Flying High: Breast Cancer Never Grounded Patient

At her annual gynecological exam, Alexa “Lexi” Paluzzi wasn’t too worried when the doctor felt a small lump in her breast. She was only 33 and there was no history of breast cancer in her family, so she breathed a sigh of relief when doctors said it was probably a hormone-related cyst that would go away on its own.

Ms. Paluzzi continued her busy life, traveling the world as a flight attendant, crushing her workouts at Orange Theory and on her long-distance runs and spending time with her parents and siblings. But six months later, the lump hadn’t disappeared. In fact, Ms. Paluzzi now had a second lump.

(Watch now: Just 33, Lexi Paluzzi wasn’t too worried when her doctor felt a small lump in her breast but it turned out to be aggressive breast cancer. See how experts at Lynn Cancer Institute helped get her back to work and life. Video by Alex Nobrega, Suite Creations.)

“I was told again that it was likely hormonal and that I could wait, but I was very insistent on wanting them removed because I was embarrassed,” she recalls. “It looked like I had two marbles in my chest when I would wear a bathing suit.”

An ultrasound led to a mammogram, which led to a biopsy. And then a diagnosis.

“She had a very specific type of breast cancer, commonly referred to as triple positive, meaning that her tumor was receptor positive, progesterone receptor positive and HER2 positive,” says Angelina The, M.D., Ms. Paluzzi’s medical oncologist at the Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health. “It is an aggressive type of breast cancer.”

The news came as a surprise to Ms. Paluzzi. “I had no pain, no symptoms, no irritation,” she says. “I was in the best shape of my life. Certainly, I didn’t feel like I had cancer. I was shocked.”

Since 2012, the incidence of breast cancer has risen 1 percent annually. Among women under age 50, the rate has increased 1.4 percent a year and is even higher in certain groups, such as Asian American/Pacific Islander women. Because younger women typically have dense breasts and breast cancer still isn’t common in those under age 40, the recommended age to begin regular screening mammograms — for those at average risk of breast cancer — is 40.

Angelina The, M.D., Ms. Paluzzi’s medical oncologist at the Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health

Ms. Paluzzi had one other factor that can make diagnosing breast cancer more of a challenge. She had breast implants. “Both silicone and saline implants have the potential to obscure the visualization of tissue around the implant,” Dr. The says. “Oftentimes, the radiologist recommends what’s called implant displacement, where they push the implant against the chest wall and pull the surrounding tissue outward, but sometimes that can be uncomfortable for the patient, especially if there is any scar tissue. Sometimes we need additional imaging to better evaluate those patients.”

Despite a breast cancer diagnosis at a young age, Ms. Paluzzi felt encouraged when she attended the Multimodality Clinic at Lynn Cancer Institute. “I guess I didn’t realize what it was until I sat down with this entire team of doctors,” she says. “I met with someone who specializes in genetics. I met with my breast surgeon, my oncologist and my radiation oncologist. It was a whole team all working together to develop a plan for me, specifically. I was assured that I was getting the best treatment possible. It was reassuring.”

Ms. Paluzzi’s genetic testing came back with no known hereditary mutations that would put her at high risk for breast cancer and she opted to freeze some of her eggs so that she’d be able to have children in the future. Her treatment included six cycles of chemotherapy with four different medications to shrink the tumor before surgery, then a mastectomy. She also had reconstructive surgery and is now on long-term recurrence prevention medications that block hormones and help the body recognize and destroy cancer cells.

“Alexa is in remission. She has no signs of any active disease,” Dr. The says. “She is working full time. She exercises on a regular basis. We encourage her to live a healthy life.”

For Ms. Paluzzi, who lives in Deerfield Beach, the journey wasn’t easy, yet she learned a lot about herself in the process. “I feel great. There’s nothing fun about cancer, but I met some truly incredible people over the last two and a half years. I’ve learned to not sweat the small stuff. I’ve come to realize that what my body can do is an absolute privilege because for the longest time I didn’t have the energy to do a lot of things. I’m accepting the new me and my new body, and I’m very grateful.”

She urges women to advocate for themselves if they believe something is wrong. “You absolutely need to say something to your doctors. I am so glad that I was insistent on getting looked at, getting what we thought were cysts drained, getting them removed. Had I not, I don’t know what my outcome would have been,” she says.

Dr. The agrees, saying that each woman knows her body best and that any changes should be brought to the attention of your doctor, including:

·      A palpable lump

·      A change in the skin color of the breast

·      Swelling of the breast or any contour change

·      Nipple change or discharge

·      Enlarged lymph nodes around the breast, armpit area or above the clavicle

“Also, leading a healthy lifestyle is critically important to lower the risk of breast cancer. The Mediterranean diet is one of the healthiest diets, and 30 minutes of exercise five days a week is recommended by the Department of Health,” she says. She also recommends getting adequate sleep, reducing and managing stress, not smoking and consuming alcohol in moderation.