August 11, 2022 by Muriel Sommers
Cancer Survivor Began Screenings at Age 35
Because her mother was diagnosed with breast cancer at age 42 ― and eventually died from endometrial cancer ― Marissa Porven started her mammogram screenings earlier than most women, at age 35. Every six months, she scheduled either a mammogram or breast ultrasound, and once a year, she underwent a breast MRI. Much to her surprise, just weeks after a screening came back clear, she felt a lump in her left underarm. It was cancer. She was 37.
“I did everything right. I did not drink coffee or alcohol, I ate right and exercised, I only used deodorant without lead,” says the Redland mom of twins. “If cancer is coming for you, it doesn’t matter.” What made her a survivor, she believes, is that in addition to having an excellent healthcare team, she is proactive about her health. “If I hadn’t felt something, if I had waited a whole other year to have a mammogram, it could have had a very different outcome for me.”
Ms. Porven’s pea-sized tumor ― invasive ductal carcinoma ― is the most common type of breast cancer, according to the American Cancer Society. It begins in the cells of a milk duct and then grows into nearby breast tissues. It makes up about 80 percent of all breast cancers.
“I hadn’t slept or taken a breath since I got the call,” Ms. Porven recalls. “But everything happened very quickly from that point on, and after I met Dr. Mautner and Dr. Guardiola, I felt a sigh of relief. She was so knowledgeable and made me feel comfortable. And he told me this was not a death sentence and that is was very treatable.”
The cancer was aggressive, however. “While invasive ductal carcinoma can occur at any age, most women are older when diagnosed,” says her breast surgeon Starr Mautner, M.D., of Miami Cancer Institute, a part of Baptist Health South Florida.
Given Ms. Porven’s young age, and the fact that the cancer had already spread to the lymph nodes, the team recommended chemotherapy before surgery, and on Nov. 3, 2020, she had her first session. Anti-nausea medications helped her through the worst, along with the support of her husband, Mauricio. Their children, Mia and Mason, had just started back to school in person, but due to the risk of COVID-19, medical oncologist Victor Guardiola, M.D., suggested home school. It made sense to them and her father would often watch the kids.
On Feb. 9, 2021, Ms. Porven rang the bell at Miami Cancer Institute, signaling the end of her chemotherapy, and one month later she had a bilateral mastectomy. Dr. Mautner also removed eight lymph nodes. At the same time, Ms. Porven underwent a reconstructive procedure performed by Harry Salinas, M.D., a reconstructive plastic surgeon at Miami Cancer Institute.
The next stage of treatment began six weeks later with proton therapy, a specialized radiation therapy particularly beneficial in patients whose cancer is located near other organs, such as the heart. On June 9, she rang the bell one more time, signifying the end of radiation.
“There is so much emotion ringing that bell,” she says. “It’s the end of a long journey.”
Like many cancer patients, Ms. Porven faced some hurdles. Lymph node removal caused her to lose some range of motion in her arm, so she turned to Adrian Cristian, M.D., chief of Cancer Rehabilitation at Miami Cancer Institute. After a full evaluation, Dr. Cristian recommended physical therapy. A few visits, with stretching and exercises, improved her range of motion, and massage with a lymphedema-certified therapist prevented lymphedema.
When Ms. Porven experienced some burning and peeling of the skin after proton therapy, Joseph Panoff, M.D., her radiation oncologist, suggested lotion. “It was painful, but Dr. Panoff explained that I didn’t need expensive creams and that Aquafor would work well. It was amazing and I began to heal quickly.”
To combat other side effects, Ms. Porven remained active, exercising nearly every day, and continued to eat a healthy diet. She also listened to self-healing meditation music and turned to the Bible. “I made a list and checked off every single treatment along the way,” she says. “As I saw the list shrinking, it was a good feeling.”
A possible genetic link
Ms. Porven’s mother was BRCA positive and she urged her three daughters to go for genetic testing. People with BRCA1 and BRCA2 genetic mutations are at a much higher risk for breast and ovarian cancer, among others.
“My sisters and I talked ahead of time about our plan,” Ms. Porven says. “We were going to decide when we would have mastectomies and hysterectomies.” To their relief, all three tested BRCA negative.
“If your mother or father has a BRCA mutation, you have a 50 percent chance of inheriting that,” explains Dr. Mautner, who refers all of her patients to genetic counseling.
Importance of breast self-exam
Ms. Porven’s self-discovery of a lump points to the importance of breast self-exam, even at a time when some organizations no longer promote it. “Self-exams can be lifesaving, but a lot of women are afraid to do it because they aren’t a specialist and don’t think they know what to look for,” Dr. Mautner says. “If you do it every month, you’ll know if something is new.”
Dr. Mautner feels so strongly about self-exam that she posts a monthly reminder on her Instagram. She also includes instruction on how to perform an exam. To learn more about how to conduct a breast self-exam, a step-by-step tutorial can be found on Miami Cancer Center’s Instagram page.
Today, Ms. Porven remains optimistic about her future. She takes an oral medication daily to reduce the risk of recurrence. She also receives a monthly injection to lower the estrogen produced by her ovaries, since her cancer was estrogen-receptor positive. But that’s a problem she plans to solve with a permanent fix. She is meeting soon with a gynecologic oncologist at the Institute to talk about the removal of her reproductive system.
“I don’t want to follow in my mother’s footsteps,” she says. “But right now I feel amazing. I feel like a warrior. I feel like a survivor.”