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Koscik, 41, of Homer Glen, is enrolled in Phase III randomized trial of hypofractionated post mastectomy radiation with breast reconstruction. Dr. Anne McCall enrolled Koscik in the trial. McCall is radiation oncologist who specializes in the treatment of breast cancer, gynecologic cancer and lymphoma at the University of Chicago Comprehensive Cancer Center at Silver Cross. “We offer it to women we think would be good candidates,” McCall said. “It by no means impacts their care.”
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McCall said that, for a long time, women whose breast cancer had spread to their lymph nodes were treated with radiation for five to six seeks. “We have since learned a little bit higher dose every day over a shorter time period worked as well and, in some cases, better,” McCall said. “But we had not validated that in women with reconstructions.” Koscik was randomly selected for the shorter course of radiation, McCall said. “And she did really well,” McCall added.
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Koscik’s cancer journey began in the spring of 2019 when her primary care physician suggested Koscik have her first screening mammogram. Koscik thought it was a good idea, too, although she didn’t expect the test to show anything. “I didn’t have a history of breast cancer in my family,” Koscik said. “Although my father did have cancer and passed from pancreatic cancer in 2004.” The mammogram detected a small cyst in the right breast and Koscik was instructed to return in six months for another scan. This time, Koscik’s mammogram was followed by an ultrasound and then a biopsy. The “cyst” was actually cancer that had spread to Koscik’s lymph nodes, she said. The actual diagnosis was breast cancer triple-negative invasive ductal carcinoma, Koscik said. “I was scared and overwhelmed with the diagnosis,” Koscik said. “I was eager to start treatment to get rid of the cancer.”
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About 10 to 15% of all breast cancers are triple-negative, according to the American Cancer Society. Theses cancers are called “triple-negative” because the cancer cells are negative for estrogen or progesterone receptors and make only a small mount of a protein called HER2. Triple-negative breast cancers are more common in young women (less than age 40) African American women or women with a BRCA1 mutation, which Koscik has. This type of invasive breast cancer also grows and spreads faster than other breast cancers and has worse outcomes. It also has limited treatment options, the American Cancer Society said. Koscik began chemotherapy on Dec.18. This consisted of infusions every week at the University of Chicago Medicine's Hyde Park location because she was enrolled in a clinical trial. This trial was called "Neoadjuvant and Personalized Adaptive Novel Agents to Treat Breast Cancer." “It was an immunotherapy drug that was injected right into the tumor,” Koscik said. “That was weekly the first four weeks and then at week seven and 10.” Koscik said the effect of the injections was monitored with ultrasounds. At each scan, the tumor was smaller, she said. “If I had to go on this journey, I wanted to participate in as many research protocols as I could,” Koscik said. Koscik said she did experience some fatigue and nausea, but she had medication to combat the nausea.
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“I was able to work full-time,” Koscik, a nurse who coordinates care for children with complex medical needs, said. “I was expecting worse: episodes of vomiting every day or just being unwell. But really the only days I had to take off were Wednesdays for the chemo. By Thursday, I was back to work. “It was better for me to work full-time, in my opinion, to take my mind off my diagnosis and my treatment. I was helping other families with whatever concerns they had. That kept me busy and out of my own troubles.” Koscik, who has an 11-year-old son, finished treatments in April and took May off from work to recover from the chemotherapy and prepare for surgery, which was June 4. And Koscik, because of COVID-19, faced that alone. “My husband dropped me off,” Koscik said. “I had to go in by myself and had to check myself in. But, luckily, the staff was just so kind and treated me so lovingly, especially when I didn’t have any family surrounding me.” Koscik opted for a double mastectomy due to the type of her cancer, her age and being positive for the BRCA1 mutation, she said. The reconstruction was done at the same time, she added. “They recommended for me to have my tubes and ovaries removed in another surgery somewhat soon but not immediately,” Koscik said. Surgery took 10 hours, but staff updated her husband several times during the process, Koscik said.
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The Susan G. Komen breast cancer foundation said women with a BRCA1 mutation have a 35 to 70% risk of ovarian cancer and an increased risk of pancreatic cancer. Koscik went home on June 7. Following a six-week recovery, Koscik started radiation. Her only side effect was a little fatigue and skin redness, no actual burns, she said. The radiation treatment was precautionary, Koscik said. “They took tissue samples from the tumor, from the breast and from the lymph nodes, Koscik said. “The pathology came back cancer free. So as far as I know, I’m cancer free. There’s no medication I need to take. I just need to follow up with Dr. McCall and my other doctors.” She would encourage women not to put off their annual screening mammography. "I am just blessed she [primary care physician] sent me for my screening," Koscik said. (All photos)
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