From Diagnosis to Cancer-Free: Noelle’s Breast Cancer Experience and What You Need to Know

Hello, and I'm your host, Dr. Valida Crowder, also known as Dr. V, Board Certified Emergency Room Physician, committed to empowering you with important health information. You know, we're going to talk today. I want to thank you guys for joining us. We're going to talk today about breast cancer and you. So, um, and I always tell people, um, if you want to actually hear this show again or you want to go back and reference the show, all of these shows are uploaded to my podcast. And you can find the podcast on Apple Podcasts, Audible, Podbean, iHeart, any sort of online streaming podcast. I am there. So if you want to actually go back and hear this episode or any of the other episodes, please go on back there and you'll actually be able to re-listen to anything that you hear. All right, so this month is breast cancer awareness month. Um, and so today we're not just talking about breast cancer. We're gonna hear from someone who has lived it. My guest, Noelle, is a former ballerina, currently an engineer and an author, non-smoker, non-drinker with no family history of breast cancer. On paper, she has no risk factors. And she's gonna tell her story today. But before we get into her story, I want to just talk a little bit about breast cancer. Other than skin cancer, breast cancer is the most common cancer for American women. It is the second leading cause of cancer death. The American Cancer Society estimates that 321,000 new cases of breast cancer will occur this year in 2026. In addition, 42,000 women are expected to die from breast cancer this year. Usually women are diagnosed right around the age of 62, 63. However, 10% of breast cancer cases are diagnosed in women that are younger than 45. So we are now seeing a lot of women diagnosed at an at an earlier age. Um, black women are more about 40% more likely to die from breast cancer than white women. Um, and this is caused by a lot of different things. And I'm going to go into them a little bit later. But some of it is staging type of cancer, uh, insurance, access to care. But there is some good news. And here is the good news two-thirds of breast cancer are caught early while still localized and have a five-year survival of about 92%. And because of that, we have about four million women that are breast cancer survivors and living today. Um, the uh the recommendation for women with no risk factors and no history of cancer is for them to have a yearly mammogram starting at the age of 40. So that is really, really important. If you're 40 years old or listening to this broadcast, it is really, really important for you to get your yearly mammogram. So today we'll walk through Noelle's journey from diagnosis to cancer-free and break down what all the words on the in the pathology reports actually mean and talk about how it is important to advocate for yourself, whether or not you have insurance or not. So I want to bring Noelle in. Noelle from line two. Welcome to the show. How are you, Noelle?

Good morning. Thank you for having me. I am doing well. Wonderful.

Wonderful. So take us back to, you know, to like before your diagnosis and before any of this. Tell me a little bit about, you know, how were you feeling health-wise? What was going on? Tell me a little bit about your story.

Yeah, absolutely. You know, I having just general fatigue, nothing serious, just brain fog. That turned out to be low thyroid conditioning or hypothyroid. Right. My primary care physician is a DO who's also a naturopath.

So let me tell people that so a DO, let me explain. A DO is a doctor of osteopathic medicine, and an MD is a doctor of allopathic medicine. But go ahead.

Right, right. So he ran all my numbers and led me have to got get that treated. I lost 40 pounds. I was feeling great. I was in working out, lifting weights, doing Zumba, and I was also around menopause age and uh post-menopausal. I started HRT, which is hormone repl replacement therapy, because I was having low estrogen systems basically.

Okay, so you were around menopause, paramenopausal, or in menopause?

Yes. Okay. I was in my mid-50s, yep.

Okay. So you started hormone replacement therapy, you got the thyroid replacement, you're feeling fabulous. So then what happened next?

Not much. I just went in for a regular mammogram. And lo and behold, the screening thought that they saw something. But I have what's called dense breast tissue, and a lot of black women have that.

Yes.

So it's harder to see something.

Correct.

I had a second screening. They saw less than they saw in the first screening. So the So they were about to discharge me and let me go.

Okay, so you had uh you had like a uh a regular usually a regular screening exam is a regular screening mammogram is like a 2D mammogram. So they thought they saw something on the first mammogram, which was a 2D mammogram, and then they wanted you to do uh basically like a a more enhanced, like a 3D mammogram.

Correct. Correct.

Okay.

I would have thought that would have caught more because it was 3D, but they didn't see anything at all. Then um the radiologist um said, Well, you're here. And I said also I'm not comfortable not having some further screening. So I spoke up and advocated for myself and she agreed, and we had an ultrasound done.

Okay.

And it took a full 30 minutes before they found the most minute tiny millimeters small um uh tumor that just just almost was hiding.

Wow. So you this was all in one visit?

