Cynthia and Jesse Savage

In This Issue

A One-in-a-Million Breast Cancer Diagnosis

Cynthia Savage, 53, of Vacaville, had less than a 1 percent chance of getting breast cancer. She was fit, healthy and had no family history of the disease. Yet in 2005, she was diagnosed with one of the rarest forms of breast cancer—Paget’s Disease of the Breast.

“My left nipple had been chapped, like dry skin, and I had no luck with moisturizers,” Cynthia says. She showed the spot to her primary care physician, Dr. Shanaz Khambatta, of the NorthBay Center for Primary Care, expecting to get some help choosing a topical ointment. Instead, Dr. Khambatta referred her to a surgeon, on the slight chance that her skin irritation was Paget’s Disease.

Doubtful, her surgeon sent a tissue sample to the lab for diagnosis. When the results came back positive, he sent it out a second time. Paget’s Disease is so rare that Cynthia is the only case recorded by NorthBay Cancer Center Tumor Registrar Charlene Thompson.

“It was a shocking diagnosis for both me and my surgeon,” Cynthia remembers.

“As he gave me the diagnosis, I kept thinking ‘I’m a nurse, I need to pay close attention to these details.’ But at the same time, as a woman it was so mind-numbing that I couldn’t take it all in.”

Paget’s Disease causes skin changes around the nipple, usually appearing as a rash or, as in Cynthia’s case, chapped skin. It usually signals that breast cancer will be found inside the breast. She had an ultrasound and then an MRI, and both were clean. Then her surgeon performed a lumpectomy, reaching deeper into her breast.

The results gave Cynthia a diagnosis—ductal carcinoma in situ of the left breast.

Cynthia had a second surgery to make sure all of the cancer was removed, followed by six weeks of radiation. Today, she is cancer- free, but still gets checkups every six months.

“Throughout this ordeal, my family and friends were so supportive,” says Cynthia, an inpatient case management supervisor at NorthBay Medical Center. “I guess someone had to represent that 1 percent who got Paget’s Disease, and I was the one.”

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