Sponsored by Cape Fear Valley Health.
When Gina Autry was diagnosed with breast cancer in April 2023, she was shocked — Gina, 41, didn’t have a family history.
Though a surprise to Gina, her story is not unusual: According to research published in the American Journal of Public Health, 80 to 85% of women diagnosed with breast cancer have no family history of the disease. Gina’s case highlights the importance of regular screenings and early detection.
Back in 2023, Gina had gone in for an annual mammogram that month because she just turned 40 and her gynecologist recommended she get one. According to the United States Preventive Services Task Force, patients with average risk should start receiving mammogram screenings starting at 40.
The day after her mammogram, she received word from her doctor, Dr. Anessa Lewis of Women’s Wellness Center on Village Drive in Fayetteville, that there was an abnormality and she needed further imaging, which revealed yet another abnormality. She had biopsies taken of those two areas.
The call came one day when she was teaching 4th grade at Mintz Christian Academy in Roseboro, North Carolina. She left the classroom to hear the words from her doctor: “invasive ductal carcinoma.”
On the phone, Dr. Lewis explained that the biopsy results showed the cancer had spread outside of her milk ducts into her breast tissue. Dr. Lewis also told Gina that she had taken the liberty of getting her a referral to see Dr. Elizabeth Sawyer, the medical director of Cape Fear Valley’s Breast Care Center.
“She told me I would be in very good hands,” Gina said.
When she met with Dr. Sawyer, Gina said she received a fairly detailed treatment plan, which included undergoing chemotherapy first and surgery second. She also had genetic testing done to see if there were any inherited genetic mutations.
“I was still fairly young at age 40 to receive the breast cancer diagnosis and sure enough I tested positive for BRCA2, which gave me a higher risk of having breast cancer,” Gina said.
Genetic mutations in the BRCA genes also cause individuals to be at higher risk for developing ovarian and breast cancer, according to the Centers for Disease Control and Prevention.
Gina’s first chemo treatment was in May 2023, which she continued through October of that year. Because of her genetic predisposition to further develop the disease, Gina decided to undergo a double mastectomy after chemotherapy despite the cancer being contained to her right breast.
Dr. Sawyer performed the surgery to remove all her breast tissue in October along with plastic surgeon Dr. Leif Nordberg of Cape Fear Valley Plastic Surgery, who paired the removal with an immediate reconstruction of her breasts. Dr. Sawyer removed Gina’s tissue and the sentinel lymph nodes towards her right arm where the cancer would have been most likely to spread and sent it to pathology.
“The next step was waiting for pathology to come back to see if I required radiation or any further treatment,” Gina said.
Gina said it was explained to her that the cancer was like a lake and the lymph nodes were like rivers to different branches, which is why the lymph nodes were also removed. When the pathology came back, it was clear that she needed further treatment.
“Dr. Sawyer said that chemo had worked to shrink the tumor, but it did not eradicate all of the cancer,” Gina said.
With the news that she had residual disease left, plus one lymph node that came back positive for cancer, she was referred to an oncology radiation specialist and scheduled radiation treatment at the Cape Fear Valley Cancer Center.
In early 2024 after her radiation treatment was completed, Gina rang the bell for the second time. She rang the bell for the third time on Aug. 8. Ringing the bell is symbolic of finishing a treatment, marking it as a milestone and beginning anew as a cancer survivor, according to Penn Medicine.
Her journey so far had included 30 rounds of chemotherapy, a double mastectomy surgery, and 28 rounds of radiation.
“I am technically cancer-free,” Gina said, with the radiation and additional chemo treatment she underwent being “the icing on the cake.”
“It added a layer of protection to hopefully make sure all cancer cells were killed and decrease the chance of reoccurrence,” she explained.
Dr. Sawyer said that Gina’s story is not uncommon and that annual mammograms are not anything to put off.
