Chicago City Wire

Just weeks after discovering she was pregnant with her fourth child, Naperville resident Stephanie Wysaski performed a breast self-exam after watching a television segment about their importance. During the exam, she found a lump, which she initially attributed to hormonal changes. She discussed it with her OB-GYN at her pregnancy confirmation appointment, who ordered an ultrasound as a precaution. The ultrasound led to further tests, including a mammogram and biopsy, resulting in a diagnosis of invasive lobular carcinoma in her left breast at eight weeks pregnant.

Wysaski sought care at Northwestern Medicine Cancer Center Oak Brook, where she met medical oncologist Dr. Annabelle Veerapaneni. Dr. Veerapaneni noted, “It's definitely not a common scenario, treating a pregnant woman who also has cancer, but it's one that we have seen in the past, and one that I'm familiar with, unfortunately.” She reassured Wysaski that treatment options were available that would not harm her baby.

Wysaski said, “The only way out is through. I have great doctors. They've been really supportive about the pregnancy and making sure that the baby's safe, that I'm comfortable, and we're doing all that we can and managing it as best we can.”

Invasive lobular carcinoma (ILC) is the second most common type of invasive breast cancer, accounting for about 10-15% of cases. Dr. Veerapaneni explained that ILC can be difficult to detect with standard imaging and often requires breast MRI for better assessment. However, Wysaski’s pregnancy limited the use of certain imaging techniques due to safety concerns.

To address the detected mass, Wysaski underwent a lumpectomy performed by Dr. Faaiza Vaince, a Northwestern Medicine breast surgeon. During surgery, additional cancerous tissue was found extending from the main mass.

Wysaski is currently receiving four rounds of chemotherapy using doxorubicin and cyclophosphamide, medications considered safe during pregnancy after the first trimester. “We're treating her with doxorubicin and cyclophosphamide, which has been shown to be safe whenever we administer it after the first trimester. She's tolerated her treatment very, very well,” Dr. Veerapaneni said.

Throughout her treatment, Wysaski has experienced hair loss and fatigue from chemotherapy infusions spaced three weeks apart. Her OB-GYN and a local Maternal Fetal Medicine team are closely monitoring her pregnancy.

“It's unexpected and it's hard, but the baby's healthy and I'm going to be okay. We are doing what we have to do,” Wysaski said.

Due to her ongoing treatment needs, Wysaski is scheduled for an early delivery at 34 weeks gestation so she can continue more aggressive therapy afterward. “Once the baby has been delivered, she will undergo diagnostic imaging to help clarify how much disease we're dealing with,” Dr. Veerapaneni said.

As a mother of three young children, Wysaski acknowledged the challenges ahead: “It's a lot thinking about having a newborn, possibly a preemie in the NICU, and then possibly surgery, probably more chemo and then radiation.”

Dr. Veerapaneni added, “She is being treated with curative intent. It will be incredibly challenging with a newborn and then a young family as well, but she definitely has exhibited the strength and the fortitude to be able to carry through with everything.”

The Northwestern Medicine Cancer Center Oak Brook is part of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital and provides multidisciplinary cancer care at one suburban location. The center offers an infusion center, on-site pharmacy and lab services, as well as PET/CT/MRI imaging.

Dr. Veerapaneni commented on the value of comprehensive care close to home: “The opportunity to be able to take care of patients in a multidisciplinary fashion with all of these resources available is something that's incredibly important to me, and especially whenever we’re able to do that for patients closer to their homes.”

Wysaski echoed this sentiment: “It makes it a lot easier having to come to so many appointments. I'm here every week, sometimes twice a week, so it makes a big difference.”

More information about Northwestern Medicine Cancer Center Oak Brook is available at nm.org.