July 19, 2021 by John Fernandez and Carol Higgins
Carla Was Diagnosed with Breast Cancer — So were Her Sisters and Daughters in Remarkable Case of ‘Family History’
After three of Carla Walker’s four sisters developed breast cancer, she lived with the uneasy feeling that she would be next. That feeling turned out to be right. In February of 2019, an MRI discovered a tumor too small to be detected by a mammogram. It was invasive ductal cancer, which makes up about 80 percent of all breast cancers.
“I was very, very lucky,” says Ms. Walker (pictured above). “My breast cancer was stage 1-A. It was the size of a chickpea.”
Early detection and treatment meant an excellent prognosis for the 59-year-old mother of two who works for Miami-Dade County Fire Rescue as a training coordinator for fire, police and 911 dispatchers.
“I knew that I wanted a mastectomy, if that was at all possible,” she says. ‘I just wanted to definitely remove any chance of it ever coming back, if there was any way at all. Not to say that it can’t, because it can. But at least I lessened those chances.”
(Watch video now: Hear from breast cancer patient, Carla Walker, and Starr Mautner, M.D., breast surgeon at Miami Cancer Institute. Video by Carol Higgins.)
“Ultimately, Carla had to make the decision that was right for her,” says Dr. Mautner. “And that was a very personal decision. Having bilateral mastectomies for her was the only way that she would ultimately have peace of mind, but this isn’t necessarily the right decision for all patients.”
Family History and Genetic Testing
Prior to her diagnosis, Carla and her sisters with breast cancer had each undergone genetic testing. None of them carried a genetic mutation that is associated with a high risk of breast cancer. While family history is important, Dr. Mautner emphasizes that only about 10 percent of all breast cancers are actually linked to a genetic mutation, such as the BRCA gene mutation.
“The most important thing to note in discussing family history for patients with breast cancer is — it is not only the mother’s side that matters,” says Dr. Mautner. “Common sense would say, ‘Well, if my mother didn’t have it and my grandmother didn’t have it on her side, maybe I have nothing to worry about.’ And that’s simply not true. The father’s history also is equally as important. You inherit half of your genes from your father.”
While Carla was recovering from her surgery, she got the news that one of her identical twin daughters, Jillian, found a lump in her breast. Two days after her 34th birthday, Jillian, who lives in Lakeland, Florida, was diagnosed with triple-negative breast cancer. Earlier this year, twin sister Samantha, in Phoenix, received the same diagnosis. Subsequent genetic test results revealed that both daughters had inherited the BRCA gene mutation from their father, who, in turn, could trace it to his father.
“Carla’s story is just so unique and unfortunate,” says Dr. Mautner. “It’s unbelievable that she was going through a cancer that was caught extremely early and then one twin daughter gets diagnosed. And because they’re identical, it makes sense that the other daughter would have the exact same genetic makeup and also be at extremely high risk. Both of her daughters had much more aggressive breast cancer than Carla. Not only did they need surgery, but chemotherapy as well. Fortunately, they’re all doing well.”
Cancer Patient Support Center
Ms. Walker credits the Cancer Patient Support Center at Miami Cancer Institute for helping her through her cancer journey and the traumatic news of her daughters’ cancer battles. “I needed help with managing myself, my own diagnosis, my daughter’s diagnosis, and then my second child’s diagnosis,” she says, thankful for the support she received from Beatriz Currier, M.D., Medical Director of Cancer Patient Support Center and Chief of Psychiatric Oncology at Miami Cancer Institute.
“I really made a home in the Patient Support Center. I have used the exercise physiologist, I’ve had acupuncture, I have had massage therapy. I’ve worked with two of the dieticians there. I couldn’t have had a better experience.”
Most recently, Ms. Walker took advantage of a unique new service offered through the Cancer Patient Support Center; nipple tattooing. As she explains: “After my mastectomy, I had no nipples or areola. That part of my skin had been removed. So, I felt kind of empty, or not quite whole. When I went in and I got that first tattoo done, she actually did a 3D tattoo of both the nipple and areola. It looks absolutely real. The results were beautiful and I couldn’t be happier. I smile in the mirror every day now.”
Dr. Mautner believes nipple tattooing is an important service to offer, saying, “It may seem like a trivial thing to have nipple tattoos, but for women who have lost their nipples, that’s a huge thing psychologically. Carla is now over a year and a half out from her surgery. She’s doing great. She has an excellent prognosis, but the nipple reconstruction really completed her journey and she feels whole again. Her confidence and her energy, you can just see that she feels back to baseline.”
Exercise has played a major role in Ms. Walker’s recovery. She’s a member of the Save Our Sisters dragon boat team alongside other breast cancer survivors.
“We get into our dragon boat, our pink boat with our pink paddles and our pink shirts, and we move. It has been just absolutely almost life-saving for me, because it’s a great way to get rid of the stress. It’s a way to move. It’s a way to exercise, and those are the things that you need a lot after cancer. And, you can do it with women who know that you’re sore, you’re tough, you’re going through something,” she says.
Ms. Walker offers this advice to other women facing breast cancer: “You absolutely cannot give up. You have to push on. You have to push through. When you think you’re at the end, find a way to take that next step. Find a way, no matter what it is.”