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Positive choice: Woman chooses elective mastectomy after testing positive for gene

By Kristen Tribe | Published Saturday, October 13, 2018
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Sharing the Good and Bad

SHARING THE GOOD AND BAD – Wendy Moreland (center) shares a hug with her mother, Betsy Freeman (left), and aunt Marilyn Hearne. They also share the BRCA2 gene mutation, which greatly increases the risk for breast cancer. Messenger photo by Joe Duty

Wendy Moreland was only 35 when she received the dreaded news.

She needed a double mastectomy – both breasts surgically removed.

“I was just shocked,” she said. “I cried to my husband. I didn’t want to cry to my mom because she had been through so much, and I didn’t want her to know I was scared and worried.”

She sniffed, blinking back tears as she recalled the memory.

“And I didn’t have cancer,” she said emphatically. “That’s another thing. I was like, ‘you don’t have cancer!’ But it’s a big surgery; it’s scary.”

Moreland, a Decatur mother of three, tested positive for the BRCA2 gene mutation, which greatly increases the risk for breast cancer. Doctors said she had an 87 percent chance of getting breast cancer at some point in her life if she didn’t have the surgery.

It was February 2017. Although she was scared, there was no question in her mind about the next step.

She scheduled surgery for Aug. 29, 2017.

Wendy Moreland

Betsy Freeman, Wendy Moreland, Marilyn Hearne. Messenger photo by Joe Duty

GENETIC CONNECTIONS

Moreland said her mother’s family has a history of breast cancer, so it was something she’d always worried about, but in her mid-30s, she had to yet to experience a scare. Earlier in her life she had a breast augmentation, but it was happenstance and a series of heartbreaking events that eventually landed her in the oncologist’s office.

Her mother’s only sister, Marilyn Hearne, fondly called “Nannie M” by Moreland, was diagnosed with breast cancer in 1999 at age 45. It was in only one breast, which she had to be removed, but her diagnosis did not require chemotherapy. Hearne, who lives in Fort Worth, said it was the most aggressive kind but it was caught early, between stages 1 and 2. She made a full recovery and has not had a reoccurence.

Ten years rolled by, during which genetic testing was further fine-tuned, and doctors were connecting the dots between the BRCA2 gene mutation and occurrence of breast cancer. So in 2009, a doctor suggested Hearne and her sister, Betsy Freeman, of Decatur be tested for the mutation due to their family history of breast cancer.

Hearne tested positive for the BRCA2 mutation, and Freeman, Moreland’s mother, was negative.

After receiving the test results, Hearne had a surgery to remove her second breast because the chances of cancer reoccurence were so great. She’d already had a full hysterectomy after the birth of her last child.

“That was a no brainer right there, just to go ahead and do that,” she said, in reference to the second mastectomy.

Having two different breast reconstruction surgeries 10 years apart has created its own set of issues and physical inconsistencies, but she’s had no other cancer scares.

Freeman, it seemed, was in the clear.

Then in October 2016, she was diagnosed with stage 4 endometrial cancer. It was discovered during a CT scan of her gallbladder.

“I went to the gynecologist yearly and got my mammograms and everything, especially because of her (referencing Hearne) and our grandmother,” Freeman said. “How that got missed, I don’t know.”

It was two months before she was due for her next annual exam.

“I don’t know if it started and grew that fast or if it was already there,” she said. “We did know I had fibroids on the outside of my uterus, and he watched those. He did vaginal sonograms every year to make sure they weren’t growing.”

The next week she had her gallbladder removed and a complete hysterectomy.

During a follow-up visit with her oncologist three months later, the doctor expressed confusion how Freeman ended up with endometrial cancer but was BRCA2 negative.

“Her face actually looked puzzled,” Moreland recalled.

Freeman said the doctor explained to her that endometrial and breast cancer share the same cell type, and endometrial cancer is somewhat “unique.” It didn’t make sense, so the oncologist ordered another genetic test.

This time it came back positive.

“Blood doesn’t change,” Moreland said. “So they shut down the labs for half a day. Everyone stopped what they were doing to figure out what happened with my mom’s blood. And it was switched with some other woman’s. So some other woman had a hysterectomy and shouldn’t have and my mom didn’t but should’ve and wouldn’t have gotten endometrial cancer.”

