NEW ALBANY • Brittany Martinez-Clark was only 30 years old when genetic testing during her annual checkup showed she had an 80% chance of having breast cancer at least once by the time she was 50.
It was late December 2018, and by January, she learned the results showed she was positive for BRCA2 gene, which makes the risk of having heredity ovarian or breast cancer increase significantly.
As a family nurse practitioner and owner of the Family Clinic of New Albany, she knew what her choices were.
“It was terrifying when they called me because I already knew in the health field what the recommendations were for that, which is a mastectomy,” Martinez-Clark said. “I was like, I’m 30 years old, I want to have another baby. There were a whole lot of questions that came with that.”
Three aunts on her paternal side had breast cancer. When one aunt did not have a mastectomy after her breast cancer diagnosis, Martinez-Clark said the breast cancer “came with a vengeance” early this year as stage 4 cancer, which is still being treated. What ultimately motivated her to pursue a prophylactic mastectomy was thinking about her then 2-year-old son.
“It was ‘OK, this is why.’ I don’t ever have to worry about getting that news now. I didn’t want my family to have to go through what I’ve seen my other family members, and what I’ve helped them through with their cancer diagnosis because it’s hard, and it’s scary,” Martinez-Clark said. “Just the thought of not being there for my son was immensely scary to me … knowing that he won’t ever have to worry about me getting breast cancer is worth it.”
Martinez-Clark met with a surgeon in Tupelo, but ultimately had her general surgery and reconstruction completed in Nashville with Drs. Sirinya Prasertvit and Jacob Unge, respectively. She took flights from Tupelo to Nashville for each appointment.
Everything about Martinez-Clark’s life changed during this time. After the mastectomy, she had drainage tubes placed on each side to help her heal properly, and her husband and mother had to help her change dressings. She went from having a busy life running her clinic of approximately 20 employees, caring for her toddler and dealing with daily tasks to putting everything on hold for a solid two months. She spent four weeks in recovery, and there was another four weeks where she couldn’t lift more than 10 pounds – something that put returning to work out of question.
She also wasn’t able to take care of her son by herself, which was hard because the two were “thick as thieves,” Martinez-Clark said.
“I had to learn how to ask for help and let somebody help me. I’m really bad at that, but I had to,” Martinez-Clark said.
Family and friends became essential during this time. Her husband, Trent Clark, helped find surgeons who accepted their insurance, and offered her both emotional and physical support. Martinez-Clark’s mother moved in with her after her first surgery to help with her son and run her business. This provided an opportunity for the two of them to connect in a way they hadn’t in years.
Her aunts were also immensely helpful in helping her find peace with her decision to seek early treatment. She remembers asking her Aunt Jan, who had already battled stage 4 breast cancer, if she would make the same decision when she was 30 years old if she knew everything she would go through.
The answer: “In a heartbeat.”
Martinez-Clark said the memory of sitting with her in the cancer center when she first underwent chemotherapy makes her thankful genetic testing is available for women at high risk of developing hereditary breast cancer.
“I think knowledge about your family history, your personal medical history, especially if you’ve undergone the genetic testing and you know these things upfront, then that’s power to fight it, and you win the battle before it starts,” Martinez-Clark said.
During her treatment, her church family brought Martinez-Clark a bounty of food. But despite the support, Martinez-Clark said she “tried not to make a big deal out of it” since she didn’t have breast cancer.
She has since learned to think of herself as a “pre-vivor.”
“I decided it’s OK to acknowledge that I did go through something and (am) making a difference for the future of my health,” she said.
If not for the screening questionnaire at her annual screening, Martinez-Clark believes she never would have considered seeking a prophylactic mastectomy and treating breast cancer before being diagnosed. An initial MRI did not reveal much, and while there was one area that was tested after surgery, everything came back negative.
Now, Martinez-Clark sees her story as a way to dispel myths that surround breast cancer. One is the idea that a preventative mastectomy would affect fertility. Martinez-Clark is expecting a daughter and said she is glad to show surgery didn’t hurt her chances of having another child.
While doctors recommend she have a total hysterectomy at 35, she said it is a decision she will approach when the time comes.
Another myth is the idea that the paternal family’s history of cancer isn’t as important in inheriting breast cancer; while her mother’s side of the family had some breast cancer history, her father’s side has a much higher prevalence of familial cancer.
Martinez-Clark said she wants to fight breast cancer however she can, whether through educating people on the subject of genetic testing, volunteering for school supply drives with her clinic, or just filling a need in the community.
Although much of her life is unchanged post-mastectomy, Martinez-Clark said she has become a lot more confident. She’s even used her experience to change how she and her employees treat and counsel patients. Since her clinic provides a lot of primary care and sees many people of lower socioeconomic status who cannot see a regular OB-GYN, she has educated her patients on options they have if facing breast cancer themselves.
“It’s still kind of newer health information, the genetic testing, and what the options are for it, so the unknown is scary for a lot of people,” Martinez-Clark said. “That’s why it’s important to get this information out and help people know that it’s available and to be proactive in accessing their health status and in making choices to move forward with it.”