WAYNE, NJ – Wayne resident, Amy Niosi and her sister Amanda Tasca are breast cancer survivors. This month is national breast cancer awareness month and Amy has given permission to share their story. They hope that this will help remind women in Wayne, and all over, to not take their health for granted. Regular self-examinations and mammograms can save lives, even for women under age 40.
This story starts with a dog.
Amanda lives in Vernon and has two pugs who love to play. One of her dogs is named Daisy and it was this dog that gave Amanda an impromptu breast “examination” by leaping onto her chest while she was lying in bed.
“After Daisy jumped on me, it really hurt,” she said. “When I checked my left breast to see if she scratched me, I felt a grape-sized lump.”
At first, she didn’t think anything of it. Amanda has fibrocystic breast tissue, which can cause breast tissue to feel lumpy or tender. However, she decided to mention her discovery to her OB/GYN a few weeks later during a checkup.
“My OB/GYN had a hard time finding the lump at first, but agreed that I should have it checked out,” she said. “Because I was younger than 40 and didn’t meet the criteria for routine mammograms, I needed a prescription for a mammogram and an ultrasound.”
Imaging tests performed at her local community hospital confirmed the presence of a 2.5 cm tumor, and a biopsy revealed that it was cancerous. Amanda was diagnosed with an early stage invasive ductal carcinoma.
“I got the call about my diagnosis the day before Thanksgiving , and that was the only time I cried,” she said. “After that, I was OK. I figured that because I had no control over the situation and it is what it is, I would do what I had to do to take care of it.”
Sharing the News
Amanda shared the news of her diagnosis with her family, including her sister, Amy — a married mother of two young children and a teacher at Passaic Valley High School.
“As soon as I found out that Amanda’s lump was cancerous, I had a sick feeling in my stomach,” said Amy. “I thought: ‘I have it, too.’”
On Thanksgiving Day, Amy tried to push the worrisome thought out of her mind. But that evening, she decided to do a breast self-exam — and sure enough, she felt a hard spot on the top of her right breast.
“Because of my sister’s diagnosis, I made an appointment [at my local hospital] right away,” she said. “After I had my imaging tests, the radiologist came in and said that she was concerned because it looked like cancer.”
Amy later learned that in addition to the tumor in her right breast, the cancer had already spread to the lymph nodes under her arm.
Starting Treatment — Together
After being diagnosed, Amy and Amanda chose to receive their cancer treatment at John Theurer Cancer Center (JTCC) at Hackensack Meridian Hackensack University Medical Center.
“Our mom demanded that we switch to JTCC for our treatment, and we thought it was a good idea,” said Amanda.
One of the first steps in developing each sister’s treatment plan was having genetic testing. Genetic testing revealed that both Amy and Amanda — as well as their other sister — were BRCA1 and BRCA2 negative, meaning that they did not carry the most common genes that are associated with an increased risk of breast cancer.
Since Amanda’s tumor was relatively small and lymph nodes did not appear to be involved, the plan was for surgery first. She was given options of lumpectomy or a double mastectomy. “I decided that the best choice for me was a double mastectomy because I wanted to do everything I could do,” said Amanda.
She underwent a successful surgery performed by Marson T. Davidson, MD, on Valentine’s Day 2020, and said she experienced a smooth recovery.
“I probably shouldn’t have been doing this, but I was up and vacuuming a few days after surgery,” Amanda said. “My mom kept telling me to relax, but other than some tightness in my chest, I felt fine.”
After recovering from her surgery, anti-hormonal therapy in the form of pills (Tamoxifen) was recommended to help decrease the risk of cancer recurring. Tumor genetic testing revealed that chemotherapy was not likely to be of benefit and hence it was not recommended. “I was so relieved that I didn’t have to have chemotherapy because I am a hairdresser, and I didn’t want to lose my hair,” she said.
In March 2020, Amanda and her husband started IVF [in vitro fertilization] to preserve their fertility, giving them the option to grow their family after Amanda’s cancer treatment is complete. The medical oncology and reproductive endocrinology teams worked closely together to coordinate this safely.
Care during COVID-19
While Amanda was preparing for surgery, Amy started chemotherapy to shrink her tumor. Because Amy’s tumor was larger than Amanda’s and had spread beyond into the surrounding lymph nodes, Amy needed a different treatment course with combination of chemotherapy, surgery and radiation.
Amy’s chemotherapy regimen lasted from January to April 2020, which coincided with the height of the COVID-19 pandemic in New Jersey. To protect her health, Amy took a leave of absence from her teaching job at Passaic Valley High School.
“I got a fever at the beginning of April, so my medical oncologist tested me for COVID-19 right away,” said Amy. “Fortunately, my test was negative.”
Like her sister, Amy also underwent a double mastectomy performed by Dr. Davidson. She had surgery in early June, followed by five weeks of post-surgical radiation. She is also receiving anti-hormonal therapy and is enrolling in a clinical trial looking at a novel therapy to help lower breast cancer recurrence.
“Since my sister already had surgery, I had an idea of what to expect,” said Amy. “And just like my sister’s, my recovery went very well.”
Reconstruction and Survivorship
Today, Amanda and Amy are thankful for the circumstances that led to their diagnoses. If not for Daisy — and all the events that followed — the pair agree that they may not have had such favorable outcomes.
“The timing of all this happened for a reason,” said Amy.
Amanda underwent breast reconstruction surgery performed by Janet Yueh, MD, in July 2020 and is now receiving hormone therapy with the drug tamoxifen to reduce her risk of recurrence. She is back to work as a hairdresser and is enjoying spending time with her husband and her pugs.
Amy is in the process of breast reconstruction with Stephanie Cohen, MD, and is planning to have breast implant surgery in March 2021. She is savoring her time at home with her two children and looking forward to returning to her classroom.
Both women hope their story will encourage women — especially those under the age of 40, when routine breast cancer screenings are typically not recommended — to be proactive and advocate for their breast health.
“I think the message here is that women have to be aware of changes with their breasts, and if something isn’t right, they need to have it checked out,” said Amanda.
“I had recently had a baby and was having regular checkups with my OB/GYN, so I thought I was good,” said Amy. “However, my sister’s diagnosis inspired me to do a self-exam — something I haven’t done since high school — and I learned to be my own advocate.”
Throughout their treatment, the sisters encouraged each other and remained optimistic, which they believe was a critical part of their successful recovery.
“I took the view that my diagnosis was not the end-all. I figured, ‘Why get depressed? Why get upset?’” said Amanda. “Breast cancer is hard, but I asked for help when I needed it and was determined to stay positive.”
“I never really worried about receiving treatment during COVID-19,” said Amy. “Going in for treatment seemed a little scary at first when everyone started wearing masks, but it was fine. Except for extra safety measures, all the staff acted normal and my treatment continued as scheduled.”
However, because chemotherapy can weaken the immune system and increase the chances of infection with viruses in the community, such as COVID-19, Amy’s medical oncologist Deena Mary Atieh Graham, MD, took extra precautions.