Last spring, Kate Payne was an excited bride-to-be, trying on dresses and picking out flowers, when she first heard the diagnosis: DCIS, an early form of breast cancer, requiring a lumpectomy as her wedding day drew near.
She had the surgery, then a second, but couldn’t get cancer-free. So on her doctor’s advice, she opted for a double mastectomy three days after nuptials – canceling a trip to Hawaii.
“I joke that I honeymooned at Rex Hospital,” said Payne, 32.
All her life, Payne kept an eye out for cancer’s arrival. Her aunt got diagnosed at age 26 and fought for seven years. Her uncle had leukemia. The history ran strong enough in her close family that when she turned 30, Payne had genetic testing to root out any mutations – a decision she credits with such an early cancer detection.
That testing, and the doctor who helped her through it, pushed her to advocate for the same kind of prevention. A year out from surgery, she will join other survivors in Research Triangle Park on Saturday as part of Triangle Race for the Cure.
“I always felt like I needed to be on top of this,” she said. “Like this was my calling.”
The blood test Payne received showed the presence of an ATM mutation, less well-known than the BRCA gene now associated with the actress and human rights advocate Angelina Jolie, who had a preventive double mastectomy in 2013.
The American Cancer Society estimates that only about 5 to 10 percent of cancers are linked to genetic mutations. But women with ATM face an elevated risk of breast cancer, estimated at 20 to 60 percent as high. Payne’s next step: a mammogram, which turned up nothing alarming; then 3-D imaging, which did.
But even as an advocate, Payne does not recommend that every woman rush out for genetic tests. She described her first doctor as having a flippant attitude about the idea, and her first advice to women would be to find a physician who will listen.
Dr. James Evans, editor of the Genetics in Medicine journal and professor at UNC-Chapel Hill, cautions against the idea of all women undergoing the same testing Payne did. Some are better candidates, especially anyone with cancer among close relatives.
“Could we get carried away with testing?” he asked. “The answer is, ‘Yeah, we could.’ ”
Not every mutation will lead to cancer, and while a genetics test result is never something to brush off, Evans stressed that results are nuanced and variable, depending on family history and the type of cancer involved. Talking with a genetics expert would be key, and risk-reducing mastectomy is only a recommendation.
What information comes out of genetics testing and how it gets used has bubbled up as far as the U.S. Congress. A bill filed in March by Rep. Virginia Foxx, a Republican from North Carolina’s 5th District, would allow employers easier access to employees’ genetic information and penalize those who refuse. Evans and many other geneticists call this a bad idea.
But Payne’s case, Evans said, demonstrates exactly what this type of testing is meant to achieve.
Payne spent only a night at Rex, and on her blog – The Best of Bugsy – she described going from a single woman with breast cancer to a cancer-free married woman in one week.
“Suddenly,” she said, “I didn’t really care if my flowers were perfect or if my dress was perfect or if I have to get a spray-tan. I was marrying my best friend.”
Next month, she and her husband, Luke, will take their long-delayed trip – not at Rex, but in Greece.
Triangle Race for the Cure
The 21st annual Susan G. Komen Triangle Race for the Cure will take place Saturday, May 6, at The Frontier in Research Triangle Park. Registration begins at 7 a.m., and the first race starts at 7:30 a.m. For a full schedule and more information, go to komennctc.org.