Sisters share breast cancer survivor and prevention stories.
Writer / Sarah R. Brodsky
One in every eight women is diagnosed with breast cancer. Advances in science have helped improve treatment of breast cancer and survival rates are increasing, but more women are now making decisions to help avoid a diagnosis in the first place.
Mollie Case is one of them. Case, an event planner who lives in Ponte Vedra, is what’s known as a “previvor.”
The term previvor was first coined by Sue Friedman, a breast cancer survivor who founded a support group known as FORCE, to label those currently unaffected by cancer but still carrying a high hereditary risk.
Perhaps the most famous previvor is Angelina Jolie. The advocate actress – whose mother Marcheline Bertrand died of ovarian cancer – spurred a national debate over women’s health decisions when she announced in a New York Times column that she carried a genetic mutation and had a double mastectomy.
But why would someone willingly choose to remove their breasts or ovaries?
For Mollie – who made her decision three years before the celebrity’s announcement – the rationale was simple: love for her sister, Jennie, and a future without cancer.
At her yearly gynecologic check-up in 2010, Jennie, then 37, was a bit perplexed when the doctor kept poking at one part of her chest during the breast exam.
“She kept asking me, ‘What is this?’ Her fingers hit something. But I didn’t feel anything. It wasn’t a pea or round. I thought it was muscle,” says Jennie, a second grade teacher at Palencia Elementary School.
She had cancer in each breast. And she didn’t have just one type of cancer. She had three, including triple negative, one of the most challenging cancers to treat.
Given her age and complexity of her cancer, doctors recommended Jennie undergo genetic testing to look for BRCA 1 and BRCA 2 – gene mutations linked to about 20 percent of all breast cancers.
Jennie tested positive. She learned the trait came through her father’s side of the family.
“My paternal grandmother had breast cancer. She was one of eight siblings and every one of them died from some type of cancer,” Jennie says.
Mollie, 33 at the time of her older sister’s diagnosis, admits that while she’s the worrier in the family, when it came to genetic testing, she wasn’t really focused on it.
“I was more worried about Jennie having cancer. It wasn’t about me,” she says.
That is until the day she was traveling for work and got a call from the genetics counselor on the way to the airport.
“She asked if I was ok to talk and I just knew I had the BRCA gene,” she says.
Eventually, Mollie met with Dr. Sarah McLaughlin, the breast surgeon at Mayo Clinic who operated on her sister.
“I remember Dr. McLaughlin told me that BRCA doesn’t mean I will get breast cancer – it just means I have an increased risk,” Mollie says. “She went through my options, including do nothing other than increase surveillance with mammograms and MRIs. But I knew my decision. If I had a chance to prevent it, there was no question.”
Mollie underwent a double mastectomy and reconstruction in November 2010 as her sister tackled chemotherapy and radiation.
Though she was open about her decision, many didn’t understand it.
“People didn’t realize prophylactic surgery was an option before Angelina Jolie. I had this done before her but nobody talked about it,” Mollie says. “I had friends who couldn’t fathom it. ‘You’re doing what? Why can’t you just monitor yourself?’”
Though Mollie never second-guessed her decision, she admits to experiencing a bit of guilt watching her sister suffer through treatments. But Jennie is glad she took initiative.
“Mollie saw all I went through – the good, the bad and the ugly,” Jennie says. “Knowing she is a worrier, getting a double-mastectomy was the best choice for her. I’m happy she had the procedure.”
Mollie often counsels other women who are contemplating proactive surgery. “I tell them to tune out the noise and make your own decision. Do what’s best for you,” she says.
Today, both sisters are passionate advocates for breast health and active volunteers. They support local walks and runs, as well the Pink Ribbon Golf Classic, which raises funds for local breast cancer research and care at Mayo Clinic and Baptist Medical Center. They also share their experiences with others.
“Other breast cancer survivors were so helpful to me when I was diagnosed. I’m now helping others and just paying it forward,” says Jennie, noting that she’s always happy to talk to people going through breast cancer.
Jennie says she’s had so many people reach out to her that she and Mollie compiled a list of things to pass on to others of what to do before and after someone has a mastectomy.
Because of the type of cancer she had, Jennie remains diligent about ongoing follow-up and is optimistic about a future cure for cancer. “It’s a rough road, but there is a light at the end of the tunnel,” Jennie says.
Whatever the future DNA holds, the sisters are certain about two things: everyone’s choice is personal and neither of them would have made it without the love and support of their family, friends and each other.