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Paula Hill, patient: My name is Paula Hill. I have lived here in the valley for over 30 years. I'm the mother of four grown children and the wife of a retired firefighter. I had been for a routine mammogram and the results came back normal. Shortly following that, I had my annual exam with my regular GYN, who did a breast exam and found a lump. I then got a phone call a few days later saying that it was, in fact, cancer. And that I should start investigating treatment. But I was also familiar with Mayo Clinic because my father had been treated about five years previous with some very cutting edge technology for a heart condition. So I included Mayo in my search for treatment knowing that they had probably the best and most advanced team available.

Barbara Pockaj, M.D., Surgical Oncologist, Mayo Clinic: I was the first one that Paula saw when she came to Mayo Clinic. And that's not uncommon in patients who are newly diagnosed with breast cancer. They come and meet with the surgeon first.

Paula Hill: When my husband and I got home that day we knew that Mayo was really where we wanted to be. The treatment plan that was laid out for me was six months of chemotherapy, followed by surgery, followed by 20 rounds of radiation, and then one year of Herceptin treatments. But what I liked about the plan was that surgery wasn't first. And that they were taking an opportunity to shrink the tumor so that there was a very good chance I could have just a lumpectomy versus a full mastectomy and that really appealed to me.

Dr. Pockaj: What I told Paula she had good news, bad news. Bad news is she had the breast cancer and it was an aggressive breast cancer. The good news is these aggressive breast cancers really respond to treatment.

Donald Northfelt, M.D., Associate Medical Director, Breast Clinic at Mayo Clinic: After we had reviewed her case we recognized that she was qualified to participate in a clinical trial that we had going on at the time. This trial is called the I-SPY 2 trial. And it was a study of various treatment options for locally advanced breast cancer. The study included testing of new drugs specifically designed to work against the HER2 protein and in that way to favorably treat her cancer.

Paula Hill: One of the things we wanted to know was how far advanced the trial was and how much success they'd had with the drug. So we learned that the trial was in the later phases. That it had already been used on human beings. I wasn't the first. And that all of the regular protocol treatment for breast cancer--my particular breast cancer--would also be included in addition to the trial drug. So I would not miss out on any treatment that I would normally get. This would be in addition to, in hopes that it would shrink the tumor even further.

Dr. Pockaj: Paula did go on to the I-SPY trial and we had really remarkable response. She had a big tumor, with lymph nodes positive, and after it was done, we had the imaging and nothing showed up on imaging. That doesn't always mean we don't find anything at surgery, but it means it shrunk a lot and we have really all the options open.

Dr. Northfelt: This is why we come to work every day. We hope to see these kinds of outcomes for our patients. We're even more grateful when we see it happen in the context of a clinical trial. In the clinical trial, new ideas are being applied to the treatment of cancer. We're always so hopeful that those are going to lead to better outcomes for our patients.

Paula Hill: I actually have resumed many--well, I've resumed my whole life. And I have a completely different outlook on life now. I think I'm much happier, less picky, not so much a perfectionist, and I really just enjoy everything that comes my way.

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Feb. 02, 2024