Even to her untrained eyes, Erin King Sweeney, 46, knew the white spot on the radiologist’s screen looked alarming. Sweeney felt dumbfounded by the diagnosis, and not just because she had little family history of cancer, but also because a manual breast exam by her gynecologist three months earlier had raised no suspicions.
After a few deep breaths, Sweeney—a mother of two, a Hempstead town councilwoman, an aviation lawyer, and the daughter of U.S. Representative Peter King—drove home from what was supposed to be a routine mammogram to Long Island, without telling anyone but her husband and parents.
A week later, in early December 2018, Sweeney received from NYU Langone’s Laura and Isaac Perlmutter Cancer Center one of 268,600 new U.S. breast cancer diagnoses last year. In her case, the diagnosis identified the most common type, hormone-receptor positive, fueled by both estrogen and progesterone. “I was overwhelmed,” Sweeney recalls. “My first thoughts were, the hell with pink ribbons. I don’t want sympathy. I don’t want to be a victim.”
While she had every reason to be optimistic about a tumor detected before she could even feel it (likely to be stage 1), Sweeney faced a slew of tests, surgery to remove the lentil-size tumor, and radiation to kill any cancer cells remaining in the breast—the standard treatment plan for invasive breast cancer detected early. Sweeney’s age—more than a decade younger than average for diagnosis (age 60)—led doctors to look for possible genetic causes. Did she carry a BRCA mutation for breast and ovarian cancer like actress Angelina Jolie? “I thought, ‘Was this going to be off the rails or manageable?’” says Sweeney.
She felt too uneasy to think about the upcoming family vacation to Charleston as she arranged an appointment with the surgeon recommended by several friends and family, Deborah M. Axelrod, MD, director of clinical breast surgery and community outreach at Perlmutter Cancer Center, one of only 50 cancer centers nationwide designated as comprehensive by the National Cancer Institute.
A call that weekend from Dr. Axelrod helped Sweeney see out of the fog. Early contact with newly diagnosed patients, Dr. Axelrod finds, can be extremely beneficial to setting a positive tone to treatment. “My challenge,” she says, “is to persuade these otherwise healthy women that being ill is temporary.” Cancer might become your obsession for the next few months, she tells them, but it is not your life.
“She gave me tough love,” remembers Sweeney. “Dr. Axelrod told me, ‘You are not going to die from this. You have a family and a career. You can cry twice a day but no more.’ That was exactly what I needed. A kick in the butt! Believe me, with cancer, you can get yourself incapacitated by worry.”
Unless they discovered a genetic mutation or that cancer had spread to her lymph nodes, the treatment plan looked straightforward, and her prognosis, excellent. A presurgical MRI, however, revealed a potential abnormality on another region of her breast, so Dr. Axelrod ordered an MRI-guided needle biopsy to check it out.
Spending up to an hour in an MRI scanner can be a challenge for anyone, but Sweeney’s acute claustrophobia gave her discomfort so severe that Dr. Axelrod had to distract her by singing along to corny Christmas songs from the control room in what Sweeney recalled as a “real vaudeville scene.” “I had to try not to laugh,” she says, “the situation was so absurd.” When that biopsy and genetic tests came back negative, Sweeney felt more intense relief than she anticipated.
Five days after Dr. Axelrod removed the tumor, confirmed as stage 1, in a two-hour outpatient lumpectomy in mid-January, Sweeney announced her diagnosis publicly. “I was really surprised,” says Dr. Axelrod. “Patients usually want to know about their ‘margins’”—the pathology report on tissue surrounding the tumor—“and whether they face another surgery before they do anything. But she was really comfortable with her decisions and optimistic.”
At a Hempstead town meeting, attended by about 300 people and broadcast live on social media, Sweeney shared a sober but also humorous account of her diagnosis and treatment. Early detection can change the trajectory of the life of a woman and her family, she said, and she vowed to support efforts already under way to pass state legislation to fund mammograms for younger women like herself. Her annual mammogram, after all, saved her.
By March, as she completed the 15 radiation treatments with Carmen A. Perez, MD, PhD, assistant professor of radiation oncology, she also finished a half-marathon, making good on Dr. Perez’s advice to stay active during treatment. Under the care of Ruth Oratz, MD, clinical professor of medical oncology, Sweeney would need to take the hormone therapy drug tamoxifen daily for the next five years to help prevent a recurrence, but her victory felt real.
Sweeney was grateful and newly appreciative of the small things, she says, like a kind word at a stressful time, or the warm pad a nurse puts on your shoulder before you ask. “Believe it or not,” she says, “my experience with breast cancer has been a positive one.”