VIRGINIA BEACH, Va. — Tasha Cade was diagnosed with breast cancer weeks after learning she was pregnant.
The diagnosis came nearly two years after the 42-year-old woman expressed doubt to doctors about normal mammogram and ultrasound readings of a growing and painful lump in her left breast.
“I’m pregnant, and you tell me I have this potentially life-ending disease that I had already seen claim the life of my grandmother?” said Cade. “I had been doing my due diligence by going to see specialists [and] by getting my routine mammograms. And yet, my concerns were ultimately dismissed.”
Cade’s medical records revealed she voiced concerns to a local radiologist about a lump in her left breast in early 2021. A mammogram and ultrasound indicated it wasn’t cancerous. She immediately sought a second opinion from a different doctor, who concurred with the original findings, citing Cade’s dense breast tissue.
“It’s nothing to be concerned about,” Cade recalled from her discussions with doctors about the normal mammogram readings. “[They said] it’s not unusual for [fibroglandular dense breast tissue] to hurt. It’s not unusual for it to be discolored.”
Black women like Cade tend to have denser breast tissue, and women with dense breast tissue are more likely to receive false negative results from mammograms.
Cade’s medical records show she continued seeking additional mammograms and ultrasounds and the lump grew in size and became painful. She hoped doctors would order a biopsy to get a better understanding of the lump.
“I was so, just, dumbfounded when [the radiologists] refused to do an actual biopsy when the lump is so visible, when the lump is so large, [and it was] painful and growing,” Cade said.
Cade learned she was six weeks pregnant on October 14, 2022 – a moment she called a miracle. Her fears about the lump intensified. According to her medical records, her OBGYN demanded a biopsy of Cade’s lump to be performed by a local surgeon. The biopsy confirmed the lump was indeed cancerous at stage zero with the potential to spread during her pregnancy.
"I was beyond angry," said Cade. “I just couldn’t understand why this was happening at such a happy time in my life."
Cade underwent an emergency lumpectomy in Hampton Roads in December 2022. However, when scans after the surgery indicated the cancer wasn’t gone, she sought care at the VCU Massey Cancer Center in Richmond. Doctors there advised her to remove the entire breast right away, and performed a mastectomy while Cade was just over four months pregnant.
“I remember lying on that surgery table and I am bawling,” said Cade. “I was a nervous wreck. Scared for myself. Scared for my son.”
Cade and her baby survived the surgery. She gave birth to a healthy little boy this summer. She credits her faith and OBGYN for demanding the biopsy that proved the lump was cancerous, confirming the fears she had all along.
“[That one extra test] can mean the difference between life and death,” Cade said.
“Somewhere between 10 to 17 percent of cancers can be missed by mammograms,” said VCU Massey Cancer Center oncologist Dr. Mary Helen Hackey. “[Mammograms have] a hard time seeing through younger breasts that are very dense.”
“Something that persists, something that's growing, needs to be evaluated no matter what, even in the face of a normal mammogram,” continued Dr. Hackney. “The only absolute way of knowing what a lump is is to do a biopsy.”
Hackney continued, “If you don't get an answer from your radiologist or your primary care [doctor], then you go see a surgeon. If you don't find the answer from the surgeon, see another surgeon."
“Breast cancer is not a death sentence. Detecting it earlier is really critical in terms of improving that longevity and not dying of breast cancer, and dying of whatever else is intended down the road,” Dr. Hackney emphasized.
“It is absolutely okay to leave the hospital system that doesn't seem to be serving you well, or the doctor that you suspect is dismissing a change in how you feel,” said Cynthia Fisher, founder and chairman of PatientRightsAdvocate.org. Fisher offered the following advice for people who are worried that their doctors are dismissing their concerns:
- Seek a second opinion from another doctor or hospital if you believe your concerns about your condition are being dismissed or not being thoroughly investigated.
- Demand the doctor document your concerns and any refusal to perform advanced testing.
- Ask the doctor to explain the tests and tools available to rule out a disease, and why they are choosing not to explore those options.
- Make clear to doctors any family history of disease and demand they document it in their records.
- Seek assistance from a patient advocate to help communicate your concerns to your doctor.
“Don't worry about hurting a physician's feelings,” said Dr. Hackney. “What you want to do is [seek another opinion] so that you can sleep at night and be comfortable that you've done the right thing for yourself.”
Cade has another surgery at the VCU Massey Cancer Center scheduled this year to remove her remaining breast. She prays this final surgery will help her rest assured that the fate her late grandmother faced will never be hers.
“I do all of this for you,” said Cade as she whispered in her baby boy’s ear. “All of it for you.”
The Hampton Roads-based organization Here for the Girls offers support and guidance for local breast cancer patients, especially those who’ve experienced early-age diagnosis or dismissals from doctors. You can connect to their community here.
Brianna Lanham contributed to this story.
