Isla Foy was well into her second trimester of pregnancy when she noticed a mosquito-bite-like pain on her breast that wouldn’t go away.
In the middle of the excitement of preparing for a newborn, she decided to see a doctor about what this mysterious pain could be.
“It got worse and worse and worse, and then eventually by about 30 weeks into my pregnancy, I was like ‘Okay, I need to go see someone’,” Isla tells Women’s Agenda.
“I thought it was mastitis.”
But after a few scans, Isla was confronted with grave news.
“I went into the waiting room, had my ultrasound and then on the screen was just a large white mass,” she says.
“And I remember saying, ‘That looks like a really bad infection’.”
She was then asked to get a mammogram.
“The doctor came in and said, ‘Isla, we think you have breast cancer and if you do, it’s a really aggressive one’,” Isla recalls.
“No one wants to hear those words. It wasn’t just my life in the balance, it was my unborn baby as well.”
While coping with the shock of her diagnosis, Isla tried to work out a way to plan the last stretch of her pregnancy around her breast cancer treatment.
But two days after she had commenced her treatment she went into early labour.
“It was decided that I would have a caesarean and that my son would be born at 34 weeks and one day, and he would spend a little bit of time in special care,” she says.
After giving birth, Isla had to endure 16 rounds of chemotherapy, a single mastectomy and 15 rounds of radiation.
The gruelling therapies left a heavy mark on Isla, who says the side effects and exhaustion she suffered severely affected her mental health.
“My depression was just after I finished all my treatment,” she says.
“After radiation, I was really struggling mentally with the side effects.
“I’m mostly back to my normal self energy-wise, but one lasting side effect is the chemo brain.”
Isla says that period was especially difficult because her husband had recently lost his mother to breast cancer and his father was then diagnosed with prostate cancer.
“It’s a very traumatic experience — I’ve tried my best to get through it,” she says.
As they continue to rebuild their lives, Isla is hopeful that dedicated breast cancer research will improve the experience for people diagnosed in future.
“Imagine you’ve been told you have cancer but it’s alright because it’s like getting a cold,” she says.
“Imagine if I just needed to take a simple pill instead of going through all the chemotherapy and having surgery and having radiation.
“The many, many women who have survived breast cancer still have long-lasting side effects from the different medicines that they take.”
New research brings hope
Associate Professor Kara Britt, who leads the Breast Cancer Risk and Prevention Lab at Peter MacCallum Cancer Centre and receives co-funding from the National Breast Cancer Foundation (NBCF) and the Mother’s Day Classic Foundation, hopes one day that no one else has to go through what Isla did.
She has spent more than a decade researching how to prevent breast cancer in women who are high-risk and her research team has had a breakthrough after studying a protein that helps the body heal wounds.
Their hope is to develop a much more tolerable option for prevention and to get this into the hands of patients through clinical trials within five years.
“Where I think our research is really important is being able to offer women an effective therapy to reduce their cancer risk or their risk of recurrence, but without all the side effects,” she says.
“We envision that they’ll be more likely to take it and that we will be able to have a larger impact on decreasing breast cancer incidence.”
In Australia, breast cancer is the most common cancer in women with one in seven expected to be diagnosed in their lifetime.
It also affects one in 550 men.
These statistics are more than just numbers for Associate Professor Britt, whose own family has been directly affected.
“I’m from a BRCA 2 family meaning that we are a family that’s at an especially high risk of breast cancer,” she says.
“My mum has unfortunately lost her life to breast cancer, my sister was then diagnosed in 2019 and now most of our family has been tested for the genetic predisposition.”
Associate Professor Britt says dedicated research in recent decades has helped improve survival rates.
But breast cancer incidence, particularly for hormonally-driven breast cancers, is increasing, and there are limited preventative and therapeutic options for women.
Associate Professor Britt says women at high risk of breast cancer usually have to make a drastic choice like undergoing a mastectomy or endocrine therapy such as Tamoxifen, which blocks oestrogen and can have a lot of side effects.
“A lot of the women will stop taking endocrine therapy because of the bone aches, the brain fogginess and the weight gain,” says Associate Professor Britt.
“They know it’s a great drug for protecting them against cancer, but it’s a hard drug to tolerate.”
And Associate Professor Britt believes there can be another way.
She is researching whether drugs that can help the body’s natural wound healing response can offer protection against breast cancer, which could lead to new treatment options that are as effective as Tamoxifen in reducing the risks but with far less side effects.
Her research previously found that protease, a protein known for wound healing shows up in higher levels in the breast tissue of women who have given birth.
Tumours are often seen as wounds that never heal and Associate Professor Britt believes protease may offer some clues as to why breast cancer develops.
Associate Professor Britt and her team also realised that lower levels of this protease are linked to poorer outcomes in those women with breast cancer.
“This protease has no known role in breast cancer but is really important in our blood and the changes in the blood that occur during wound healing,” she says.
“The other thing that’s very exciting for me as a biochemist is to study what it is actually doing in the breast.
“How does this protease provide protection against breast cancer? What other cell types is it working on in the breast? Is it working on the breast cells themselves or does it work on the immune cells and the microenvironment?”
Associate Professor Britt also wants to investigate if existing drugs, that impact protease levels and are used safely on people with blood disorders, can be repurposed for breast cancer treatment.
This could be groundbreaking because it would mean medicines that we know are already safe to use with limited side effects could be offered to women with breast cancer without the need for lengthy trials.
NBCF believes this research has the potential to transform prevention and the experiences of women at risk of breast cancer.
“We’re trying to listen to what the patients are saying,” Associate Professor Britt says.
Zero Deaths from breast cancer
NBCF Executive Director of Research Dr Julie Ince-Demetriou says prevention is a powerful step to reach our vision of Zero Deaths from breast cancer and research like Associate Professor Britt’s will provide us with new biological insights to help with this effort.
“We’re investing in research to understand how we can prevent breast cancer through precision prevention, that means tailoring prevention strategies to individuals who are at higher risk,” she says.
Dr Ince-Demetriou says dedicated breast cancer research has helped bring the death rate down by 40 per cent over the past 30 years.
But with around 21,000 diagnoses each year, she says there’s still work to be done.
“Investing in prevention is absolutely essential, because if we can stop breast cancer before it starts, especially by identifying those at higher risk, that’s an extraordinary outcome,” she says.
“Research truly matters, it’s central and critical to improving breast cancer outcomes.
“Investment in breast cancer research will continue to power innovation, so that we can understand how to prevent breast cancer through precision prevention, how to detect it as early as possible, how to stop its progression and reoccurrence, and how to treat hard-to-treat and metastatic breast cancers.
“Collectively, that research must continue so that we ultimately save lives.”
The National Breast Cancer Foundation (NBCF) funds world-class breast cancer research to prevent, detect, stop, and treat this disease – research that ultimately saves lives.