Sebastopol family faces down breast cancer three times

For one Sebastopol family touched by breast cancer, lightning struck not twice but three times. And it began unexpectedly, with dad.

While showering one day, Tom Mautner felt a lump. He was not trained, like most women, to do self-exams, but the 2 1/2-centimeter swelling was impossible not to notice.

Three days later, while undergoing his annual physical, his doctor confirmed his fears. He had a tumor. By the afternoon he had undergone a mammogram and was meeting with a surgeon for a biopsy. The lump was malignant. He had breast cancer, and it was at stage two. (There are four stages.)

“I thought, ‘My life is over.’ That’s just the way it hit me,” Mautner recalled of that frightening moment 13 1/2 years ago.

What the 74-year-old HP/Agilent retiree could not imagine is that he would face the trauma of a breast cancer diagnosis two more times in his family -- once with his daughter, Victoria, and then again with his wife, Cheryl.

“It’s unusual to have a cluster like this. I’ve been doing this work for 42 years. I have never seen anything like it,” Sutter Health oncology nurse Cindi Cantril said of the Mautners, who she has known for years. None of them has the genetic mutations in the BRCA1 and BRCA2 genes that are connected to breast cancer incidence and that have devastated some families. They’ve even led some women, most famously actress Angelina Jolie, to have their breasts and/or ovaries removed as a precaution without any cancer diagnosed or evident.

More rare, however, is the incidence of a husband and wife, genetically unrelated, both contracting breast cancer. A British mathematician, commenting on a similar case in England four years ago, placed the odds of a husband and wife both getting breast cancer at 20,000 to one.

Mautner had survived melanoma as a young man in 1967 and always worried, somewhere in the back of his mind, that cancer could return. He never dreamed it would return in his breast.

“Why would I expect to get breast cancer? It’s pretty far out of my family line,” said Mautner, who had no known relatives with breast cancer.

Only about 1 percent of all breast cancers occur in men, but that amounts to nearly 2,000 new cases annually in the U.S. An estimated 40,000 women and 440 men die each year from the disease, according to National Cancer Institute.

What the Mautners also have in common is the fact that they all are cancer survivors.

Tom’s cancer was not aggressive. He had a lumpectomy and 27 lymph nodes removed, although all proved cancer free. He opted not to undergo chemotherapy, which he said would have given him only a 10 percent greater chance of long-term survival.

The bigger battle came 2 1/2 years later, when his daughter, Victoria Zemrak, was diagnosed with a more aggressive type of breast cancer. She was only 34 and the mother of five kids, the youngest only four.

“I found a lump but it was right before Thanksgiving, so I didn’t want to deal with it,” she said. “My (now ex) husband had just lost his job. We didn’t have insurance. I thought, I’m not going to deal with it until after all the holidays.”

When she finally did go in, the doctor told her it was probably a cyst but, given her family history, recommended a mammogram. Zemrak didn’t have the money to pay for it, so her sister, Jennifer, tapped into a foundation that provided the funds to pay for what ultimately was a life-saving procedure in mid-February. It disclosed three lumps, two malignant. Zemrak’s cancer had advanced to stage three. She underwent a lumpectomy and then a full mastectomy on her right side. That was followed by eight treatments of chemotherapy with two different kinds of drugs; she was very sick.

“My kids were amazing,” she said. “They tried to help out as much as possible. And my parents were awesome.”

Tom Mautner, however, secretly felt rattled. “I was shocked. I thought, ‘Why us?’”

“It was really hard. Her marriage had been off and on. She was going through a hard time,” mom Cheryl, 68, recalled. “We just went to the hospital and stayed with her and never left until she came home. But she’s a strong person. She did well.”

Zemrak had a HER2-positive breast cancer, which means there is the presence of a protein that promotes the growth of cancer cells. About one in five breast cancers are HER2-positive. A year after completing her chemotherapy a drug called Herceptin, which was found to be effective in preventing a recurrence of cancer, became available and she began taking it. More than a decade later, she remains cancer-free.

Dr. Peter Brett, a medical oncologist with Sutter Health in Santa Rosa who treated both Zemrak and Cheryl Mautner, said cancers that are HER2-positive tend to come back within three years after surgery.

“She’s 11 years out. Hers will never come back. I’m sure she’s cured,” Brett said.

Zemrak, a hairdresser who works at the Coast Guard Station at Two Rock, was undergoing breast reconstructive surgery two years ago when her mother Cheryl got the bad news -- now all too familiar in the Mautner family.

“I held off telling her,” said Cheryl, giving in to her motherly instincts to protect her daughter. “She was having surgery and I wanted her to get through and everything done so she wouldn’t have it on her mind.”

Cheryl Mautner had two tiny masses, one the size of a blueberry and the other the size of a lentil. Hers was at a very early stage. She had both removed and underwent radiation.

The Mautners are open about their cancers. Although many men are slow to talk about it when they experience breast cancer, Tom didn’t hold back. He warned men at work to be aware. He counsels his son Daniel, 39, and other men in his family to be vigilant.

Last weekend Cantril recruited the Mautners to participate in the Stepping Out To Celebrate Life Fundraiser and Fashion Show at the Marin Civic Center, which raise funds for breast cancer charities. They donned outfits they wouldn’t otherwise wear - Tom and Victoria in contrasting leather jackets and Cheryl in a beaded gown - and took to the runway beside fellow breast cancer warriors, some still very much in battle.

“They’re just a very loving couple who really support each other and their daughter,” Cantril said of Tom and Cheryl, married now 47 years.

Zemrak said participating in the event was like “icing on the cake” for her recovery. Seeing other women, one as young as 24, face their disease with such resilience was inspiring and put her own situation in perspective.

“It’s going to be 12 years for me in March,” said Zemrak, now 46 and grandmother of three. “I realize I’ve been given a lot of really wonderful time. Cancer has made me realize just how precious life is and what is really important. All the small stuff? Don’t sweat it. It will work out. But the people who are in your life and who support you and are there for you and who love you? Sometimes it gets messy, but those are the people that matter.”

You can reach Staff Writer Meg McConahey at meg.mcconahey@pressdemocrat.com or 521-5204. On Twitter @megmcconahey.