Gina

Age at interview: 45
Outline:

Gina, age 45, has had several benign breast lumps. She has a strong family history of ovarian and breast cancer. A close relative was diagnosed with triple negative breast cancer but tested negative for a breast cancer gene mutation. Gina’s insurance refused to cover genetic testing but later covered screening at a high-risk breast clinic and a comprehensive academic cancer. Recently retired, she hopes her new insurance will cover her screening protocol. Support from her family, being proactive, medications, therapy and deep breathing all help Gina manage the anxiety that comes with her fear of getting breast cancer.

Background:

Gina is a White 45-year-old woman, who lives in a rural area of the Midwest with her husband. She recently retired from her job as a teacher.

Cancer-Related Experience: Elevated risk

Type of Inherited Risk: Family history of cancer

See full story

In April of 2009, Gina found a very large lump in her breast. Results from a stereotactic biopsy were “inconclusive,” and no further action was recommended. Young and scared, she pushed to see another doctor who said, “if the results were inconclusive and you want it out, let's take it out.” The incisional biopsy results found a benign fatty necrosis. Aware of the link between their grandmother’s ovarian cancer and breast cancer, breast self-exams became very important for Gina and her female relatives. Then a close relative was diagnosed with triple negative breast cancer; she tested negative for breast cancer genetic mutations, but the genetic counseling process revealed a lot more breast cancer in the family tree.

Gina’s employer-based insurance would not cover genetic testing, as she herself did not have breast cancer. Three benign breast biopsies later, Gina’s insurance agreed to cover screenings at a high-risk breast clinic—but not genetic testing. She was classified as high risk for breast cancer, having “everything but the true gene,” family history, being overweight, and no children of her own children. Gina hopes her annual mammograms, breast MRIs and taking tamoxifen until her oophorectomy and hysterectomy, will reduce her risk. Gina retired recently. Her new “affordable” insurance will not cover care at the high-risk breast clinic. Heart-broken to be leaving her high-risk oncologist, Gina is “100%” ready to push for what she needs if her new insurance won't follow her current protocol.

Gina is a self-described worrier. Medication, therapy, and breathing techniques help. She avoids internet chat groups where she sees too many negative comments and not enough “proactive positivity.” For information, Gina has relied on her “physician and her reassurance.” She credits her family’s support before screenings or biopsies, noting “breast cancer brought us closer.” With a healthy dose of realism, Gina does not buy into the idea that, “if I do everything possible that I'm never going to have it.” But she knows with early detection, “your life expectancy is longer.”

After learning more about her heredity and other risk factors, Gina knows she really wants to be around for a long while to be with her husband. She notes, “He is, he is my purpose in life. I'm here for him. Which is why I'm going to be proactive.” And part of being proactive is to raise awareness that family risk for breast cancer is common, breast cancer does affect younger people, and fear is normal. She would ask health professionals when treating a patient who is scared or timid to “consider where they are at and show respect.”

 

 

Gina is about to lose a doctor she relies on because her insurance has changed.

Gina is about to lose a doctor she relies on because her insurance has changed.

SHOW TEXT VERSION
PRINT TRANSCRIPT

I recently retired because of some different health issues, unrelated. And now I haven't had any specific incidences, but I'm going to have to leave Dr. [NAME], which breaks my heart. And I'm nervous. I'm nervous that our new insurance won't follow the protocol that she's been doing for oh six, seven years, probably. But I don't know that. I just-- I have an appointment in a few months with my new breast doctor. And it's not at a high-risk clinic. So that does worry me.
---
Dr. [NAME] told me that everything will be followed. And she would give a recommendation of the same treatment, protocol, to follow. Obviously, I'm not going to be able to go to the current clinic that I'm at. So, yeah. There's just that nervous edge on me because I was feeling so comfortable with my doctor, and what we were doing, and knowing I was being watched closely and-.
---
Well, even while I was teaching, you know, there were-- because the schools always try to go with the lowest price. And then-- so there were always changes. I always decided to keep paying whatever I needed to, because they would give us choices once we were on the state plan, so I could go to my same doctors. Well, now that my husband farms, and I'm not teaching, we had to think about finances and what our lowest premium and lowest deductible was going to be. And unfortunately, to keep all of our other doctors that we wanted, that were still in that plan, I had to lose my breast doctor.

 

Gina feels that her co-workers treated her differently because of her frequent screening.

Gina feels that her co-workers treated her differently because of her frequent screening.

SHOW TEXT VERSION
PRINT TRANSCRIPT

This may sound odd. I do kind of feel like-- I don't know if stigma is the word-- but because I am watched over so carefully, like I almost sometimes feel like other people, coworkers, friends, strangers, are like, “why, why do you have another appointment? Why?” You know, “they're watching you in three months?” Like not understanding the high-risk part. And then kind of almost making me feel like hypochondriac, or something. But I'm doing what the doctors are telling me to do.

 

Gina says the worry that accompanies a biopsy doesn’t get any better no matter how many times she has the procedure.

Gina says the worry that accompanies a biopsy doesn’t get any better no matter how many times she has the procedure.

SHOW TEXT VERSION
PRINT TRANSCRIPT

That fear never goes away. Like, you would think after the fourth biopsy you'd be like, “oh, it's going to be fine. It's a breeze.” Your appointment gets closer, and you're a nervous wreck that entire window until they call you and tell you, youknow, “it's OK. It was benign,” or whatever. But I definitely still have anxiety and fear every time. And I'm assuming most people do. I mean, that isn't something you can just be like, “oh, it's it’s fine.” I don't think it's that easy.