A local cancer survivor’s advice: Ask for specifics to make treatment decisions

Plus, what are MammaPrint and Oncotype DX tests?

Photo by Aaron Spicer

When preschool teacher and mother of two Lisa Dixon Cipolla, 47, of Alexandria, had a physical in October of 2017, her primary care physician suggested a mammogram. Though she hadn’t felt a lump, she hadn’t had imaging in five years, and Cipolla figured she’d “cross it off the list.” She was stunned when they said the mammogram was “irregular, off.” An ultrasound revealed a 3-centimeter mass, and she was scheduled for a core needle biopsy at Inova Mount Vernon Hospital. She remembers her doctor’s call summed up in three words: invasive ductal carcinoma. “It was all very overwhelming, such a blur,” she says. “My first thought was, I waited five years between mammograms, so what if I’m stage 4, how many years do I have left? Will I get to see Elizabeth finish college or Nicholas graduate high school?”

Her primary care doctor recommended surgeon Dr. David Weintritt in Alexandria, and acquaintances had positive comments about him too, so she consulted with him immediately. On Jan. 2, 2018, Cipolla underwent a lumpectomy and removal of three lymph nodes at Inova Mount Vernon Hospital. She bounced back quickly after surgery, with no pain. “I don’t even have a scar,” she says, and credits Weintritt as a blessing. “He’s amazing. I whole-heartedly recommend him, because he focuses on breast cancer.”

Soon she was ushered into the dizzying world of a stage 2B diagnosis: deciding on the best treatment. Her oncologist recommended the Oncotype DX test on the tumor, which predicts the rate of recurrence. It showed she was “low risk,” and chemo would only benefit her by 3 percent, she says. When the BRCA1/2 tests for hereditary breast cancer genes returned negative, Dr. Weintritt suggested the genomic test MammaPrint. That test returned “ultra low-risk” results, she says, and so she chose to forgo chemotherapy and opted for radiation, 10 years of the estrogen blocker drug Tamoxifen and mammograms every six months.

Cipolla finished radiation at Inova Alexandria Hospital last April and reports all imaging since gave no suspicious findings. Cipolla is ecstatic to be cancer-free. “I have so much hope,” she says. She offers sound advice to others: Bring someone (to appointments) to take notes. “So much is thrown at you at once, but it will all be OK.” Second, “stay off the internet. Don’t look up pictures of lumpectomies and mastectomies. Your surgery may be different, and you don’t know how old those pictures are.” She stresses cancer isn’t a “one-size-fits-all disease.”

And, she adds, “once they say you’re cured, live like you didn’t have cancer. Take your medicine, go to your appointments and just live.”

What are MammaPrint and Oncotype DX?

According to the American Cancer Society, these two relatively new tests look at your genes in order to determine the likelihood of a breast cancer reccurrence. The Oncotype DX, which is used in cases where tumors haven’t spread to more than three lymph nodes, examines 21 genes via tumor biopsy samples and can help determine if chemotherapy would be beneficial.

The MammaPrint test, also used when the cancer hasn’t spread beyond three lymph nodes, looks at 70 different genes to predict the risk factor of a cancer returning. Both tests may help you make more informed treatment decisions with your doctor.

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