Debi Arbucias vividly remembers the day in November 2019 when she was diagnosed with a particularly aggressive type of breast cancer called triple negative.
“I went into shock,” said the Pewaukee resident, 59, who runs two boutique stores in Waukesha County. “I’ve never experienced anything like it.”
Now that Debi is considered cancer free after treatment with the Froedtert & the Medical College of Wisconsin Cancer Network, the compassionate care she received is firmly etched in her mind.
“I’m so grateful to my doctors,” she said. “They saved my life.”
Innovative Treatment for Breast Cancer
Debi’s road from an emotionally distraught patient to full recovery underscores more than just the importance of an annual mammogram. It also reflects the importance of seeing a specialist who treats your type of cancer at a hospital that offers pioneering treatments, often stemming from clinical research. Patients also benefit from a multidisciplinary team approach to medicine.
Debi sought a second opinion after her mammogram revealed a tiny tumor in her left breast. At the Froedtert & MCW Clinical Cancer Center at Froedtert Hospital campus, she consulted with Yee Chung Cheng, MD, medical oncologist and MCW faculty member, and Amanda Kong, MD, MS, breast surgical oncologist and MCW faculty member.
Dr. Kong said one strength of the Froedtert & MCW Breast Cancer Program is its multidisciplinary approach to treatment.
“We’re all part of one cancer network, which allows for collaboration and easy communication about patient care,” she said. “That enables us to develop optimal treatment plans. Many of our doctors have specialized fellowship training in our respective fields. Plus, we have access to clinical trials.”
Typical treatment for operable breast cancer is often surgery first, sometimes followed by chemotherapy and/or radiation therapy, and finally hormonal therapy. But, since triple-negative breast cancer is aggressive and carries none of the three receptors that can help guide specific treatments, Dr. Cheng suggested doing chemotherapy first.
“About 15% of breast cancer cases have no receptors for the hormones estrogen and progesterone or for the HER2 protein,” Dr. Cheng said. “The lack of receptors means we don’t have the information we normally use to select specific drugs that target these receptors on cancer cells. For these patients, chemotherapy is the main systemic treatment and is usually given after surgery. In our Cancer Network, we recommend giving chemotherapy before surgery in order to determine the response.”
There is another benefit to doing chemotherapy first. If the tumor is large, chemotherapy can shrink it enough to require only a lumpectomy. If no tumor is found during surgery, doctors know the chemotherapy was completely effective.
Clinical Breast Cancer Trials Offers the Best Possible Outcome
“Debi agreed to participate in a clinical trial I was conducting to see if adding a fourth drug to three drugs traditionally prescribed for breast cancer would spur better outcomes,” Dr. Cheng said.
The chemotherapy, which Debi described as the hardest part of treatment, lasted several months, ending in April 2020.
It destroyed the tumor, producing what Dr. Cheng called a complete response — the best possible outcome, with very low odds of recurrence.
In late April, Dr. Kong performed a lumpectomy. “Recovery from this outpatient surgery is relatively fast,” Dr. Kong said.
To determine the cancer’s location, Dr. Kong relied on a small marker — about the size of a grain of rice — inserted during Debi’s biopsy.
“When chemotherapy destroys the tumor, there is still a target to aim at,” Dr. Kong said. “Surgeons remove tissue around the tumor site that could contain microscopic cancer cells.”
Debi then received radiation therapy. As she looks back, Debi is grateful for the compassionate care she received. During chemotherapy, for instance, Dr. Cheng called her at home — on the eve of a holiday — to see how she was doing.
Debi also recalled how Dr. Cheng assured and comforted her during their initial meeting. She was distraught about the diagnosis — her sister died of cancer and had a di cult time during chemotherapy.
“Dr. Cheng sat down, held my hand and said, ‘I have treated 85-year-old women who have gone through this treatment plan,’ ” she said. “He promised me I could do this.”
From doctors and nurses to wig consultants and counselors, Debi said everyone exuded professionalism and compassion.
“Everything was so organized and efficient,” she said. “I felt care and concern in every aspect.”
She is also grateful for the love and support of her husband, Anthony, and their three children.
“He picked up our family’s world and did everything,” she said. “He was our rock.” Debi urges women to get a mammogram every year. “It’s the easiest thing to do, and it takes just a little time out of a day,” she said. “You just have to do it.”
