Published: February 10, 2008 10:12 pm         

32-year-old Enid woman with breast cancer wants to raise awareness of disease

When Enid resident Brandy Walker was diagnosed with inflammatory breast cancer last August, she didn’t understand how it could have happened.

After all, she was only 32 years old. Now, she wants more women to be aware this disease is not exclusive in terms of age.

“I’m 32 years old,” Walker said. “I would never have thought about doing a mammogram. I would have gone in earlier, if I had known.”

Though her family did have a history of breast cancer, Walker thought she was too young to have contracted the disease. What she would find out is IBC is one of the most aggressive strains of the disease and one that has a survival rate of only 40 percent for patients after five years. After receiving her diagnosis, Walker decided it was something she would get, but it would not get her.

“My motto is, I have cancer. Cancer does not have me,” she said.

Approximately, 200,000 women and 1,700 men are diagnosed with breast cancer each year, according to the National Breast Cancer Foundation. More than 40,000 women die each year from the disease. The fact is, breast cancer is a devastating disease, and IBC may be its most devastating form.

On Aug. 11 2007, Walker said she discovered a golf ball-size knot in her breast after she noticed a rip in her bra. She said two weeks later her breast was extremely hard, red and swelled into the size of a grapefruit. Doctors would later discover Walker had cancer cells in eight of 23 lymph nodes.

According to the National Cancer Institute, Walker’s symptoms fit right in line with what doctors normally see in IBC. Typically, though, IBC does not produce a distinct mass or lump that is noticeable within the breast. The lack of a mass or lump makes it difficult for radiologists to detect IBC through a mammogram. IBC cells infiltrate the skin and lymph vessels and block the lymph vessels. The skin of the breast typically can resemble that of an orange. Doctors refer to this as peau d’orange. The appearance often is similar to other inflammatory conditions like cellulitis and mastitis.

Rene Dexeus, clinical director and nursing coordinator at Dexeus Oncology, said women often are unaware they have inflammatory breast cancer because they think the initial symptoms are just a rash or spider bite. Dexeus, who is a registered nurse, an MSN and an oncology certified nurse, said patients are so unaware, by the time they come in the signs are immediately noticeable and recognizable.

IBC is a rare form of cancer. Only about 4 to 6 percent of women are diagnosed with it each year. Dexeus said studies have shown women with a high-fat diet are more likely to be diagnosed with the disease. She said the numbers are similar for all cancers, though, and diet and exercise can play a big part in prevention and recovery.

There have been few cases of IBC in Enid. April Foster, cancer registrar for St. Mary’s Regional Medical Center, reported only having seven cases from 1991-2007, and Oleta Utsler, registrar at Integris Bass Baptist Health Center, reported only five cases since 1996. Walker said one of the oncologists she went to said he had never actually had an IBC patient.

After her initial diagnosis, Walker said she went in to have a mammogram done, followed by a biopsy. Several rounds of chemotherapy followed until she was able to undergo surgery to remove both breasts on Jan. 11 at Mercy Hospital in Oklahoma City. Walker said the chemotherapy she had was a total body treatment and something she absolutely had to undergo.

“I was told it would have spread all over my body,” she said.

IBC treatment usually has several stages after diagnosis and assessment. Most patients will first undergo chemotherapy, or neoadjuvant therapy, to try and kill all the cancer cells before they spread through the body. Patients then are evaluated again to determine if they are operable or inoperable.

For operable patients, surgery is done and followed by radiation treatments. If a patient is unable to undergo the operation, he or she will directly go into radiation therapy. Patients then are placed on one of two drugs, Tomoxifen or Anastro-zole, to help reduce estrogen and hormone levels. High estrogen levels can lead to the growth of cancer cells.

Walker is due to begin radiation treatment in the next few weeks and will be having a hysterectomy to try and control her estrogen levels. She said doctors have prescribed Tomoxifen for her. The hope is to essentially starve the cancer cells until they die.

IBC is rare in young women, according to the National Cancer Institute. Only 2.1 percent of women between the ages of 20 and 30 are, on average, diagnosed each year in the United States. The numbers for women between the ages of 31 and 40 are slightly higher at 9.7 percent. Women are most likely to be diagnosed with IBC between the ages of 41 and 60.

Dexeus said the best thing for women to do is to give themselves self-examinations regularly. Women should begin regular exams at the age of 40, but Dexeus said if there is a history of breast cancer in their family, women should start early. Instructions on how to do this are available online at the National Cancer Institute’s Web site. Dexeus said nobody knows their breasts or bodies better than themselves.

Walker said her family has been supportive during this time, and she has even given them a nickname.

“They are so wonderful,” she said. “I call my family my bra. If you met my family, you would know why I’ve been so positive.”