Denise Portner - Patient Story
"If I hadn't been aware of my genetic status, I might still not know I had breast cancer."
— Denise Portner, Breast Patient
Both Denise Portner's mother and aunt are breast cancer survivors who were diagnosed at age 60. Both underwent genetic testing and learned they carried the BRCA2 genetic mutation, that indicates an increased risk of breast cancer. In May of 2008, Denise and her sister underwent genetic testing, and it was determined that Denise was also a carrier.
Genetic counselors at the hospital where her mother was treated advised Denise to consider prophylactic oophorectomy (surgery to remove one or both ovaries) to reduce her risk for both breast and ovarian cancers. In August 2008, she came to Fox Chase's Family Risk Assessment Program and met with Dr. Mary Daly to get a second opinion. Dr. Daly concurred, and gave her a book that the program developed: Ovarian Cancer Risk-Reducing Surgery: A Decision Making Resource. This book includes testimonials from women facing the same decision, and their thought processes. But then a more pressing concern arose and Denise had to shift her focus.
By June 2009, Denise, at 46, a mother of two teenagers, decided to go ahead and have the preventive surgery. She made an appointment to see a gynecologic surgeon at Fox Chase, and in the meantime, scheduled her first breast MRI since the genetic testing.
Denise was diagnosed with breast cancer the day before her daughter's high school graduation.
The MRI showed an area of concern. She underwent an ultrasound-guided biopsy of the breast tissue, and on June 16, 2009, the day before her daughter's high school graduation, a member of the Risk Assessment Program team called to tell Denise that she had breast cancer.
"If I hadn't been aware of my genetic status, I wouldn't have had an MRI, and I might still not know I had breast cancer, because I never felt a lump," Denise says. In fact, a mammogram taken after the cancer diagnosis came back negative. "I feel fortunate that my mother and aunt received good advice and were tested, so that I was able to catch it as early as I did."
Denise then met with Richard Bleicher, MD, a surgical oncologist and breast service line leader. Because of Denise's diagnosis and genetic status, Dr. Bleicher recommended double mastectomy to prevent recurrence.
"Being told you have cancer can be a surreal experience," Denise explains. "You feel fine, but you apparently have a life-threatening disease. It's critical to be able to put your trust in a team of professionals. From the moment of diagnosis at Fox Chase, I felt that I had stepped into a finely-tuned operation of providers at the top of their game, ready to take care of whatever arose, and concerned about my emotional well-being as well."
In preparing for the decision, Denise got a second opinion, consulted family and friends and other survivors, reviewed the medical literature, and had a heart-to-heart with her husband, a family physician. In the end, she decided that she wanted to put the concern behind her and the best way to do that was proceed with the surgery. Meeting with Sameer Patel, MD, FACS, a plastic and reconstructive surgeon at Fox Chase, also aided her decision, as she learned that she could have reconstruction that would make her look and feel whole again.
"I appreciated that my oncologists were willing to give me their opinions and help me clarify my options."
"Throughout the process of cancer treatment, there are many important decisions to be made," shares Denise. "I appreciated that my oncologists were willing to give me their opinions and help me clarify my options."
Denise underwent surgery in the summer, chemotherapy during the winter, and radiation therapy in the spring, followed by the originally-planned oophorectomy. With a flexible and supportive employer, she was able to maintain her job at an advertising agency in the city, working from home when she needed to.
"It was a challenging ride, but I always felt that I was getting the best possible treatment, and so fortunate to have a world-class cancer center within a 10-minute drive of my home. It was easy for family and friends to accompany me to doctor appointments and to sit with me in the infusion room, and I was able to integrate appointments into my day," she adds.
"The oncologists at Fox Chase are champions for their patients," Denise says. One in particular worked with Denise's insurance company to get approval to use Intensity Modulated Radiation Therapy (IMRT) in her case. It is more time-consuming and costly than standard therapy, but because of the requirements of her case and his commitment to minimizing the impact to her heart, he argued for its use.
With treatment behind her, Denise has regained her energy, has a renewed sense of purpose at work, and is anxious to help other women manage the challenge of cancer treatment. She serves on the board of directors of Living Beyond Breast Cancer. She also made a video of her experience in honor of the 20th anniversary of the Risk Assessment Program, celebrated in November 2011 at the studios of local NPR affiliate, WHYY-FM.
"Being involved in the Risk Assessment Program is like having a really smart and caring group of friends. It's a comfort to be connected to a program that is using all of our experiences and family history combined with research and clinical trials to provide state-of-the-art care and education. I feel good that I am contributing to the body of knowledge for our children's generation," concludes Denise.