An average woman has about a 13% chance of developing breast cancer during her lifetime, according to the National Cancer Institute. A BRCA1 or BRCA2 gene mutation raises breast cancer risk to 30%-70%, and BRCA testing is recommended for women with personal or family history of certain cancers, a known BRCA mutation in the family, or Ashkenazi Jewish ancestry.

“While most women who undergo genetic testing do not test positive for a cancer-risk-increasing BRCA mutation, they have generally been referred for testing because of strong personal or family cancer history,” said Fahima Dossa, MD, PhD, surgical oncologist at Cedars-Sinai Cancer and lead author of the study. “Future cancer risk for these women has not been well studied, and our findings are the first to calculate that risk so that we can better guide all women who undergo BRCA testing.”

Looking at the health records of almost 16,000 women who underwent BRCA testing in Ontario, Canada, from 2007 to 2016, investigators found that women who tested negative for a BRCA gene mutation still had a 25% lifetime risk of developing breast cancer.

And lifetime risk for those with a variant of unknown significance, which means little is known about that particular variant, was 30%, according to the findings.

Each patient’s individual risk for breast cancer was substantially affected by their family history. Among women who tested positive for a BRCA mutation, breast cancer risk varied from roughly 56% to 86%, depending on the number of immediate family members who had breast or ovarian cancer, the study found.

“Based on these findings, a physician might recommend more frequent mammograms or breast MRI to a BRCA-positive patient in their 50s or 60s with no family history of breast cancer, but suggest preventive mastectomy as an option for a young BRCA patient with several cases of breast cancer in the family,” Dossa said.

Dossa said that the only women in the study with the same breast cancer risk as the general population were those who had family history of cancer and a known BRCA mutation in the family, and were tested for that specific mutation but did not have the mutation.

“This study is a reminder to patients about the importance of having discussions with their doctors about genetic test results,” Dossa said. “We finally have some data to help inform those conversations.”

In July, Cedars-Sinai opened the Cedars-Sinai Cayton BRCA Center to provide coordinated screening, guidance and treatment to patients with BRCA mutations.

“Our leading-edge research supports our efforts to care for and improve outcomes for these patients,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer. “Connecting science with cancer care is at the heart of what we do.”

Other study authors include Kelly Metcalfe, RN, PhD; Zharmaine Ante, MSc; Ning Liu, PhD; Jordan Lerner-Ellis, PhD; Andrea Eisen, MD; and Nancy N. Baxter, MD, PhD.

Funding: This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC). This study also received funding from the Canadian Cancer Society (grant #315358). This work was also supported by the Canadian Institutes of Health Research (CIHR) grant funding no #148470.

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Breast tumors are currently classified into basic subtypes such as HER2-positive and triple-negative. Based on a tumor’s subtype, doctors can prescribe chemotherapy, immunotherapy or other treatments to shrink the tumor before a patient undergoes surgery to remove it. This can allow some patients to have a lumpectomy rather than a full mastectomy.

Presurgical treatment, also called neoadjuvant treatment, can also help kill cancer cells that have spread beyond the breast, which can help prevent cancer from returning.

“The issue is that a single breast tumor can include many cancer subtypes, but current tests classify the whole tumor as one,” said Eytan Ruppin, MD, PhD, deputy director of the Translational Research Institute at Cedars-Sinai and co-corresponding author of the study. “With BRIDGE, we use gene activity to measure the various subtypes within a tumor and better pair patients with the most effective presurgical treatment.”

Together with the composition of the tumor, BRIDGE provides a score that tells clinicians how likely a patient is to respond to a given presurgical treatment. The tool analyzes the same tumor biopsy samples physicians routinely take when a patient is diagnosed.

“We addressed the most common presurgical treatments given in the major breast cancer subtypes,” said Thomas Cantore, PhD, a postdoctoral scientist in the Ruppin lab and co-corresponding author of the study. “Applying BRIDGE to data from hundreds of patient samples whose cancer type and treatment response were known, we found that it accurately predicts which patient may or may not respond to which therapy.”

Building on the work of others on Ruppin’s team, the investigators next took BRIDGE a step further.

“Our second step was to apply AI tools to BRIDGE to create BRIDGE-Slide,” said Nishanth Ulhas Nair, PhD, a research scientist in the the Jim and Eleanor Randall Department of Surgery and co-corresponding author of the study. “Rather than requiring costly genomic sequencing of the tumor, BRIDGE-Slide can infer the makeup of a tumor from an image of the biopsy slide. This saves time, and thousands of dollars, and could help democratize precision oncology, making personalized breast cancer treatment accessible to all.”