This was all in one visit. The 3D, the talk with the radiologist. I stayed another 30 minutes for the ultrasound. They showed it to me and scheduled me for a biopsy.

Okay, gotcha. All right.

That was a big day.

That was a big day. All right. So did you leave there you left there with a biopsy appointment, but you also left there uh understanding that you might have cancer. Did they use the C word? No. No.

They they use the regular, but when the they called in about three people to look at this, I I knew that they were just being polite.

Right. Okay. All right. So then what happened next?

Well, since like you said, I had no risk factors, never drank smoked. Um so now I'm facing in my mind a a po a possibility of of being uh uh having cancer, waiting the waiting gain with the biopsy, had a needle biopsy done, and they did find it to be cancerous.

Okay.

Um then comes the pathology report, they take the tissue. And well, there's people reading the report and making a report, and as an engineer I do reports all the time, and I'm thinking, okay, it depends on who does this report.

Right.

Whether they they lean on the side of uh one way or uh or another.

Right.

So I decided at that time um to have the report read by two separate uh hospital systems. Yes. Just to just to make sure we were all in agreement.

In agreement with everything. So just so that I can actually just, you know, when you get a needle biopsy, just so I can sort of tell the audience how this sort of works in the hospital, they're literally putting um very, very, very thin slices on a slide. And then that slide then goes to the pathology department, and the pathologist who is a physician, um, will put various dyes on the slide. And this is to determine what type of cancer you have, because there's there's more than one type of breast cancer, and then also in addition to that, you have to really understand um what sort of receptors the are on the breast cancer. So when you talk about breast cancer, you know, you can have ductal carcinoma, you can have uh lobular carcinoma. What kind did you have?

I had ductal, it was in the duct.

All right, so you had ductal. Then the other thing that is important, and these are the different dyes that they put on, there's various markers. So um there's estrogen receptors, there's uh progesterone receptors, and there's uh HER2 uh receptors, which are growth factor receptors. So you'll hear people saying, you know, maybe that I was triple negative or triple positive or I was positive for the estrogen receptor, but I was negative for everything else. All sorts of things like that. Um it makes a significant difference. You know, black women are more likely to be triple negative, which means all those receptors are negative, and that also is a more aggressive type of tumor. A triple negative tumor is more aggressive and has a a poorer survival. Do you know what your markers were as far as your your um estrogen, progesterone, and HER2 markers?

Yes, and just to tell you, Dr. V, as you know, these results are reported like in a horrible, like an email. I'm reading this and saying triple positive, and I'm thinking that's something horrible because usually positive is you have the thing there looking for.

Right. When really, really, yeah, when really the one that you don't want to read is the one that says triple negative. Absolutely. Yeah, yeah, I got you.

I would you know, I was looking for something positive or negative. Right. So I was triple positive, meaning they could actually treat more things to help it slow down or or not grow and treat.

Right.

So I I you know, as a doctor, I know that I had to take a pr approach of now who do I want on my team to help me fight this because I don't want to be a case number, I don't want to be a a part in the system of, you know, people that do this every day, and you're just the next number.

Right. So so once you had the needle biopsy, you knew you had ductal cancer and you knew that it was triple positive. So the next step after that was to really determine did to determine the stage and the grading. Right? And the stage is how far has this thing spread, right? Is it just in that little local area? Did it go to my lymph nodes in my arm? Did it go to other organs in my body? Um, the grade is how aggressive is the cancer. Is it a slow growing cancer or is it a fast growing cancer? So you then had staging done, correct? That's what we call it. Is is when you had I did.

Okay. Yes. They I had stage one A.

Okay.

So because of the size, it was A, and then because stage one, it hadn't gone anywhere, um my lift note was removed during the surgery, that we'll talk about in a minute. So um that's what was determined.

So um so when they actually removed, so normally what they do with staging is that is you you went to you the the operating room and had a procedure, and were you let go that day, or did you spend the night in the hospital? How did that work?

You know what? I was in early in the morning and out by the end of the day. I could not believe it. Oh, that's great. I had such a an amazing team. But I must say, I had to take a step back and decide the care that I was gonna receive because I was being funneled into my local hospital five minutes away to a general surgeon who doesn't do doesn't really know breast. And um I don't I can't imagine the outcome difference because when I went back for uh my future checkup exams, they could not tell I had surgery if I hadn't told them.

Wow.

So the outcome matters. I had a plastic surgeon and a breast surgeon working on me in the OR together.

Okay.

And it it was a phenomenal result.

And you had the plastic surgeon for what reason?

