Dr. Pichardo Johansson: Surviving Breast Cancer
“The radiologist said the lump I felt was “probably benign” but she recommended to repeat the study in six months,” shares Oncologist Dr. Pichardo Johansson of her symptoms. “By the time I had the repeat test, the lesion had grown, so a biopsy was ordered. The biopsy was positive for ER-positive Her-2-Neu-negative invasive ductal carcinoma.”
Dr. Johansson’s diagnosis was a combination of screening mammograms and self-examination. She opted for bilateral skin-sparing mastectomies (removing the other breast for prevention) with reconstruction, Dr. Johansson also tested with Agendia’s MammaPrint, a genomic test that measures 70 genes and the risk-of-recurrence. MammaPrint identifies, with more than 98 percent accuracy, breast cancer patients who will not benefit from chemotherapy.
“My Mammaprint test showed a high-risk type of cancer,” she shares. “So, I completed chemotherapy. I also had radiation therapy and I’m currently on hormonal blockade therapy with tamoxifen.”
According to Agendia, MammaPrint potentially spares over 100,000 women annually with early-stage breast cancer worldwide from the unnecessary toxicities and side effects of chemotherapy. Patients can save up to $1M in unnecessary medical costs by safely forgoing chemotherapy without jeopardizing their outcomes. It is the only FDA-cleared test of its kind.
With breast cancer being the most common cancer (and the leading cause of death from cancer) among Hispanic women, Dr. Johansson believes this is not only due to less frequent breast exams but also due to delays in follow-up treatments.
“An estimated 2,800 Hispanic women in the U.S. die of breast cancer every year,” she shares. “This doesn’t mean that breast cancer is “more common” in Hispanic women, but unfortunately reflects the fact that we tend to be diagnosed with more advanced types of breast cancer than Caucasian women. We can change that by becoming proactive in our screening, self-exams and doctor visits.”
When diagnosed with breast cancer, she immediately wondered if she would need post-operative chemotherapy. She requested her surgeon to use the MammaPrint test on her tissue. For Dr. Johansson, having a ‘yes’ or ‘no’ answer instead of a ‘gray’ response was very important. Mammaprint is only indicated in women who already have a diagnosis of breast cancer, “which is positive for the estrogen receptors and has zero to three positive lymph nodes,” she shares.
“Women who fall in this category can request their surgeons to order the test at the time of surgery,” she shares. “If it wasn’t done, their oncologist can add it on afterwards. Knowing myself, I knew that if I fell in the gray zone, I would obsess without end about whether I should have the chemotherapy or not. The test came back showing I fell right above the threshold, in the high-risk category, so I ended up having the chemo. The purpose of the test is to spare women who do not need chemotherapy from getting it and dealing with the side effects. I’m glad I took the MammaPrint test, because then I knew for sure that the type of cancer I had required it, therefore, the side effects were worth it.”
Dr. Pichardo Johansson is a board-certified hematologist-oncologist and cancer survivor practicing in Florida. She graduated from Pontificia Universidad Catolica Madre y Maestra, Santiago in the Dominican Republic. She completed her Hematology Oncology Fellowship at Northwestern University of Chicago, Chicago, IL. Dr. Pichardo-Johansson is board certified in medical oncology and internal medicine. She specializes in breast cancer, lung cancer, colon cancer, and lymphomas. When she was a teenager, her mother was diagnosed with a rare form of cancer at the age of 47. This is what inspired her to become an oncologist.