The next step for investigators is to further test BRIDGE and BRIDGE-Slide in clinical trials, Cantore and Nair said.

“These biopsy slides are a gold mine of information,” Cantore said, “and we are focused on leveraging them.”

Additional Cedars-Sinai authors include S.R. Dhruba, E. Campagnolo, J. Levy, K. Yao, I. Liao, and Y. Yuan.

Other authors include D-T. Hoang, L.R. Pal, A. Stemmer, T-G. Chang, E. Shulman, J.S. Lee, S.M. Stemmer, S-J. Sammut, S. Lipkowitz, P.S. Rajagopal, M. Filipits, and C. Caldas.

Funding: This research was supported in part by the Intramural Research Program of the National Institutes of Health (NIH), National Cancer Institute (NCI). The contributions of the NIH author(s) are considered Works of the United States Government. The findings and conclusions presented in this paper are those of the author(s) and do not necessarily reflect the views of the NIH or the U.S. Department of Health and Human Services. This research is partially supported by a grant of the Korea-US Collaborative Research Fund (KUCRF), funded by Ministry of Science and ICT and Ministry of Health & Welfare, Republic of Korea (grant number: RS-2024-00468417). This work used the computational resources of the NIH HPC Biowulf cluster (http://hpc.nih.gov). The results shown here are in part based upon data generated by the TCGA Research Network: https://www.cancer.gov/tcga.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The new

“The generosity and foresight of the Cayton Goldrich Family Foundation gave us the resources to conduct outreach and coordinate care for these patients,” said Cristina Ferrone, MD, chair of the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai. “By bringing together our dedicated physicians and recruiting top talent from around the country, we are making this centralized BRCA center unlike any other.”

Individuals of Ashkenazi Jewish descent, and those with family history of breast, ovarian, prostate or pancreatic cancer, or people who have been diagnosed with one of these cancers, should be screened for BRCA1 and BRCA2 mutations, Ferrone said.

Cancer Screenings

“This center will provide every relevant service: comprehensive risk assessment, state-of-the-art surveillance, prevention strategies, clinical trials, and access to the latest scientific discoveries,” said Farin Amersi, MD, a surgical oncologist who treats patients with BRCA mutations. “More importantly, it will create a true home for patients and families facing hereditary cancer risk.” 

A patient’s first visit to the center begins with genetic counseling to help patients understand their unique cancer risk. For women, the initial visit also includes a breast MRI or mammogram, and a pelvic ultrasound and blood test to screen for ovarian cancer. Men undergo imaging to screen for breast cancer and an exam and blood test to screen for prostate cancer. For pancreatic cancer, both men and women may have abdominal imaging and discuss the possibility of endoscopy screening, depending on their individual risk.

“At many other institutions, patients diagnosed with a BRCA mutation have to make appointments for each of these screenings separately, with different physicians,” Amersi said. “Our patients will have all their screenings—and receive their test results—in one visit. This will help relieve the anxiety of juggling multiple appointments and waiting to learn the results of these tests.”

The process condenses what could be eight to 12 different appointments into a single day, Ferrone said.

“For patients with BRCA mutations, these screenings are repeated every six to 12 months, so you can imagine how disruptive separate appointments are for patients, many of whom work and have families,” Ferrone said.

Based on their test results, patients meet with a team of specialists about the best path forward, taking into account the patient’s age, fertility goals and individual cancer risk.

Preventive Treatment

For breast and ovarian cancer prevention, patients and their care team discuss the need and timing for possible preemptive surgery.

BRCA1 and BRCA2 mutations have slightly different risks associated with them, said Marla Scott, MD, a gynecologic oncologist.

“People with BRCA1 mutations have roughly a 40% higher risk for gynecologic cancers, and are a younger average age when cancer tends to appear,” Scott said. “This means we have a discussion about removing the fallopian tubes and ovaries, as well as consideration for hysterectomy and mastectomy, between ages 35 and 40.”

A reproductive endocrinologist is on-site to discuss fertility preservation—including egg and embryo freezing and in-vitro testing and fertilization—as well as hormone replacement options to manage symptoms of surgically-induced menopause, Scott said.

For people with BRCA2 mutations, there is a slightly lower increased risk of gynecologic cancer, and age of cancer onset tends to be about 10 years later, allowing doctors to delay preventive surgeries, Scott said.

“With the exception of regular breast exams, patients may get to ‘graduate’ out of further screening for gynecologic cancers if they have a risk-reducing surgery and show no signs of cancer,” Scott said.