Well, um, they're removing the tumor from one side, which would make the other side look larger now. So to balance the two, they did and I had plenty of bread breast tissue, they did a removal, uh a reduction rather, when they removed some of that um breast on the uh breast tissue with the tumor around it. And so they reduced the size of my breast and lifted them. Um and I can hardly tell there was uh reduction.

Wow. And so was that something that you had to pay out of pocket for or or or tell me?

Absolutely not.

Okay.

Medically necessary is to make the woman, you know, appear whole. So I have a friend who recently had surgery and they did uh breast implants for her because she didn't have the breast tissue.

Right.

So she has now a brand new uh set of um breasts in in place of um all the breast tissue that was removed.

Yeah, so I think I think that's it. Awesome. I think a lot of people don't realize that um, you know, back in the day, you know, when we actually were doing this, um, they would not actually do any sort of breast augmentation or minimization or lift to sort of even the woman out. And um you kind of had to get that on your own. And these days now, they are understanding that it is really medically necessary, even just for for your regular spine support, that you know, that if you have any sort of um reduction on one side, that it needs to sort of be uh needs to have the same thing and you kind of need to be balanced out so you don't have problems later on with back and spine, et cetera. So a lot of people don't realize that um that is uh that is at least in the in the US can be determined to be medically necessary and be part of your um insurance coverage.

So you absolutely that's available.

So you got you were determined to be 1A um and you were triple positive, which was good. And did you know the grade of the tumor? How aggressive it was?

Grade grade two.

Grade two. Okay, grade two, all right, which is kind of like in the middle, right? So the grades are one, two, and three. So two is kind of in the middle. So now, once you had all of that done, so you're clear now that you have cancer, you've caught it early, it's localized, they take it out, they do the the breast augmentation, the lift, you're all balanced. Did you have chemo, radiation? What sort of treatment did you have after that?

Well, I had this fortunate um blessing to have an oncologist who was had had prior work with my primary care physician who's a naturopath, and understood a lot of options that he presented to me. So I was not determined that I would need chemotherapy because it had not spread and the chemotherapy was simply gonna be overkill basically.

Okay.

Um now I have someone seemingly similar. I'm not the doctor, I don't know the whole case, but she had 1A as well, and she was on chemo and really suffered. So it matters who you get as your oncologist, this whole team. I had a psychotherapist, I had a physical therapist, I I had, you know, my surgeons, my radiologist, my imaging people, getting my labs done, diet diet and exercise, this whole approach. And um, you know, that's how I really began healing. I did not need uh uh um chemo, but I did elect radi radiology.

Radiation. Radiation radiation. Yes, yes.

So low dose and the smallest amount, but I did do that for three weeks.

Okay, all right. And you did it once a week for three weeks?

Every day.

Every day for week. Monday through Friday. Okay, every day, Monday through Friday for three weeks. And then afterwards, um, were you put on any well, first of all, how long ago was this? Because I think this is really important. You've now been cancer free. What when was this roughly that you had this diagnosis and how and um and you've been I'm assuming you've been cancer free since?

Yes, I have. I've had that checked. Um I've been cancer free going on two years in January. Oh, congratulations. So that thank you.

Yes, and so um and then during that time, during this two-year period of time, you had radiation. Um, was there anything else because you were on hormone replacement therapy and thyroid replacement therapy because you initially had the brain fog and you started feeling better with that. So what did they I I'm assuming they took you off the hormone replacement therapy, even though it was uh I'm assuming they took you off of that.

That's that's right. And because because you're adding estrogen back in and the cancer was estrogen positive, it was explained to me that way that the the hRT wouldn't cause it necessarily, but the fact that it was already present, they wouldn't want to uh stimulate the cancer um at all.

I understand.

However, it was removed, but it could there could be some microscopic uh pieces that would respond to estrogen.

Okay. And then were you placed on any other medication?

Yes, there was a her because I was HER2 positive, there's something that targets that called a her septin.

Yes.

So it intercepts the Herceptin, yeah, Herceptin Hylecta. And sometimes you may hear, and sometimes you may hear TV commercials where people say, and you'll hear the broadcast say for HER2 positive breast cancer. So people, when you're listening to commercials, you'll sometimes hear some of these medications actually advertised. Um and this is specifically for breast cancer where people have are HER2 positive, which means they have that receptor for the um uh for the growth factor. Um and basically what uh Hercept and Halecta is is just it's just a monoclonal antibody that is um you know operates, you know, against that receptor in a in a very simplistic form. I think that, you know, we talked about we talked about monoclonal bodies a lot during COVID. And as I told people, monoclonal antibodies will be used for a lot of different things, and a lot of things that we heard from COVID are actually going to be used in cancer treatment and Alzheimer's treatments and a lot of different things. So you were on her septin high lecta. Um anything else that you were on?

