Side by Side
Twin sisters face breast cancer and a genetic risk of stomach cancer together.
Ask these 51-year-old identical twins from South Orange County, and they’ll tell you they believe the threat of breast cancer, subsequent genetic testing, and care and guidance from Providence Mission Hospital saved their lives.
Kerrie and Kristine’s story began in the spring of 2020, when Kerrie’s husband noticed a hard lump on the right side of her right breast. She was overdue for a mammogram, but Kerrie couldn’t feel anything.
A couple of months later, Kristine felt a tenderness on the left side of her left breast.
“I felt a little ball, and it was tender to the touch,” Kristine says. “A wave of stress went through my whole body. I broke out in a sweat. I ran downstairs and told my husband. It was midnight, but I called Kerrie.”
In the morning, Kristine called her primary care physician, Andrew Truong, MD, who was able to see her the next day. Kerrie accompanied Kristine to the appointment and also asked to be seen by Dr. Truong, based on the lump Kerrie’s husband had previously felt.
Although the twin sisters look a lot alike, live within blocks of each other, and shop, garden and work out together, Kristine says that togetherness hadn’t extended to doctor visits, until now. That began a frightening journey they took hand in hand. Dr. Truong examined both sisters and sent them to the Women’s Wellness Center for immediate mammogram and ultrasound appointments.
The mammograms revealed a six centimeter lump in Kristine’s left breast, and a two-centimeter lump in Kerrie’s right breast.
“The doctor at the Women’s Wellness Center told us separately that it looked like cancer,” Kerrie says. “Immediately, the panic started for both of us.”
The twins underwent biopsies. Kerrie had stage 1 lobular breast cancer. Kristine’s tumor was categorized as stage 0 pre-lobular breast cancer.
At Providence Mission, we personalize cancer care, giving each patient recommendations from a multidisciplinary team of experts and helping patients understand all their options.
After meeting with Marla Anderson, MD, a specialist in breast surgery, the sisters each opted for a bilateral mastectomy—vowing that they did not want to worry about a breast cancer risk in the future. They’re recovering well from the August 25 surgery, which Dr. Anderson performed on both sisters on the same day.
During the time they were undergoing breast cancer treatment, one of our nurse navigators, Susann Burnett, recommended genetic testing. After providing a saliva sample and details of their family history, the twins pretty much put it out of their minds for a month.
When the geneticist, Susy Malca, called with their results, however, they learned their breast cancers were genetic. They had a gene mutation, called CDH1, that gave them as much as a 42% chance of developing lobular breast cancer in their lifetimes, as well as an 83% chance of developing hereditary diffuse gastric cancer (stomach cancer).
Although the biopsies of their stomachs found no cancer, the diffuse way the cancer appears made the risk too great to do nothing. Kristine and Kerrie had laparoscopic robotic surgeries to remove their stomachs in November 2020, performed by highly skilled surgeons John Shaver, MD, and Louise Bacon, MD.
“Though only 5% to 10% of breast cancers are associated with a genetic mutation, Kristine and Kerrie’s story highlights the fact that genetic risk is significant,” Dr. Anderson says. “Individuals need to pay attention to family history to properly assess risk and benefit from genetic testing. A well-known study called the Nordic Twin Study reported that when an identical twin is diagnosed with cancer, the co-twin has a 46% risk for cancer development.”
“Getting breast cancer could have very well saved our lives,” the twins say in harmony. “We couldn’t imagine life without each other.”
While they joke that they’re “getting a midlife makeover,” Kristine and Kerrie now realize the importance of family history and genetic makeup. Kristine’s two teenage daughters have a 50% chance of having the same gene mutation.
“Thank God we did the genetic testing,” Kristine says.
Estranged for some time from their father, who passed away from cancer at age 56, they hadn’t paid much attention to the family history of cancer. The twins now believe that stomach cancer was most likely the cause of his death. Their paternal grandmother also died of cancer at age 51.
They just recently tracked down their two half sisters in Arizona and informed them about the genetic risk. One of the half sisters has since undergone genetic testing and is also positive for the CDH1 gene mutation. She plans to have the same surgeries and treatment that the twins had.
“Thankfully, due to early detection, neither of us will need to have radiation or chemotherapy as part of our cancer treatment,” Kristine says. Also, both sisters were found to not yet have cancer of the stomach after their full gastrectomies, and therefore they did not require any further treatment or chemotherapy.
Comprehensive cancer care, including an emphasis on patient education, prevention and overall wellness, is always our goal at Providence Mission. Kristine and Kerrie call their care team at Mission a “dream team,” and say their nurse navigators Susann Burnett and Nancy Christensen are “amazing angels” who helped them through the entire process.
Photography by: Kristin Anderson
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