Scott added that while managing cancer risk can be challenging for people with a BRCA mutation, having a place they can go for guidance is empowering. The hope, Ferrone said, is that community outreach efforts will bring these benefits to even more patients.

“We are incredibly fortunate to be able to offer free genetic testing in high-risk populations in the near future,” Ferrone said. “This will help us identify more at-risk patients and get them enrolled in the appropriate programs to help them manage their risk and preserve their health.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The new tool, called Path2Space, predicts gene expression across the tumor area based on digital images of biopsy slides, which contain thin slices of tumor tissue that can be examined under a microscope.

Because tumors do not have the same composition and gene expression throughout, Path2Space predicts what is known as “spatial” gene expression, estimating it at many different points within the tumor. The process takes only minutes and costs significantly less than conventional spatial gene expression profiling, which typically takes several weeks and costs thousands of dollars.

“This tool makes two major contributions,” said Eytan Ruppin, MD, PhD, deputy director of the Translational Research Institute at Cedars-Sinai and senior author of the study. “It will enable us and others to study larger datasets and understand the spatial structure of tumors. But what really motivates me is that, if we can successfully validate the tool in clinical trials, it could improve cancer care for patients.”  

Investigators “trained” Path2Space using data from a large group of patients with breast cancer, where the biopsy slides and spatial sequencing were both available. They then tested the tool on three additional patient datasets to validate its performance.

“For each sample, we looked at the actual, measured gene expression and compared it with our tool’s prediction,” said Eldad Shulman, PhD, co-first author of the study and a research fellow at the National Cancer Institute, who will soon join Ruppin's lab as a research scientist. “For each sample, we predicted the spatial expression of almost 5,000 genes, and the predictions matched the measured expression well across all three patient groups.”

Path2Space is also designed to help scientists discover new biomarkers that could guide treatment decisions and identify patients at higher risk of poor outcomes.  

“The tool looks at characteristics within the tumor, such as whether a gene is expressed in some areas of the tumor and not others,” said Emma Campagnolo, co-first author of the study and a research fellow in Ruppin’s lab. “We found specific spatial patterns of gene activity in tumors that predict how patients respond to treatment.”

Identifying spatial biomarkers is challenging, Shulman said, because the high cost of spatial profiling by traditional methods means very little of this data is available.

“Before we developed Path2Space, the largest cohort we could find to study the spatial organization of the tumor environment was about 30 patients,” Shulman said. “With this tool, we can study slides from thousands of patients. Path2Space is tapping into the potential of spatial biology in a way that has not been possible until now.”

Path2Space could be applied to other cancer types once it is trained on the correct data, and the lab is finalizing a study applying it to head and neck cancer, Campagnolo said. The team is also working to make the tool more precise. It currently looks at groups of 10 to 20 cells together, and the goal is to eventually be able to assess individual cells.  

“With the help of clinical collaborators, we next want to bring Path2Space into clinical trials,” Ruppin said. “It represents an exciting development in a growing field and has to be tested carefully. But we are hopeful that it could make an impactful contribution to science and to patient care.”

Robert Figlin, MD, interim director of Cedars-Sinai Cancer, noted that translational research is a hallmark of the institution.

“The development of tools that apply leading-edge science to patient care is the best way to serve our patients—and to improve cancer care on a global scale,” Figlin said.

Additional Cedars-Sinai authors include Yuan Yuan, Karine Sargsyan, and Simon R.V. Knott.

Other authors include Roshan Lodha, Youngmin Chung, Amos Stemmer, Thomas Cantore, Beibei Ru, Tian-Gen Chang, Sumona Biswas, Saugato Rahman Dhruba, Sumeet Patiyal, Sushant Patkar, Andrew Wang, Ranjan K. Barman, Chuhan Wang, Rohit Paul, Sarath Chandra Kalisetty, Tom Hu, MacLean P. Nasrallah, Ellis Patrick, Jean Yang, Amy Plotkin, Padma Sheila Rajagopal, Stephen-John Sammut, Stanley Lipkowitz, Peng Jiang, Carlos Caldas, Kenneth Aldape, Joo Sang Lee, and Danh-Tai Hoang.

