After a breast cancer diagnosis, twins become genetic testing advocates

Twin sisters Ana and Roxana Lopez were only 17 when their mother died of breast cancer. Over the next eight years, several of their aunts and female cousins would also be diagnosed with breast or ovarian cancer. But it wasn’t until Roxana received her own breast cancer diagnosis in August 2015 that the common thread became clear.

“At age 25, breast cancer was just not something I thought would happen to me,” Roxana says. “But shortly after I was diagnosed with stage II invasive ductal carcinoma in my left breast, I underwent genetic counseling. And I tested positive for the BRCA1 mutation.”

An obligation to share test results

As an aspiring nurse and an MD Anderson employee at the time, Roxana knew how significant that test result was.

“It not only explained why I got cancer at such a young age, but also my family history,” she says. “I felt obligated to share my results so that other family members could be tested, too, and consider taking preventive measures.”

It turns out that all three of Roxana’s siblings — including her two older brothers — also have the BRCA1 mutation. For Roxana and her twin sister, that meant choosing to have double mastectomies.

“I opted to have a bilateral mastectomy to reduce my future breast cancer risk, which is significantly higher due to the BRCA1 mutation,” Roxana says. “Considering my family history, I regret not learning about it sooner. I wonder now if my cancer could have been prevented.”

“There’s a chance that I might never develop breast cancer, even without surgery,” Ana adds. “So I could’ve opted for increased surveillance. But looking back and remembering how much my mom suffered, I knew it was an experience I never wanted to go through again. I decided to take a leap of faith and move forward with the preventive double mastectomy.”

Twin sisters both choose a double mastectomy

Isabel Bedrosian, M.D., and Scott Oates, M.D., performed Ana’s double mastectomy in February 2016. The same surgical duo performed Roxana’s double mastectomy in May 2016, after she’d completed seven rounds of chemotherapy.

“Choosing to be treated at MD Anderson was an easy decision, since I was working there as a research data coordinator at the time,” Roxana says. “As a patient, I want to know the ‘whys’ and ‘what ifs’ of every decision being made, no matter how scientific the explanation may be. And our doctors have been amazing. I particularly appreciate the way Dr. Oates informs and educates us in a manner that’s easy to understand.”

“I can’t imagine going anywhere else,” Ana adds. “I am so grateful to all the amazing doctors, nurses and staff. Their expertise and compassion have made this experience much less daunting.”

Advocates for genetic testing

Both twins will graduate from nursing school in December 2017. And they hope to return to MD Anderson as clinical nurses one day so they can help other patients on their cancer journeys. In the meantime, they’ll continue to encourage others to get tested for the BRCA mutation, especially if cancer runs in the family.

“Your health is too valuable not to take action, so don’t put it off,” Roxana says. “I’ve now started scheduling regular screenings for breast, ovarian and pancreatic cancers, as well as melanoma.”

“If we had done genetic testing sooner, we might have acted more quickly,” Ana adds. “We never expected to face cancer again so soon.”

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