“Eighty percent of women do not have a family history,” Dr. Sawyer said. “The risks are not just related to family history. Other types of cancer increase the risk of carrying a genetic mutation.”
Dr. Sawyer said other factors include having dense breasts, starting your period early in life, or having a child late in life.
She also said that if a patient has increased risks of developing breast cancer, the Cape Fear Valley Breast Cancer Care Center has enhanced surveillance to try to catch the disease early.
“For average risk, women should start screening at age 40, do it every year, and not stop ever, according to the American College of Radiology,” Dr. Sawyer said. “But let’s say you have a family member like a mom, a sister or aunt who have had breast cancer — we will back up 10 years.”
She said if a family member was 45 when diagnosed, the provider would start a more intensive screening at age 35. If a genetic mutation is discovered in a patient — which she said more and more women are being tested for early — the doctors recommend screening at age 25. According to Dr. Sawyer, the genetic mutation can be carried by men, who can also develop breast cancer, though the risk for men is far more rare than it is for women.
“I always say bad news does not get better with time,” Dr. Sawyer said. “We haven’t found a way to prevent breast cancer, but when we detect it early, there is a 96% survival rate in the first stage and possibly have less aggressive treatments if it hasn’t spread.”
She said her goal when she became the medical director of the Breast Care Center was to make it a program where women could feel confident that they were getting the best care.
“We’ve worked really hard to create a bubble for these women,” Dr. Sawyer said. “We work to make them feel protected and safe with the best treatment.”
To ensure that they create the best treatment plans, her team gets together twice a month to go over every single patient and have a multidisciplinary discussion regarding treatment.
“We all get all of the doctors and support staff together to talk about the treatment plan including new clinical trials and medicines,” Dr. Sawyer said.
She added that it is important to “know your lemons” and have an acute breast self-awareness. The “Know Your Lemons” campaign is a breast health education program that helps women recognize changes in their breasts such as hard lumps, dimples or anything else that may be a sign of breast cancer.
“It’s important to recognize changes in your breasts and know your risk factors,” Dr. Sawyer said.
Gina said she was lucky to catch her breast cancer early. She was also grateful to have her family around and credits her faith.
“It was my relationship with the Lord that got me through this journey,” Gina said.
The beginning of Gina’s treatment was preceded by another major medical diagnosis within her own family. In the summer of 2022, her oldest son, Hollin, had a non-cancerous brain tumor removed at age 15. Gina was diagnosed with breast cancer that next April.
“He showed such strength and faith during that time,” Gina said. “I knew I needed to do the same. He set the example before me.”
She said she saw her Christian faith play out in every step of her journey.
“I have seen His fingerprints in my medical team, in the peace He gave, and even when my husband shaved my head and I went out in public for the first time with a bald head,” Gina said.
Her husband Max, son Hollin, and twins Lia and Cole along with her parents, extended family, and church friends kept her going.
“They offered support beyond belief,” Gina said. “From feeding my family to sending care packages, I was never alone.”
Her friends even gave out bracelets that said “She can, she will” and sold 450 T-shirts that helped support her medical journey with the same motto and “Praying for GG.”
“When all I could see was the valley, the Lord could see what was on top of the mountain,” Gina said. “It was the Lord, my friends, my family, and my medical team who never left my side.”
She said that her doctors, including her oncologist Dr. Kenneth Manning, Dr. Sawyer, chemo nurse Jayme Arnette, and Dr. Nordberg, are some of the best around.
“They have been tremendous,” Gina said. “From the front desk receptionist to every doctor, I had peace knowing I was in good hands.”
Gina completed her breast reconstruction in early September and will be undergoing a complete hysterectomy as a preventive measure for ovarian cancer at the beginning of 2025.
To learn more about the Cape Fear Valley Breast Care Center, call 910- 615-5655 or visit capefearvalley.com/woman-children/mammography/breastcare.html.
Read CityView Magazine’s “Arts & Culture” October 2024 e-edition here.