Funding: This research was supported by the Intramural Research Program of the NIH, NCI, and the Center for Cancer Research. The contributions of the NIH authors were made as part of their official duties, as NIH federal employees are in compliance with agency policy requirements and are considered works of the U.S. government. This research was also partially supported by a grant of the Korea-United States Collaborative Research Fund, funded by the Ministry of Science and ICT and the Ministry of Health and Welfare, Republic of Korea (grant number: RS-2024-00468417; Y.C. and J.S.L.), and by an Institute of Information & Communications Technology Planning & Evaluation (IITP) grant funded by the Korea government (MSIT) (RS-2019-II190421, AI Graduate School Support Program, Sungkyunkwan University; Y.C. and J.S.L.). This work has utilized the computational resources of the NIH HPC Biowulf cluster.

Competing interests: E.D.S., E.M.C. and E.R. are listed as inventors on a provisional patent (application no. 63/703,060, United States, 2024) filed based on the methodology outlined in this study. E.R is (non-paid) member of the scientific advisory boards of Pangea Biomed (divested), GSK Oncology and the ProCan project. E.R is a founder of MedAware Ltd. The other authors declare no competing interests.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“After 35 years of marriage, my heart still sings when I look at her,” Philip said. “My cancer was much worse on Linda than it was on me, and her cancer was worse on me than it was on her. Whichever one of us was sick, the other one filled in the gaps. But that’s the way we normally live our lives. Whatever one needs, the other one provides.”

Philip’s pancreatic cancer was detected in early 2024 during an unrelated MRI of his kidneys. Arsen Osipov, MD, medical director of the Pancreatic Cancer Multidisciplinary Clinic and Multidisciplinary Cancer Programs and Integration at Cedars-Sinai, Philip’s oncologist, said it was a stroke of luck.

“He was diagnosed at a curable stage, before the cancer had spread,” Osipov said. “Only 10 to 20% of patients with pancreatic cancer are diagnosed this early.”

Philip was one of the first patients to visit the multidisciplinary clinic, where in a single day he met with medical oncologists, radiation oncologists, surgeons, gastroenterologists and other experts, and agreed on a treatment plan: four months of chemotherapy, followed by radiation and a complicated surgery called a Whipple procedure.

“This is a complex operation where we remove what’s called the head of the pancreas, the first part of the small intestine, the gallbladder and the bile duct,” said Nicholas Nissen, MD, director of Hepatobiliary and Pancreatic Surgery. “After removal, these structures are reattached to restore normal function.”

This procedure once required large incisions, but because radiation and chemotherapy successfully shrank Philip’s tumor, Nissen was able to perform the procedure robotically.

“This allows us to make smaller incisions, with lower risk of complications and a shorter recovery time for the patient,” Nissen said.

After four days in the hospital and two more months of chemotherapy, Philip was declared cancer-free in June.

But the couple had just a few days to celebrate.

Less than a week after Philip learned he was cancer-free, Linda was diagnosed with breast cancer after undergoing a routine mammogram.

“As a health system, we focus on screening and are always developing new ways to detect cancer early,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer. “For both of these patients, early detection was key to the best possible outcome.”

Still, the diagnosis was a bit of a shock to Philip and Linda.

“It was sort of unbelievable,” Linda said. “But we had been through the whole process with Phil, and his surgery was much more serious than mine, and he did so well that I felt much more comfortable.”

And she, too, was lucky, said Armando Giuliano, MD, director of Breast Surgical Oncology at Cedars-Sinai Cancer and Linda’s surgeon.

“She had a screen-detected cancer that has no symptoms. You can't feel it. It causes no pain, no discharge,” Giuliano said. “The only way you can detect a cancer like that is with breast cancer screening. And those cancers are the smallest cancers—the cancers that are the easiest to cure.”

Giuliano was able to perform a breast-sparing therapy known as a partial mastectomy or lumpectomy.

“We remove the area of the breast that has cancer, all the way around so that we have clean margins,” Giuliano said. “And then we do an internal reconstruction to make the breast look as natural as possible.”

Giuliano also performed a procedure he pioneered, which he continues to develop at Cedars-Sinai, called a sentinel lymph node biopsy, removing one or two lymph nodes to be certain the cancer had not spread beyond the breast.

“He did such a beautiful job that if you were to look at my breast, you would not know I had had surgery,” Linda said.

Linda’s cancer was an infiltrating ductal carcinoma, a cancer that starts in the breast ducts and can spread throughout the body. It was also HER2 positive, so it required further treatment.

“Around 20% of cancers have this overexpression of the HER2 protein, which makes them more aggressive and at higher risk of spreading,” said medical oncologist Philomena McAndrew, MD. “For this reason, after Linda’s surgery we treated her with chemotherapy and immunotherapy. We followed that with radiation therapy, and Linda did incredibly well throughout each of these steps.”

One important element for Linda was McAndrew’s recommendation to use a cooling cap to help avoid hair loss during chemotherapy.

