Terri Mitchell of Santa Rosa, a lifelong swimmer and runner, was shocked when she found a lump on her left breast, a month after she turned 51 in 2010.
"Breast cancer was never on my radar," said Mitchell, who works as a loan consultant for Ryan Mortgage Company in Santa Rosa. "My left breast was sore, and I was sure it was from doing push-ups. But it never went away."
The mother of four hadn't had a mammogram for two years, so she immediately made an appointment. It turned out to be an aggressive form of breast cancer known as HER2. Worse yet, it had already spread to her lymph nodes.
HER2-positive tumors produce too much HER2 protein, making them fast-growing and likely to spread, often to the bones or the brain, through the bloodstream.
At the urging of a colleague, Mitchell went to oncologist Alice Guardino at the Stanford Cancer Center, who enrolled her in a drug trial for Lapatinib, an inhibitor that blocks the HER2 growth-receptor pathway.
"It's an FDA-approved drug, but is typically used with people whose cancer is metastatic (has returned and spread)," she said. "The drug goes across the blood-brain barrier, so it can get into the brain."
After six months of chemotherapy and Lapatinib, Mitchell had a mastectomy on her left breast and took Herceptin for a year. The drug provides a type of antibody that targets the cancer cells and reduces the risk of cancer recurrence.
The good news came after the mastectomy, when she learned that the surgeon had difficulty finding the site of the original tumor. And all her lymph nodes came back negative, or disease-free.
"I really think she saved my life," Mitchell said of her doctor. "She had an aggressive treatment and a drug trial going, and she was forward-thinking."
To celebrate her clean bill of health, Mitchell began training with three friends to complete the Avon Walk for Breast Cancer in Santa Barbara earlier this month.
"For me, it will represent a return to health," she said before the walk. "I feel great, because I'm taking better care of myself."
The four-member team, which raised nearly $10,000 in donations, planned to walk 39miles over the course of two days to help raise money for research and for people who can't afford treatment or screenings such as mammograms.
"Avon uses a lot of the money to provide services to people," she said. "Everybody should be able to get the kind of care I got."
Training alongside Mitchell were two of her Bennett Valley neighbors, Gail Perry and Robin Warren, who mobilized a support team to provide everything from meal delivery to transportation during her treatment.
Because she was part of a drug trial, Mitchell underwent a barrage of tests, including baseline tests and biopsies, throughout the 18-month treatment.
"I had brain MRIs, heart scans, everything," she said. "I was down there two or three times a week for a different scan."
The fourth team member was Libby Hutton, a deputy county counsel with the Sonoma County Counsel's office, who had a brush with breast cancer six years ago, when she was 55.
"Having had it, you really appreciate how prevalent it is," Hutton said. "A lot of the people in our tennis group have had it."
Both Mitchell and Hutton, who found the lumps themselves, stress the importance of self-examination and timely follow-up.
"I found my own in a self-exam," Hutton said. "It was a teeny, tiny tumor not visible on a mammogram."
And although the campaign against breast cancer proudly drapes itself in pink, Hutton pointed out that many men are diagnosed with the disease as well.
"Every three minutes, another person is diagnosed," she said. "Every 14 minutes, another person dies. And 41,000 will die from it this year."
Hutton said it's important to know your own body and to listen to your intuition and trust it.
"We're our best protectors," she said. "I had no history. There was no reason to suspect anything, and it was practically a miracle that I happened to have found it."
After she finished her last chemotherapy treatment in August 2011, Mitchell resumed her exercise routine of swimming and spinning at the Montecito Health Center in Santa Rosa.
Earlier this year, she started going on 20-mile training walks with her teammates to prepare for the Avon event.
Her advice to others with a breast cancer diagnosis? Get a second opinion, even if you think you don't need it.
"Treatment at a teaching institution opens the doors that you don't get to open elsewhere," she said. "I was part of a research project, so I got to take advantage of that."
Along with her doctor, she credits her husband, attorney Steve Mitchell, and the goodwill of the community with helping her get through the journey.
"I had so many people who sent me well wishes and brought meals," Terri Mitchell said. "All of that good will goes so far. All those particles line up to determine your fate."
A positive attitude may also play a role in the healing process, in a spiritual if not a physical realm.
"I like to emphasize the idea that I'm not just a survivor, but a conqueror," Hutton said.
"I beat it," Mitchell said. "It didn't beat me."
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