How Genomic Testing Brought Me a Sense of Control During Metastatic Breast Cancer

April 6, 2021
Marianne McNally

Marianne McNally is a real estate agent and metastatic breast cancer survivor living in Oregon.

You never think it’s going to happen to you, but it can. In 2009, I found a lump in my breast. Soon, I was diagnosed with localized breast cancer. Suddenly, I had to figure out how to balance taking care of my family, working full-time, and going through chemotherapy.

But that was just the beginning. Three years later, I was getting a computed tomography (CT) scan and my doctor saw a spot on my rib. Later, the cancer would spread to my shoulder blade and spine. I now had stage 4 metastatic breast cancer. Not only had my cancer spread, or metastasized, throughout my body, but I also learned that my cancer was “smart.” It transformed from ER/PR-positive and HER2-negative to triple-negative, which is an aggressive type of breast cancer that is difficult to treat.

My mind started swirling with thoughts. How am I going to do this again? Will I be able to keep working? Will I have to lose my hair again? I work in real estate, so being around people is important and, quite frankly, my favorite part of the job. I didn’t want my cancer to be the first thing people saw when they looked at me.

Knowing my disease will likely progress, my oncologist and I are making sure we plan ahead. Last May, after trying a few different treatments, my oncologist suggested that I get comprehensive genomic profiling (CGP), which is a type of tumor marker testing. My oncologist described how CGP could help identify what gene mutations my cancer has so that we could better plan for my future course of treatment. 

I got my CGP test through a liquid biopsy, which is based on a simple blood draw. The results from my test indicated that there are PIK3CA and PTEN mutations, which means certain targeted therapy medications may be options for treatment. I am a very organized person and love having a plan, and the test report was the plan I had been looking for. It’s like a tool I can pack away in a toolbox on the top shelf and have it ready to use when I need it.

Norah Lynn Henry, MD, PhD, FASCO

“Identifying specific mutations in a tumor can reveal potential treatment opportunities, either with approved medications or as part of clinical trials, that are tailored to that cancer and that might not otherwise be considered. All patients with metastatic breast cancer should talk with their oncologists about whether their cancers should be genomically profiled.” – Norah Lynn Henry, MD, PhD, FASCO, an Associate Professor in the University of Michigan's Division of Hematology/Oncology in the Department of Internal Medicine, Breast Oncology Disease Lead at the Rogel Cancer Center, and Cancer.Net Associate Editor in Breast Cancer

After receiving my results, I wanted to help other women facing a metastatic cancer diagnosis to gather their own tools. Seven years ago, I started a breast cancer support group in my town through a larger patient group, Breast Friends of Oregon. Through this group, I have been able to help other women how important it is to be part of treatment planning with their doctor. This is called shared decision-making. I love to share my own experience, and I try to educate as many people as I can about the value of genomic testing. Encouraging other women to be part of the health care decision-making process feels like it’s helping me even more than I can help them.

Every day, I wake up and choose to have a positive attitude. Most days, I only think about cancer a few times, but I still have days when it consumes all my thoughts. Those are the days I look to my support group and remember we are in this together. Everyone goes through cancer differently, but I learned you don’t have to go through it alone. You can find a support group in your community or online and share your experiences with other survivors, including those who are recently diagnosed and just starting on their own path.

When it comes to cancer, there’s not too much that’s within my control. In fact, life may seem out of control. But having my genomic testing results in my back pocket for the day when my current treatment may stop working is comforting. With cancer, I’ve learned that I always have to be my own advocate. Having the CGP test results gives me the information I need about my tumor to help me be a better advocate for myself and for others.

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