“I'm so thrilled that I did,” Linda said. “Dr. McAndrew told me that when women lose their hair, it's very traumatic. When they look in the mirror, they realize how sick they are. Fortunately, that didn’t happen to me, and I was so grateful.”

Linda completed her final radiation treatment in January and will continue preventive therapy for five years. She and Philip will also have regular follow-up screenings.

But for now they are headed from their “city house” in Culver City to their main house in Lake Arrowhead, to spend time with friends they haven’t seen in a while.

Then they’ll continue their journey, in sickness and in health, together.

“We’re going on a cruise to Hawaii at the end of February,” Linda said. “We're just trying to pack some fun into the next 20 years.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Cedars-Sinai has received a $30 million gift from the Cayton Goldrich Family Foundation to establish the Cedars-Sinai Cayton BRCA Center, a first-of-its-kind in Southern California. The state-of-the-art center will concentrate on the research, diagnosis and comprehensive treatment of illnesses linked to mutations in the genes known as BRCA1 and BRCA2.

These genes, when functioning properly, help repair damaged DNA to prevent tumors from forming. However, mutations in the genes can significantly increase the risk of certain inherited cancers, including breast, ovarian, prostate and pancreatic malignancies.

“We can help prevent harmful BRCA mutations from being passed down from carriers to their children and grandchildren and work toward ending the cycle of inherited cancer risk,” said foundation trustee Barry Cayton.

Trustee Andrea Goldrich Cayton added, “Our family has personally been affected by BRCA gene mutations, so we feel especially compelled to make a transformative mark in the healthcare space linked to holistic BRCA research and care.”

The Cayton and Goldrich families are longtime supporters of Cedars-Sinai. In 2019, the Goldrich Family Foundation donated $10 million to establish the Jona Goldrich Center for Alzheimer's and Memory Disorders at Cedars-Sinai. The center was named for the late patriarch of the Goldrich family, who was a Holocaust survivor and prominent Los Angeles real estate developer and philanthropist.

“Cedars-Sinai is truly humbled and honored by our continued visionary partnership with the Cayton Goldrich Family Foundation,” said Peter L. Slavin, MD, president and CEO of Cedars-Sinai and the David and Meredith Kaplan Presidential Chair. “They embody humanitarianism and hold a strong belief in science’s ability to transform healthcare and improve human life.”

About 1 in 400 people in the U.S. carry a BRCA mutation. Males are less likely to be tested for the mutations, and female carriers are more likely to be diagnosed with breast cancer. BRCA mutations increase cancer risk in both genders, but the specific forms of cancer and rates of diagnoses differ.

Some population groups are more prone to BRCA mutations, including people of Eastern European Jewish, Korean, Mexican, and African American ancestries. Currently, there is no comprehensive BRCA clinical and research center in Los Angeles to serve high-risk communities. Cedars-Sinai leaders said the new center will play a major role in advancing research, education and clinical innovation.

“The Cedars-Sinai Cayton BRCA Center will offer patients personalized guidance and timelines for their care, including risk-reducing procedures, genetic testing, specialized screenings and reproductive medicine services to help break the cycle of genetic cancer risk,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences, dean of the Medical Faculty and the Helene A. and Philip E. Hixon Distinguished Chair in Investigative Medicine. “We will develop a hub of translational discovery science devoted to eradicating the cellular underpinnings of BRCA mutations.”

Read more on the Cedars-Sinai Blog: 7 Tips to Reduce Your Breast Cancer Risk

As a highlight of the symposium, Armando E. Giuliano, MD, division director of Breast Surgical Oncology in the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai, will receive the William L. McGuire Memorial Lecture Award in recognition of his significant contributions to the field of breast cancer research.

“It is a great honor to receive the 2025 McGuire Award,” Giuliano said. “We’ve made tremendous progress in the surgical treatment of this disease, and I am especially grateful to the brave patients who participated in the trials that helped us develop new standards of care and improve the lives of patients with early metastatic breast cancer.”

Giuliano was instrumental in refining sentinel lymph node biopsy for breast cancer in the early 1990s, sparing many women from more invasive breast cancer surgery. This technique identifies and removes only the first lymph node where cancer is most likely to spread to determine whether removing additional nodes is medically necessary.

Through two large multicenter trials, ACOSOG Z0010 and ACOSOG Z0011, Giuliano and team validated the technique that led to establishing the less-invasive sentinel lymph node biopsy as the standard of care, as opposed to axillary lymph node dissection, which removed most or all nodes and is associated with increased surgical complications. The findings from these trials transformed surgical management of breast cancer.

