Diagnosis gave doctor ‘ultimate breast cancer fellowship’

VANCOUVER, Wash. – Dr. Cory Donovan knew by the fourth year of medical school that she wanted to specialize in breast cancer treatment. What she didn’t know is that before finishing her specialty training, she would be a breast cancer patient.

Donovan was just completing her surgical residency at Oregon Health & Science University in Portland when she felt a lump in her breast. Immediately, she assumed she had breast cancer.

But, after a few days, Donovan talked herself down. She was only 34 years old. Lumps were most often benign in women her age. She must be overreacting, she reasoned. After all, she was preparing to start her fellowship training in breast oncology. Breast cancer was just at the forefront of her mind.

So she did what she would advise a patient her age to do: wait. She decided to wait a couple months to see if the lump would go away.

“It didn’t go away,” Donovan said. “It got bigger.”

Donovan underwent an ultrasound of her breast and lymph nodes in September 2015.

“As soon as I saw the lymph nodes, I knew this was not benign,” she said.

Just two months into her breast oncology fellowship at Cedars-Sinai Medical Center in Los Angeles, Donovan was diagnosed with triple-negative breast cancer with positive lymph nodes. The diagnosis, she said, was terrifying. She knew the severity of the diagnosis and the difficulty in treating triple-negative cancer.

“There was an impulse for me to be my own doctor,” she said. “But I think the best thing I did was pick my people and let them make the decisions.”

Donovan put her trust in her team of doctors – many of whom were her also her teachers. And that decision, while it’s not for everyone, worked out for the best in Donovan’s case.

The now-36-year-old is cancer-free and launching her career as a breast surgical oncologist at Legacy Health. On Nov. 1, she’ll begin seeing breast cancer patients at Legacy Salmon Creek Medical Center.

Still, the irony of her diagnosis isn’t lost on her.

“There’s so much irony,” Donovan said. “It just drips out.”

Aggressive approach

Donovan had decided several years before her diagnosis that she wanted to be fellowship-trained in breast oncology. She chose the program at Cedars-Sinai because the doctors are among the best in the country. She never expected she would gain the perspective of a patient during the training.

Now, she calls her time in L.A. “the ultimate breast cancer fellowship.”

After her diagnosis, Donovan went through a two-week process to have her eggs harvested and embryos frozen at a fertility clinic. For the next five months, Donovan underwent aggressive chemotherapy to attack her difficult-to-treat triple-negative cancer. Donovan tested positive for a genetic mutation, but it’s unclear how big of a role the mutation played in her diagnosis. But, to be on the safe side, she opted for a double mastectomy.

After surgery, Donovan learned she had a pathologic complete response. In other words, the cancer was completely gone with surgery.

“I won the cancer lottery,” she said.

Still, Donovan opted to undergo radiation. She was young and nervous and preparing to launch a career as a breast cancer surgeon. She wanted to be sure there was no trace of cancer.

Donovan completed radiation in July 2016 and, a month later, married Evan Wyse. The couple moved to Portland in August, after Donovan completed her fellowship. They’re expecting their first child in February.

Private struggle

While undergoing treatment, Donovan was still seeing patients. She didn’t mention her diagnosis to patients, but it soon became obvious she was undergoing chemotherapy. She started losing her hair, her skin turned yellowish and she got puffy.

“Patients knew I had it, and they would ask questions, and I hadn’t figured out how to talk about it,” Donovan said. “I don’t want them to compare their cancer to mine.”

She did then what she does now: shares her personal cancer story only when she sees that her experience can be helpful.

She can tell women that after their bilateral mastectomy, it will be difficult to open drawers and doors. And she knows that attaching drain tubes to a ribbon around your neck will keep them from getting stuck to your shirt.

When patients are scared to undergo chemotherapy, she can tell them that it is horrible, but they will make it through it.

She can also recommend trashy celebrity magazines to give them mindless entertainment during the hour-long sessions.

She can also tell other young breast cancer patients that they, too, can come out on the other side and continue their lives like she has.

While Donovan’s breast cancer diagnosis hasn’t made her change the way she treats patients, it has made her think more about survivorship issues.

“It makes me think about the consequences” of those treatments, she said.

The cancer diagnosis did slow Donovan down in her fellowship training. She stepped back from her work and instead spent some time doing research.

She started by looking at outcomes of women younger than 40 with breast cancer.

Many people couldn’t understand how Donovan could dig into a topic that hit so close to home. But, for Donovan, seeing how well other women were doing was encouraging. It also showed her just how different breast cancer is for every woman.

“I’m able to look at everyone’s story as different than mine,” she said.

And that perspective, she said, is important for Donovan to offer to her patients, as well.

“I can tell patients, ‘Your experience is your own,’ ” she said.