Actually, um I am still on a natural immunotherapy. The mistletoe plant uh they do an extract and do mistletoe injections is widely used in Europe. And I'll do that for five years and it it boosts the whole immune system. And so I really feel great using that.

All right.

And then I finish with the perceptin after one year.

After one year. Okay. And then were you on anything like uh tamoxifen or anything that blocks uh estrogen or estrogen receptors?

It is, it was rec it was offered to me. Um and this is why I think it's so important to have a great work and relationship with your specialist. I elected not to do it because what he showed me in terms of the research, I wanted to see a study.

Okay.

What what is the per the risk and the benefit to taking this medicine?

Gotcha.

And there was because it was such an early stage it was a small risk there was a small benefit, definitely. But for me there were other larger benefits with the mistletoe and simply uh other other natural things like phytoestrogen, melatonin, um all those together as well as diet there's some studies out about reducing your fat on your body.

Absolutely that makes a huge difference.

And fat.

Yeah. And fat carries the estrogen too yes and and that happens and and and I and I tell people that fat carries estrogen whether or not you're a man or a woman and that's how come sometimes you will see an obese man begin to develop breast tissue, right? Or you know a significant amount of breast tissue. Extra weight uh and fat, particularly around your middle section is estrogen producing. So um so okay so then you're on the herceptin and then you're also doing what you're doing well with your uh naturopathic physician. So one of the things that I think is really important about this is that you really had a team that you could talk to, get the facts on what was you know what risk benefits and kind of decide the path for yourself. And I think that you know if you could just describe that relationship a little bit because I think that relationship with your medical team is really really important for people and they don't always have that you're absolutely right when I got this diagnosis my my whole perspective changed my whole world stopped as far as everything else I thought was important.

I I started focusing on what what I need to do to heal. And my I was presented with my own mortality at that point. So everything um that I started doing was research for myself and um I just realized that from other doctors uh like yourself who are out in the media educating people um that I really have the the right and the absolute privilege to to select my team. I had um taken my time a a month or two to change hospitals. I took my time to get that uh second uh pathology report done uh later my oncologist was changed he had left the practice the one who was so very excellent and fortunately I was done with my treatment right but I was paired with someone and we we had no personality match. Right he was by the book, didn't know me, canceled and moved my appointment did my appointment on the phone for five minutes and decided to drop me. Wow I mean all I mean I just met you but that that's how it can go so I mean it's so important um to to interview your doctors really you're the you're the client. Right and they're getting paid like for my insurance I can tell you that her septon alone was like a 250K per year.

250K per year. Yeah yeah so you you really yeah you are the customer. And I think that's I think those points that you bring up are really important no matter what disease process you're dealing with. You really want to make sure that you have a physician that you actually gel with you respect they respect you and they involve you in the decision making. I mean ultimately it's your body and your choice and also I I shared I always tell people you know it's important for you to do your own research but it's important to actually collaborate with your physician because they have access to research that you cannot find on the internet right there are studies you cannot find them on the internet. They are published they are trademarked um and you know your your your physician has a wealth of research and data that they can share with you. And if you're seeing something that is contradicting what they're telling you you want to actually share with them what you're seeing and they can explain to you how it does or does not apply to you. So I think that that's really really important. So you know give me a couple of things that you would like one or two things that you would like people to know. Obviously number one is actually get a second opinion uh and make sure that your doctor treats you uh as a partner and it's a teamwork approach. Is there anything else?

You know what I would like people to make sure that they do not don't fail to get your mammograms. I I had public insurance for mid time for a small time because of changing employers and there was a lapse during COVID I couldn't get appointments and so make sure you keep those things regular because thank goodness I have had a clear um result and then I had this cancer um finding but it could have gone a whole different way and then the other thing I use my short and long term disability benefits. Yes use that if you have that kind of coverage.

Yes that's important every every decision has a risk and a benefit so absolutely well Noelle thank you for um having the courage and sharing your story today. We're so happy that you had a great outcome and um thank you for joining us and sharing your story. I think it really really um will help someone today it is really important to get your mammograms every single year. I recommend that people get them around your birthday because then you always remember when your birthdays are remember this is the Ask Dr V show and we rebroadcast all of these shows in a podcast called What the Health is happening that is available on all streaming platforms. We are committed to answering your most pressing healthcare questions you can make sure to email me or send me an audio message at info atasdrv.us You can also follow me on YouTube. Get your mammogram every year read your report ask questions until you understand the answers and if the doctor isn't giving you options or really communicating with you find one that will we'll be back next week where you can stay informed and empowered about your health I want to thank you for joining us today.