“The pioneering contributions Dr. Giuliano has made to breast oncology have not only changed the field, but they have directly and positively impacted the lives of millions of women worldwide,” said Cristina Ferrone, MD, chair of the Department of Surgery at Cedars-Sinai. “It is a privilege to work alongside Dr. Giuliano, and I wholeheartedly congratulate him on this well-deserved honor.”

Giuliano, the Linda and Jim Lippman Chair in Surgical Oncology, associate director of the Samuel Oschin Comprehensive Cancer Institute and co-director of the Saul and Joyce Brandman Breast Center—A Project of Women’s Guild, will present his award lecture on Wednesday, Dec. 10, at 9 a.m. CT.

Additional Cedars-Sinai experts attending the meeting:

Yuan Yuan, MD, PhD, director of Breast Oncology and medical director of Breast Cancer Research, will present data on how patient-derived organoids—tiny groups of cells—can guide therapy in patients with metastatic breast cancer. She also will present research on AI-driven H&E slides predicting triple-negative breast cancer patients’ response to therapy, as well as data from an ongoing clinical trial of a novel PD1-VEGF bispecific antibody for early-stage triple-negative breast cancer.

Stephen Shiao, MD, PhD, professor of Radiation Oncology and radiation oncology director of the Breast Oncology Disease Research Group, will participate in a plenary talk regarding a randomized trial of no-, low- or high-dose preoperative radiation with pembrolizumab and chemotherapy in node-positive, HER2-negative breast cancer. He can also discuss the potential of GLP-1 receptor agonists in combination with radiotherapy to improve overall survival in triple-negative breast cancer. Luxi Chen, MD, who will present a poster detailing this research at the conference, is a recipient of a San Antonio Breast Cancer Symposium Young Investigator Award.

Scheduling interviews:

To schedule an interview with a Cedars-Sinai expert, please contact:

Jillian Scholten | 949-244-2561 | jillian.scholten@cshs.org

Read more in Cedars-Sinai Discoveries: Abreast of Trends in Cancer

“We’ll take care of you,” they told her.

Sanchez, 29, had been a patient at Pasadena-based Huntington Health, an affiliate of Cedars-Sinai, for months. She and her husband were airlifted there after a near-fatal head-on collision in the San Gabriel Mountains near Los Angeles. She had grown close to the trauma surgeons, nurses and other providers who saved their lives and cared for them throughout their long recoveries.

Her caregivers’ prompting to always listen to her body and her confidence in their expertise led Sanchez back to the medical center two years later when she felt a lump in her breast and felt certain it was cancer.

“There are closer hospitals to where I live, but I knew the doctors and nurses at Huntington cared about my health and wellbeing,” Sanchez said. “If they were able to save me after my car accident, I knew they would take great care of me during cancer, as well.”

Today, thanks to Huntington Cancer Center, Sanchez is cancer-free.

While Sanchez’s intuition about where to go for cancer care was spot-on, her medical oncologist, Niki Tank, MD, praised her for immediately noticing a change in her body and seeking a diagnosis.

“I remind patients they are their own best advocate and to not be intimidated by the medical system,” Tank said. “Wendy paid attention to her body and her instincts, and she is doing well today. Her future is very, very bright.”

Healing Habit Sparks Discovery

The car accident in 2022 left Sanchez with a fractured collarbone, ribs and sternum; a broken lumbar spine; a broken tibia and fibula; and damaged internal organs. Surgeons had to remove her colon and two feet of her small intestine. Multiple surgeries to repair her body left her with additional scars.

Her plastic surgeon, Sanjeev Puri, MD, recommended a therapeutic ointment for a long scar stretching from her abdomen to her chest. Applying the ointment became part of her nightly routine.

One evening, smoothing the ointment up her torso, she felt a lump just above her breast.

“I panicked,” Sanchez said. “I told my husband, ‘I think I’m touching cancer.’”

The next morning Sanchez went to her doctor at Huntington Ambulatory Care Center. A subsequent mammogram, ultrasound and biopsy led to a diagnosis of triple-positive ductal carcinoma. This type of breast cancer has receptors for estrogen, progesterone and HER2 and can be treated with targeted therapies.  

Tank, who specializes in breast cancer for adolescents and young adults (people ages 15 to 39), said triple-positive ductal carcinoma is more common in women younger than 50.

“Breast cancer among people in Wendy’s age group tends to be very aggressive and spread quickly,” Tank said.

Sanchez’s cancer was diagnosed at stage 1, meaning it had not spread. But the tumor cells in the breast were large.

