Experiencing shortness of breath may have saved Yvonne Coble’s life not once — but twice.
Last December, Coble’s daughter encouraged her to start jogging so they could participate in a fun run together. Coble, 52, said she thought it was hard to catch her breath because she hadn’t been regularly exercising, but her daughter insisted she visit a doctor.
Emergency room doctors quickly admitted Coble to the hospital after discovering she had life-threatening blockages in her coronary arteries. She underwent triple bypass surgery a week later.
“The heart attack was a complete surprise. The shortness of breath I thought was caused because I had started jogging. I didn’t think anything of it,” said Coble, of Fort Worth. “I totally missed the warning signs.”
Five months later, Coble suffered a heart attack. When doctors performed a follow-up scan of her heart because she continued to experience shortness of breath, they became concerned about a shadow seen in her breast tissue.
It turned out to be a less-common but very aggressive form of breast cancer, known as triple negative breast cancer, that requires immediate surgery and intensive treatment.
Coble, who is undergoing treatment at Texas Health Arlington Memorial Hospital, is among the 1 in 8 women in the United States that the American Cancer Society says will develop breast cancer in her lifetime. Because she was not getting regular mammograms, Coble said she is grateful that her tumor — less than 2 centimeters in size — was caught early through a chest scan.
“I’m so thankful I had shortness of breath that day,” Coble said. “It really saved my life.”
Good survival rate
triple negative breast cancer tends to occur more often in younger women and African-American women and is more difficult to treat because doctors can’t use the same drugs or therapies employed to attack the more-common, less-invasive types of breast cancers, said Dr. Alfred DiStefano, an oncologist at Arlington Memorial.
“There is a little more pressure to get things done quickly. The tumors don’t grow from day to day but the longer you delay the less chance you are going to get a benefit,” said DiStefano, adding that he prefers to begin treatment, which can include a lumpectomy or mastectomy and chemotherapy, within three weeks of diagnosis. “It’s a more aggressive variety of cancer that has taken some of our good treatment options out of the picture.”
A majority of breast cancer cases are hormone-receptor positive, meaning they can be treated with estrogen and/or progesterone. Only 1 to 3 percent of invasive breast cancers are diagnosed as triple negative, which means the tumors lack estrogen and progesterone receptors or human epidermal growth factor receptors, which promotes the growth of cancer cells.
“It sounds scary. We say things like ‘triple negative’ and ‘aggressive.’ Those are ominous words we are using,” said Dr. Kory Jones, a breast surgeon and breast program medical director at Texas Health Arlington Memorial Hospital. “It just means that you have a more aggressive cancer and we are going to treat you more aggressively. You still have a good survival rate and your prognosis is still good although it may not be as good as other types of breast cancers.”
A new career
Women who have been diagnosed with triple negative breast cancer are encouraged to undergo testing for the breast cancer gene 1 mutation , which increases their risk factor for future breast tumors and ovarian cancer.
Because of the higher risk of the tumors coming back even after treatment, DiStefano said, doctors are seeing more younger women with triple negative breast cancer choosing to undergo double mastectomies in the past five years.
“That is a personal choice. It is not an absolute medical necessity,” DiStefano said.
Though her surgery and series of chemotherapy and radiation treatments began quickly, Coble said she isn’t afraid. Strong support from her friends, family and the staff at Arlington Memorial, especially oncology nurse navigator Jane McNelis, have helped her through the physically and emotionally draining process, she said.
After she recovers, Coble said she hopes to begin a new career providing counseling or support for other people with cancer. Until then, she said she has been encouraging women to get routine mammograms.
“I am very confident in my treatment,” Coble said. “I feel my chances are very good. I believe it was caught early.”