second reconstruction after the first one failed. She did not have any chemo and is doing great to this day. Looking for help for myself, so I could help her, I found Bosom Buddies Breast Cancer Support Group and the MCCSN in Tullahoma and Camp Bluebird and Vanderbilt's Breast Cancer Support Group in Nashville. I also went to the Family Cancer Risk Service for genetic counseling.

We recorded my medical family tree and obtained my father's medical records as he had died at 50 from probable pancreatic cancer metastatic to the liver at diagnosis. His sister and her daughter had both died of metastatic breast cancer at fairly young ages. At the time, I remember the pathologist telling me that he thought that our family may have the BRCA2 gene mutation (as my long term survival may point to), but he said that at that time it was beyond their scope of knowledge whether my father's pancreatic cancer was linked. I opted not to have the genetic test at that time because I wasn't sure what I would do with the information.

God was preparing a support network for me because in the Spring of 1998, ten years after my initial diagnosis, we got the devastating news that I had a local recurrence in the same breast. I had found a new lump and had my annual mammogram and a core needle biopsy at Vanderbilt. We do think it was a second primary cancer and not my original tumor because it had been ten years. Well, tell a 34 year old woman she has breast cancer for the second time, in the same breast. To me it was and is a recurrence as I am still the same body and mind, the same person. Unable to separate myself from my first experience, my worst fear had come true! This was mentally, and of course physically, much harder to deal with than the first time and our faith got us through it all. Adam amd Rachel were 14 and 12.

On July 1, 1998, I had a double mastectomy and bilateral tissue expander reconstruction. I soon started four AC (Adrimiacin and Cytoxan) chemo treatments lasting from July to October. Loosing my hair due to chemo was a new and unwelcome experience, almost as devastating as losing my breasts. I had the second step of my reconstructive surgery in January 1999, and the third and fourth steps in April and November 1999. I had pain in my back from the stretching process of the reconstruction until I had a series of "Prolotherapy" injections that has made my pain minimal and tolerable. The side effects of the chemo were much worse this time, as the new anti-nausea regimens did not work for me. I did, however, finish all of the recommended treatments. It took me well into the Spring of 1999 to feel "good" again.

Since my surgeries and treatment ended my oncologist has talked to me several times about having BRCA gene testing done. In the past I had always thought that I would do it someday, but have recently come to realize that I needed to know because having the BRCA 1 or 2 gene mutation makes me at increased risk for other cancers, including ovarian. I did have my test this past Fall and do have the BRCA2 gene mutation. Knowing why I had breast cancer, not only once, but twice, really has been a help to me, as I think we all ask and want answers about why things happen to us. Knowing the probable reason I lost my father to cancer as a 13 year old child has been a great comfort to me. I am now being followed more closely for ovarian cancer. Sometime in the future, when the time is right for me, I will have my ovaries removed to further reduce my risk.

I personally have never cherished life so deeply while at the same time accepting my own mortality. This feeling is hard to describe, but I know that it's God's way of making me so passionate about what He has lead me to do since. As of the Fall of 1999, I began coordinating the Bosom Buddies Breast Cancer Support Group in Tullahoma and last February, I returned to work as a part-time mammographer, after not working in the field for six years. Now, I feel advocacy work for women with breast cancer is part of that same calling. I went to Washington DC three times last year for the National Breast Cancer Coalition, Tennessee Breast Cancer Coalition and the local Komen affiliate. All of these are extremely rewarding experiences that fulfill me greatly and let God sustain me and my family through it all.

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