Her care team, including Tank and surgical oncologist Amy Polverini, MD, advised chemotherapy and a bilateral mastectomy.

“I didn’t need a second opinion,” Sanchez said. “I trusted them immediately.”

On May 2, 2025, Polverini removed the tumor, five lymph nodes and Sanchez’s breasts. When Sanchez later underwent breast reconstruction, her plastic surgeon of choice was Puri—who had recommended the scar ointment that led to her discovery of the lump.

Breast Cancer in Young Women

Breast cancer among women under 50 is on the rise. According to the American Cancer Society, the number of cases has increased about 1.4% each year since 2012—double the rate seen in older women. A 2024 JAMA Network study showed rising rates of hormone receptor-positive tumors in younger women.

Experts are not entirely sure why.

Sanchez asked Tank if extreme trauma to her body from the car accident could have spurred cancer.

“There are things we still don’t know about why breast cancer develops,” Tank told Sanchez, who was not at high risk to develop the disease.

“While the data isn’t conclusive, there may be a link between physical trauma, the body’s stress response and inflammation that can create an environment where cancer cells thrive. But this doesn’t mean car accidents cause cancer.”

Among known breast cancer risk factors are family history of the disease, tobacco and alcohol use, and a diet of heavily processed foods.

In another nod to the importance of self-advocacy, Tank noted that because Sanchez was not at high risk for developing breast cancer, she would not have been screened for the disease at her age. American Cancer Society guidelines recommend mammogram screening for women at average risk beginning at 45.

A Full New Life

Sanchez is embracing her new life and new memories these days. She and her husband are just back from Disney World, still on a Magic Kingdom high.

“Looking back, I can’t believe everything I’ve survived,” Sanchez said. “I miss the life I had before, but I’m living this new life to the fullest.”

As she left a recent doctor’s appointment, Sanchez met another breast cancer survivor who shared that it had been 30 years since her own diagnosis.

Sanchez smiled.

“I look forward to saying that one day, too,” she said.

Read more on the Cedars-Sinai Blog: 7 Tips to Reduce Your Breast Cancer Risk

According to the Centers for Disease Control and Prevention, about 10 percent of new breast cancer cases in the U.S. are in women younger than 45.

“We don’t have routine screening recommendations for patients younger than 40, and people aren’t aware that if they have a strong family history, especially in a first-degree relative like a mother, sister or aunt, they should be screened sooner,” said Mary El-Masry, MD, the hematologist-oncologist who led Dade’s care team.

Dade, who received her care from an integrated team at Cedars-Sinai Cancer Beverly Hills, is dancing once again, but treatment for triple-negative breast cancer wasn’t easy. It began with a regimen known as KEYNOTE-522. The protocol included four types of chemotherapy medications to shrink the tumor, plus an immunotherapy drug to help Dade’s immune system do its part in fighting the cancer.

Also there to help were her mother and her partner, Marcus Mack.

“I really just kind of fell into the hands of my care team, knowing that this treatment regimen was going to be extremely rough,” Dade said. “I had moved in with Marcus only three months before I was diagnosed. And then my mom moved in. Who would have thought that my mother and my partner would both be taking care of me.”

Tumors like Dade’s are “negative” for three important receptors—estrogen, progesterone and HER2—that many treatments use to target tumors, making them among the most aggressive and challenging to treat. El-Masry called the protocol Dade received a “breakthrough” in the world of triple-negative breast cancer.

“Mataya has an excellent prognosis,” El-Masry said. “She had a complete clinical response to her treatment. We could see her tumor shrinking.”

Following her chemotherapy and immunotherapy regimen, Dade opted for a double mastectomy with reconstructive surgery. And as a social media influencer, she chose to document her treatment journey.

“This is a message to my future me that I am a baddie and I will get through cancer,” she said to her followers.

For young women like Dade, El-Masry said that it is important to seek out earlier screening if there is family history of cancer—and to be your own advocate.

“If you feel something, bring it to someone’s attention and push to have some imaging done,” El-Masry said. “That could mean a mammogram or, if you are concerned about radiation exposure, an ultrasound. And if imaging isn’t showing anything but you feel a lump, you should ask to have it biopsied so we can be sure it isn’t something we need to be concerned about.”

Several days after her surgery, Dade was able to post the news her friends and family had been waiting for: “I, Mataya Dade, am cancer free.”

With that, she is at work creating a podcast—supported by Mack, a composer and producer—called “You Survived! Now What?” The plan is to offer advice and create a community for other young cancer survivors who are taking their next steps in life—just like Dade and Mack are taking theirs.

