Searching for Solutions
Later, in the shower she was surprised to feel a lump in her breast, but tried to convince herself it was a hematoma from the fall. After all, she was 39, an avid runner with a healthy lifestyle and no known family history of cancer.
At a routine checkup a week later, her primary care physician ordered an urgent mammogram at the Eisenhower Lucy Curci Cancer Center. The mammogram was followed by a biopsy and grim news: breast cancer. This time she was truly shocked.
“How could this happen to me?” Warfield remembers thinking. She would soon find out.
Genetic testing revealed an inherited mutation that puts her at a higher risk of breast cancer. PALB2 - partner and localizer of BRCA2, a better-known gene playing a role in breast cancer - normally protects against cancer. When it mutates, it can’t fulfill that role.
Discovering your own history
“I come from a family of secret keepers,” says Warfield. “Little did I know that my father’s mother had breast cancer, my aunt had it and all of the female cousins on my father’s side had it.”
She went on a search for the best cancer center and oncologist, which led her to conversations with doctors in Los Angeles, points east and back home to Eisenhower Lucy Curci Cancer Center, where she met Manasa Vulchi, MD, a Board Certified Medical Oncologist and breast cancer specialist.
“Being aware of your family history is extremely important,” says Dr. Vulchi. “If we had known Allegra had this mutation, we would have potentially started doing breast MRIs at age 25 and added in mammograms annually at age 30, and possibly found her cancer much earlier.”
Warfield was impressed with Dr. Vulchi’s empathy - and with what she offered next. After outlining two standard-of-care treatments, Dr. Vulchi told Warfield about I-SPY2, an innovative immunotherapy clinical trial at UC San Diego Health.
“We want to take advantage of all the opportunities we have for our patients,” says Dr. Vulchi. “I thought Allegra should be part of a well-designed clinical trial.”
The I-SPY2 trial is testing the effectiveness of giving new drug agents to high-risk breast cancer patients before primary therapies, such as surgery, to improve outcomes.
Warfield began trips to UC San Diego Health every three weeks for treatments aimed at shrinking her tumor and minimizing cancer spread. At each step, she was determined to advocate for herself. She dove into research about her specific cancer, which she learned was Luminal B, a more aggressive subtype of hormone receptor-positive breast cancer.
“I wasn’t in control of the diagnosis, but I could control my reactions to it,” she says.
Warfield’s tumor responded to the therapy in the clinical trial, but not as well as hoped. She began chemotherapy at UC San Diego Health, then returned to Eisenhower Health to complete it. She was determined to thwart one more loss - her hair, a common treatment side effect.
“I was already grieving the loss of so much identity,” she says. “I knew that even with the chemotherapy, I would be losing my breasts and my ability to have kids.”
Cooling off the side effects
Warfield decided to try scalp cooling. Bundled in warm blankets, she wore a “cooling cap” or cryotherapy helmet with each treatment. Eisenhower Lucy Curci Cancer Center offers the only full-service scalp cooling program in the Coachella Valley.
“This FDA-approved technique has helped so many women,” says Dr. Vulchi.
It worked for Warfield.
Throughout her chemotherapy sessions and more, her longtime partner, Joseph Wagner, has been by her side. Warfield also found encouragement throughout Eisenhower Health, including the Lucy Curci Cancer Center Breast Cancer Support Group and every level of Eisenhower staff, including the valet who greeted her “with a hug and positivity,” welcoming receptionists, and nurses, who offered compassion and experience.
By June, Warfield was back to her running schedule even as she continued chemotherapy, switching from one drug that didn’t produce a strong response to another known for its effectiveness in the BRCA2 family.
To help prevent cancer recurrence, Warfield underwent a double mastectomy and full reconstruction in August. In the fall, because cancer had reached her lymph nodes, she underwent radiation treatments at Eisenhower BIGHORN Radiation Oncology with Jeffrey Burkeen, MD.
She requested no tattoos - used to guide the radiation beam - on her skin. The medical team suggested a washable marker.
“I always felt heard and understood at Eisenhower Health,” says Warfield. “I was always presented with options.”
She thinks about the time she spent looking for the right care only to find it so close to home.
“Who knew this level of care was only seven minutes away?” she says.
Warfield “rang the bell” to mark her last radiation treatment November 6, 2024. Her cancer is now in remission.
She takes a monthly hormone blocker to suppress estrogen, as well as an oral chemotherapy, Verzenio®. This cyclin-dependent kinase 4/6 (CDK 4/6) works by targeting two proteins (CDK 4 and 6) that can cause cells to grow and divide uncontrollably. The goal is to reduce the risk the cancer will spread to other organs.
Warfield remains positive.
“Cancer is part of me genetically,” she says, “but it doesn’t define me.”
To learn more about Eisenhower oncology services, visit EisenhowerHealth.org/Cancer
or call 760.674.3602.
