Angel Marie Fields was out with friends when she noticed that her chest felt tight and heavy. She felt a lump but did not give it much attention. After all, she was only 26.
When she checked it again later, it felt like one big lump. She made an appointment with her ob-gyn, Hany Ahmed, MD, who found three distinct lumps – two in her left breast and one in her armpit – and referred her to the Memorial Hermann Cancer Center-Greater Heights for an ultrasound.
“At that point, I still thought I had nothing to worry about. I was certain it was benign because of my age,” Fields says. “They did a mammogram and a biopsy that same day – all the tests were scheduled a couple of hours apart.”
During the biopsy, the radiologist placed three biopsy clips to help Fields’ surgeon localize the tumors with greater precision. The following day Dr. Ahmed’s office called and asked her to come in.
“When I told them I’d come my next day off, they said they wanted to see me ASAP,” she recalls. “I’d recently had a Pap smear and thought there might be something wrong with that. When my doctor read over the breast biopsy report, I went into panic mode. I asked if I was dying. He said, ‘We don’t know how far along it is yet,’ but he already had Dr. Adams, Dr. Bhuchar and Dr. Surapaneni lined up as my team.”
Surgeon Ronnie Adams, MD, medical oncologist Vinod Bhuchar, MD, his partner Shahab Khan, MD, and radiation oncologist Aparna Surapaneni, MD, were at the Cancer Center’s weekly breast cancer conference when Fields’ case was discussed. Radiology and pathology were also represented. The biopsy showed stage 2B invasive ductal carcinoma with lymph node involvement.
“Breast cancer is uncommon at such a young age, but we do see cases and it’s well documented in the literature,” Dr. Adams says. “Because of her family history, her BRCA mutation and the extent of her disease, we recommended full bilateral mastectomy as the best treatment course.”
With multiple tumors and lymph node involvement, Fields underwent a four-week standard-of-care chemotherapy regimen to shrink the tumors as much as possible before surgery. By her third round of chemotherapy, she had lost her appetite and was too fatigued to work. When she finished her fourth round, she thought to herself, ‘This is what you have to do, girl, so pick up your head and be strong so you can survive for your kids.’ I did a lot of praying.”
Shortly after she finished chemotherapy, Dr. Adams performed the bilateral mastectomy on Oct. 3, 2016. “When I woke up, I looked down and for the first time saw myself without breasts. It was a shock, but I was up and walking around the next week.”
Fields underwent six weeks of radiation therapy.
"It wasn’t a cakewalk,” she says. “I was tired, but I have to say that the entire staff at the Cancer Center was awesome in helping me through it. They were so supportive. My family still had to go on with life. If I had to bring my kids when I came in for chemotherapy, they took care of them. When I stopped working, I needed help with my rent. The nurse navigator arranged that for me. Dr. Adams did a great job. Dr. Bhuchar and Dr. Khan were wonderful. Everyone arranged everything around my schedule. It wasn’t that I got special treatment. I watched them take care of other patients in the same way. We became a little family.
“When I was first diagnosed, I thought, ‘I have cancer. I want to go to MD Anderson.’ But when I met my team, I really liked them and felt confident,” she adds. “I know I made the right decision.”
Dr. Adams describes Fields’ case as “difficult overall. No physician wants to deliver the news to any patient who has a bad disease, and especially not to a patient so young,” he says. “A diagnosis of breast cancer is a lot to take in. Sometimes I feel we’re putting an avalanche of information on our patients. We talk about the operation, chemotherapy, radiation therapy and possible reconstruction. Because Angel was BRCA positive and had a 20 to 45 percent chance of developing ovarian cancer, we recommended a salpingo-oophorectomy and hysterectomy, so we talked about harvesting eggs in case she wanted to have another pregnancy later in life. There are so many important decisions that our patients have to make, all of which have long-term repercussions. She had good family support and worked through it very well.”
Fields opted for reconstructive surgery. Plastic surgeon Carlos Murillo, MD, who is affiliated with Memorial Hermann Greater Heights Hospital, put in tissue expanders immediately after her bilateral mastectomy during the same surgery.
“Once I have my reconstruction, I’ll be done,” she says. “I just have to do checkups once a year and take tamoxifen for 10 years.”
Fields has two children – a daughter, Mia, age 5, and a son, Juelz, age 7. She says she is doing fine.
“I’m starting to get back to my normal life,” she says. “I’m happier today. I’ve talked to a lot of girls my age who have had cancer. Everything happens for a reason. Now I’m trying to help others through their journey.”
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