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After her stage 4 breast cancer diagnosis, independent filmmaker Kailee McGee decided not to leave her director’s chair. Instead, she leaned in and produced an award-winning short film about her experience. And, thanks to her care team at

“I'm on the other side of active treatment,” said McGee, who turned 37 in August. “I did chemotherapy, I had a double mastectomy, and I had radiation, and I'm still currently on an immunotherapy drug. But I want to point out that I'm cancer-free. I've been cancer-free for a while. I've gotten several clean scans, and that is just so exciting.”

After feeling a lump and having a mammogram and other tests, McGee was diagnosed with triple-negative breast cancer, an especially difficult type to treat. That’s because triple-negative cancer cells lack surface proteins that would make them vulnerable to estrogen receptor-targeted therapy or HER2-targeted therapy. Triple-negative is a rare type of the disease, representing only 10%-15% of breast cancers.

“Also, with treatments such as chemotherapy, those triple-negative breast cancers often outsmart the treatment. Fortunately, the addition of immune checkpoint inhibitors to the chemotherapy backbone represents a breakthrough in treating these cancers,” said McGee’s oncologist, Yuan Yuan, MD, PhD, director of Breast Medical Oncology at Cedars-Sinai Cancer. “Huntington Cancer Center is an affiliate of Cedars-Sinai Cancer, so we were able to offer Kailee leading-edge treatment close to her home.”

The cancer had spread from the breast to the lymph nodes in McGee’s neck, and Yuan recommended treating it aggressively. McGee underwent 16 rounds of chemotherapy, along with immunotherapy to help her immune system attack the cancer. After six months of therapy, she had a complete clinical response and the Cedars-Sinai Huntington Health tumor board decided to proceed with a double mastectomy. The surgery, performed by breast oncology surgeon Amy Polverini, MD, was followed by radiation treatment.

Ruth Williamson, MD, medical director of Radiation Oncology at Huntington Cancer Center, an affiliate of Cedars-Sinai Cancer, was McGee’s radiation oncologist. Williamson said that there was no evidence of active cancer after McGee’s chemotherapy and immunotherapy, and that radiation therapy reduced the risk that her cancer would return by 75%-80%.

“If there's one cell left behind in the regional lymph nodes, the cancer comes back,” Williamson said. “The radiation is extremely effective for targeting the areas where it might come back, and increasing the chance that Kailee is going to be cured of this disease.”

In the middle of treatment, McGee decided to write, produce, direct and star in a film about her experience. Called “Can,” the film won the Audience Award at South by Southwest Film Festival earlier this year.  

“Creating art has always been the way that I've processed my own life, and the world, and what's inspiring me or haunting me,” McGee said. “So I didn't really know what else to do to make sense of this experience.”

At Kailee’s side throughout was her partner, JP Bolles, also a filmmaker and director.

“I think it was incredible to see Kailee have such a drive to do something,” Bolles said, “to take the experience that she was having and make art with it, and just how beautiful that is.”

McGee credits Bolles and her film project with creating a healing environment for her.

“I know that part of the reason that I was so optimistic and strong going through this journey was because of the support that I had from JP and from my family and friends,” McGee said. “I created this community with my collaborators and my friends to heal with me in the moment. It gave me a job and a purpose, and it gave me something to think about that wasn't just going to doctor appointments and getting treatment.”

Rather than focusing on her cancer treatment, McGee’s film centers around what she calls her “existential identity crisis,” examining what it means to be a woman and an artist, and her inner struggle during treatment.

“At the beginning of cancer, I couldn't wait for it to be over so I could close that chapter and never have to think about cancer again,” McGee said. “And now my reality is that in so many different ways—health and spiritually and community-wise—cancer is just part of who I am, and it's part of my life, and it's part of my story, and the journey continues, and acceptance of that is what I want to share with this film.”

After breast reconstruction surgery later this year with James Andersen, MD, McGee will continue to be monitored by Yuan—through imaging and a new type of test that looks for cancer DNA in her blood—to make sure she stays cancer-free.

Both Yuan and Williamson found McGee’s film eye-opening, and believe it has important messages for breast cancer survivors—and all women.

“I thought it was a beautiful way of letting women with breast cancer understand, especially those who have gone through a mastectomy, that those self-image issues and those personal issues are somewhat universal,” Williamson said, “and that we can talk about them and identify those issues and help.”

Read more on the Cedars-Sinai Blog: How Do Your Genes Fit? Cracking the Code on Breast Cancer Risk