Dawn Wade, of Racine, was 63 years old in November 2022 when she noticed a lump in her left breast. A mammogram and diagnostic tests showed she not only had cancer in her left breast but also had a small tumor growing in her right breast. Dawn said she knew immediately she wanted to get treatment with the Froedtert & the Medical College of Wisconsin Cancer Network.
“I wanted the most innovative care and the latest treatment options,” she said.
Understanding HER2-Positive Breast Cancer and Its Aggressive Nature
A breast biopsy revealed estrogen receptor positive (ER+) and HER2-positive (HER2+) cancer in Dawn’s left breast and ductal carcinoma in situ (DCIS) in her right breast. ER+ means high levels of the hormone estrogen are helping the cancer grow and spread. HER2 is a protein on some cancer cells that also drives cancer growth. DCIS is considered stage 0, but still needs treatment, as it can become invasive if left untreated.
“We know HER2+ tumors tend to behave more aggressively,” said Adrienne Cobb, MD, MS, surgical oncologist and MCW faculty member. “They are more likely than some other types of breast cancer to spread to other places in the body.”
Why Personalized Treatment Plans Are Critical for Breast Cancer
Dawn’s treatment plan began with chemotherapy and targeted therapy drugs.
“Choosing the right treatment with the right timing for each person’s cancer is critical,” said Thomas Giever, DO, medical oncologist and MCW faculty member. “With HER2+ cancer, chemotherapy and HER2 targeted therapy before surgery help improve surgical outcomes, guide postoperative therapies and extend survival. These are factors regardless of a patient’s choice of lumpectomy or mastectomy.
“Chemotherapy and HER2 targeted therapy can also decrease or eliminate cancer in the lymph nodes,” Dr. Giever said. “In some cases, they allow less aggressive lymph node removal during surgery — which reduces the risk of lymphedema, a condition that causes painful swelling from buildup of lymph fluid.”
Dawn opted for a bilateral mastectomy — removing all of the breast tissue on both sides — rather than a lumpectomy, a procedure to remove only the tumor and a small amount of surrounding tissue. According to Dr. Cobb, mastectomy and lumpectomy, when followed by radiation therapy, have similar survival rates.
“Dr. Cobb listened and understood how I felt,” Dawn said. “That was so important to me. We had a good connection from the start.”
The Role of Radiation Therapy After Breast Cancer Surgery
Dawn received radiation therapy to eliminate any cancer cells remaining after drug therapy and surgery. While radiation therapy is not always needed after a mastectomy, it was an important step for Dawn, because presurgery imaging and biopsies revealed cancer had spread to her lymph nodes.
“Radiation therapy eliminates cancer cells on a DNA level,” said Christina Small, MD, MPH, radiation oncologist and MCW faculty member. “It can have side effects, like skin redness and swelling, but our breast care nurses have remedies to help. If needed, we refer patients to our Oncodermatology Program, where specialists help patients manage side effects related to the skin, hair and nails.”
Dawn’s surgical pathology results confirmed ER+ and HER2+ cancer, helping guide the final steps in her treatment plan: anti-estrogen therapy and the appropriate HER2 targeted therapy.
Convenient, Comprehensive Care Close to Home
Dawn had surgery at Froedtert Hospital campus and the rest of her treatment at the Cancer Center at Drexel Town Square Health Center in Oak Creek. Because it was near her home, it made treatment convenient.
“Since my treatment had several facets, I was mindful to focus only on the treatment in front of me,” Dawn said. “That kept me from worrying about possibilities down the road. I couldn’t have done it without the support of my church, family, friends and online support groups. I trust that with the care I received, I am cured of cancer. I’m so happy with my choice.”
