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Breast Cancer Can't Stop Young Woman from Pursuing Career Goals

Baptist Health Miami Cancer Institute

One day before she was set to begin a rigorous graduate studies program to become a physician assistant (PA), Andrea de Armas got stunning news. She had breast cancer. She was only 26.

 

“I was very active and healthy,” Ms. de Armas says. “While I was showering, I discovered a lump on the outside of my breast and thought it could be a cyst. It wasn’t tender or painful. I thought, there’s no way this could be cancer. I felt I would have had other symptoms.”

 

A mammogram, ultrasound and breast biopsy at Baptist Health Miami Cancer Institute revealed that Ms. de Armas had invasive ductal carcinoma, a common breast cancer that starts in the milk ducts and spreads to nearby tissues. And genetic testing showed something else worrisome.

 

(Watch now: Just before starting her physician assistant degree program, Andrea de Armas, 26, was told she had breast cancer. Now, thanks to experts at Miami Cancer Institute, she’s not only a survivor, she’s also one step closer to getting her degree. Video by Alex Calienes, Gort Productions.)

 

Cristina Lopez-Penalver, M.D., a breast surgical oncologist with Baptist Health Miami Cancer Institute

 

“Andrea was also diagnosed with a genetic mutation that she inherited — PALB2. It’s a mutation that increases your lifetime risk for certain types of cancers including breast, pancreatic and ovarian cancer in women and prostate cancer in men,” says Cristina Lopez-Penalver, M.D., a breast surgical oncologist with Miami Cancer Institute.

 

Lumpectomy or mastectomy

Ms. de Armas wanted to undergo a double mastectomy, but she was adamant about beginning her PA program on time and not missing classes. “Dr. Lopez-Penalver knew where my head was and gave me options. She is so personable and always made me feel like I had a choice,” she says. “My treatment plan wasn’t traditional, and it was the clinical team at the Institute who made it possible.”

 

To accommodate Ms. de Armas’s goals, Dr. Lopez-Penalver suggested the tumor be removed during an outpatient lumpectomy, which, with its short recovery time, wouldn’t interfere with classes. That would be followed by a bilateral mastectomy during the semester break.

 

On June 8, 2023, Dr. Lopez-Penalver performed the lumpectomy. Ms. de Armas began chemotherapy and had the double mastectomy with reconstruction as planned over the December break. That was followed by radiation (an additional safeguard after several of her lymph nodes also tested positive for cancer).

 

“Tailoring treatment, or personalizing care is important,” says Dr. Lopez-Penalver. “This is not a one-size-fits-all approach. We didn’t feel comfortable waiting several months to start treatment, which is why we suggested the lumpectomy first.  I was very happy we were able to tailor her treatment.”

 

Handling school and treatment

Today, Ms. de Armas is in her second and final year of PA school and feeling good. “I was motivated to stay in the program and I knew mentally I could do it,” she said of PA school. “I credit the program and my family with helping me through. I would have chemo in the morning and then go to school, and if I missed an exam, I’d take it during lunch. I would have radiation after school, and everyone would ask me how my classes went. Everyone at the Institute is just so kind and understanding.”

 

Dr. Lopez-Penalver gives the credit to Ms. de Armas. “Andrea is amazing. She knows what she wants. She wants to become a PA and she’s not going to let breast cancer stand in her way.”

 

Because Ms. de Armas’s breast cancer was hormone-positive, she is on hormone therapy with an oral medication as well as monthly injections to prevent her ovaries from producing estrogen. It’s a therapy that lowers the chance of recurrence, Dr. Lopez-Penalver explains. “Most women who have a hormone-positive breast cancer remain on therapy for five to 10 years,” she says. “Most of these therapies will put you into temporary menopause.”

 

The team at the Institute talked with Ms. de Armas about fertility preservation, as they do with all patients in their childbearing years. Because of her young age, however, Ms. de Armas felt reassured that she’d have as good a chance as any woman of conceiving later, when and if she wants to have children.

 

Andrea de Armas, PA (left), was diagnosed with breast cancer the day before she was set to begin a rigorous graduate studies program to become a physician assistant. After being treated successfully at Miami Cancer Institute, Ms. de Armas is now one step closer to earning her degree..

 

The genetic link

In the meantime, other family members have also gone through genetic testing, some of them testing positive for the same mutation as Ms. de Armas. “It is peace of mind for them,” she says, “because when you know you have a genetic predisposition, you can have your mammogram annually and also have a breast MRI every six months. You can catch something early.”

 

The PALB2 gene mutation is one of a number of mutations shown to increase breast cancer risk, including ATM, BARD1, BRCA1, BRCA2, CHEK2, RAD51C, RAD51D, CDH1, TP53, NF1 and STK11.

 

Because mammograms aren’t typically recommended for average-risk women until age 40, Ms. de Armas wasn’t even old enough to have begun annual screening. According to Dr. Lopez-Penalver, that’s all the more reason for young women to advocate for themselves by:

 

·      Knowing their family history — both their mother’s and father’s sides, since half of our DNA comes from each parent

·      Losing weight if they are overweight

·      Staying active and exercising

·      Not smoking

·      Performing monthly breast self-exams and looking for any signs of a problem, which includes breast lumps or asymmetry, skin changes such as dimpling or thickening, or nipple discharge

 

Ms. de Armas believes her experience as a patient and breast cancer survivor has given her an empathy and better understanding of her future patients. “I didn’t expect any of this to happen, but I wouldn’t change a thing,” she says. “I have been very reflective in the past year. I may want to work with people who have chronic illnesses, like autoimmune illnesses that have no cure. Those patients have to learn to manage. That’s something I would love helping with.”

Healthcare that Cares

With internationally renowned centers of excellence, 12 hospitals, more than 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices spanning Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.

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