In 2020, with the COVID-19 pandemic sweeping the globe and people staying at home and keeping their distance, Morgen Chesonis-Gonzalez did what about 41% of Americans do during “anxiety-filled times”: He skipped medical appointments. In her case, it was her annual screening, which the public school clinical art therapist in Miami usually does in the summer.
But in August, persistent pain in her armpit forced the mother of two to summon courage and schedule a mammogram. The already stressful situation was made even more alarming by protocols that made the hospital feel “like an episode of ‘Twilight Zone,'” Chesonis-Gonzalez said.
But the truly surreal moment came with her diagnosis. With two masks and her husband listening from the car, she had to ask the oncologist to repeat it, thinking she had heard it wrong.
She has two forms of breast cancer.
Treats two forms of breast cancer
Chesonis-Gonzalez was diagnosed with triple-negative breast cancer in her left breast, which has no receptors for other types of cancer and can be more aggressive and harder to treat. She also had hormone receptor positive invasive ductal cancer in a separate area of the same breast.
The two forms of cancer meant Chesonis-Gonzalez had to undergo aggressive treatment, said Dr. Starr Mautner, a breast surgical oncologist at the Miami Cancer Institute in Florida. Mautner is one of the doctors on the Chesonis-Gonzalez team. Having two forms of cancer at the same time like this is rare, Mautner said, but not unheard of, estimating that it occurs in only 5 or 6% of breast cancer patients.
Treatment begins when the school year begins. While she taught her students online, Chesonis-Gonzalez also underwent four months of chemotherapy to shrink the tumor.
During those chemotherapy sessions, Chesonis-Gonzalez sat alone in the hospital, unable to have anyone by her side due to pandemic restrictions. Friends and family don’t risk visiting, especially when they are immunocompromised, so food with congratulatory notes is left on the back porch. Her husband continued to attend oncology meetings by phone, taking notes in the hospital parking lot.
After months of chemotherapy, Chesonis-Gonzalez underwent a bilateral mastectomy.
“Since I was only 47 years old, the constant worry of my life when cancer could appear in a healthy breast was unbearable,” said Chesonis-Gonzalez. Once again, he entered the hospital alone. The surgery involves tissue expansion, or empty implants placed during surgery to make breast reconstruction easier later.
After surgery comes physical therapy to regain some movement in the chest and shoulders. He had a specific goal: To be able to raise his arms above his head and hold the position long enough for the radiation treatment. Physical therapy was difficult, but eventually she was able to begin daily photon radiation sessions, targeting her right breast to make sure no cancer remained.
Mautner said that after ten months of active treatment, there were no signs of cancer in the samples taken from Chesonis-Gonzalez. After six months of healing, she can request reconstruction surgery, replacing the tissue expander for breast implants. Now, three years later, Chesonis-Gonzalez is almost done with maintenance endocrine therapy, which helps keep the cancer from returning.
Breast cancer symptoms and screening
One in 8 women will be diagnosed with breast cancer in their lifetime, Mautner said. Mammograms are “important to detect potential problems at an early stage,” he said, and women should start getting them regularly at age 40.
People who are at higher risk because of genetic markers, family history or breast density should ask their doctor about a breast MRI, Mautner said, because it can find lesions that a mammogram can’t.
It is also important to know the signs of breast cancer, says oncologist Dr. Christina Annunziata. Persistent pain in the armpit like Chesonis-Gonzalez experiences can be a sign, especially of advanced cancer, he said. People should also watch for redness of the skin, changes in the nipples or lumps in the breast. Mautner added that discharge from the nipple can also be a sign of breast cancer.
Annunziata said that when screenings dropped during the pandemic, they returned to normal levels.