Freeman was shocked.

“I was like, ‘Oh, my gosh. You’re kidding,'” she told the doctor. “So are you telling me if I had gotten the correct results in ’09, I might not be going through what I’m going through right now? She said, ‘possibly.'”

Moreland said, “No. Her exact words were: we probably would have never met.”

HARSH REALITY

Moreland said the lab, fearing a lawsuit, offered to test Freeman’s children for free, so Moreland and her brother, Shane, were tested in January 2017.

“My physical traits and my personality are a lot like my dad’s, so in the back of my mind, I thought I wouldn’t be positive,” she said. “I thought, ‘It’s going to be Shane. Shane’s going to be positive.”

In February 2017, results said the siblings both have the BRCA2 mutation.

For men, the mutation is a greater risk for prostate cancer, but the threat of breast cancer is still there. The discovery required no immediate action by her brother, just regular check-ups and monitoring.

But for Moreland it led to the double mastectomy, and even though she’d already had a partial hysterectomy, she’s been instructed to have her ovaries removed by age 45. She has a 60 percent chance of getting ovarian cancer until they are removed.

Although Moreland is a self-proclaimed “worrywart,” she’s decided to delay that surgery a bit since she’s so young, to avoid the effects of menopause.

But she felt a sense of urgency when it came to her breasts, even though the doctor said it didn’t require “immediate” action. She delayed the surgery a few months so it wouldn’t interfere with her kids’ stock show schedule. She didn’t want them to miss out on anything, but she said it was a stressful few months leading up to the surgery. Looking back, she wishes she’d done it sooner to get it behind her.

“People were like, ‘oh, you’ve already had [breast augmentations], so this should be easy,'” she said. “But I told them, ‘No. This is not the same thing. This is them cutting off my breasts.”

Moreland said she had the option to keep her nipples, but there’s still a risk of getting breast cancer if all the breast tissue is not removed.

“I said, ‘Cut it all off. I don’t even want these suckers on here,” she said. “I’m terrified after seeing what my mom and aunt went through.”

So in August 2017, Moreland had her breasts removed and reconstruction started all in one surgery. The implants were inserted in the first surgery, and the second surgery, during which fat was transferred from her stomach to her chest, was in November 2017.

Moreland said the fat smooths the transition from the sternum to the breast and also “adds warmth.” In a breast augmentation, Moreland said the patient’s breast tissue is used to cover the implants, which makes it look more natural and provides warmth. Without her own breast tissue to cover, her chest is cool in some places, to her and to the touch.

The final step was in early 2018 when she had areolas tattooed on her breasts. Moreland said she had no idea that was part of the process, and as it was described to her, she was a little confused.

“They were like, ‘you get to pick your color and everything,’ and in my head I’m thinking I’m going to a tattoo parlor, but no, she’s a nurse and she travels and does it a lot for reconstructive doctors,” she said.

Moreland, a dental hygienist, took six weeks off work after the first surgery, but only four days following the second one in November. She goes for regular checkups, and although she no longer needs mammograms, she will still be examined by a doctor regularly, “just in case.” She said her son, who is 19, has mentioned being tested, but they haven’t done it yet. Her girls, still young, will also be tested in time.

“I feel blessed I live in a time where [technology and medicine] has come this far,” Freeman said, reflecting on her family’s trials and recent ability to side-step cancer.

She decided not to sue the laboratory that mixed up the results and has instead focused on recovery and her family. When her doctor gives her a clean bill of health from the endometrial cancer, she will also have a double mastectomy to avoid getting breast cancer in the future.

The trio of ladies have a no nonsense approach to taking care of themselves and others.

Hearne encourages every woman to be aware of their bodies.

“Every woman should check their own breasts outside of doctor’s appointments,” she said. “If you check it enough, you’ll know if something is off.”

Freeman also encourages women with a history of breast cancer in their family to seek genetic testing.

“Just because no one in your family hasn’t been tested, doesn’t mean you can’t be,” she said.

It might provide answers to save generations.

“Catching it early is the key to saving yourself,” Freeman said.

Or, catching it before it occurs.

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