Metaplastic breast cancer survivor grateful for immunotherapy combination clinical trial

Alejandra Cintora González is an active wife and mother who eats healthy and doesn’t smoke. So, when she was diagnosed with metaplastic breast cancer at age 41, it took her by complete surprise.

Metaplastic breast cancer is aggressive and makes up less than 1% of breast cancer diagnoses. It’s so rare that the clinician who called Alejandra with her diagnosis wasn’t even sure what her next steps should be.

“I was scared, and I wondered why this was happening to me,” says Alejandra.

She’s thankful that she made an appointment at MD Anderson, where she was given options for treatment.

Symptoms that led to breast cancer diagnosis

Alejandra recalls experiencing fatigue and mood swings about 10 or 12 months before her breast cancer diagnosis. She thought these might be signs of perimenopause, so she did some research and began taking vitamins.

A few months later, she began to have loose stools. But it wasn’t until December 2023 that she had her most concerning symptom.

“I was lying in bed, and I felt a lump on my left breast; it was probably the size of a grape,” she recalls. “I thought that was weird, but it wasn’t the first time I felt something on my breast. They’d found a small cyst in my right breast during my last mammogram. I figured this was also a cyst, just in my left breast this time.”

Then she started having sharp pains in her armpit. Alejandra saw her gynecologist, who immediately sent her for a mammogram. She also had a breast ultrasound because she has dense breast tissue.

“I’m curious by nature, so I was looking at the images as I was getting my ultrasound, and it didn’t look like the cyst I’d had before,” she says.

The technician scheduled a biopsy, and Alejandra received her metaplastic breast cancer diagnosis on March 30, 2024.

MD Anderson guides metaplastic breast cancer treatment

Alejandra searched online to learn about metaplastic breast cancer. She found a Facebook group for women who had the same diagnosis and read through their stories.

That’s when she learned about MD Anderson and breast medical oncologist Clinton Yam, M.D.

“Dr. Yam is an expert in triple-negative breast cancer and has a lot of experience treating metaplastic breast cancer, which is usually triple-negative,” she says. “MD Anderson was considered top-notch, and Dr. Yam was highly recommended.”

Alejandra told her husband, and they agreed to call MD Anderson to make an appointment. They also contacted a local hospital in Nashville.

“I read that metaplastic breast cancer grows quickly,” she says. “My main objective was to get an appointment with an oncologist who is an expert in treating this type of cancer, so I could start treatment.”

Alejandra had her first appointment at MD Anderson in April 2024. She got new tests and imaging.

“It’s important to get the most precise diagnosis as early as possible,” she says. “When I got diagnosed back home, they only found the lump in my breast. The technician at MD Anderson who did my ultrasound was very thorough. She took almost an hour and checked everything.”

The ultrasound and subsequent biopsy showed that the cancer had spread to Alejandra’s lymph nodes, which changed her diagnosis from stage II to stage III. She also had scans to see if the cancer had spread to other organs, but it had not.

Yam explained the treatment plan to Alejandra and her husband. She’d start with a combination of the chemotherapy drugs paclitaxel and carboplatin every week and immunotherapy (pembrolizumab) every three weeks. The goal was to shrink the tumor.

Alejandra explained it would be difficult to travel to Houston for treatment, so Yam suggested he work in tandem with her oncologist in Nashville.

“I was able to have my chemotherapy infusions done locally, and my doctors worked together under Dr. Yam’s guidance,” she said. “I was glad I could be with my family.”

Why Alejandra enrolled in a clinical trial at MD Anderson

The tumor had not shrunk enough after Alejandra completed her first phase of treatment. This meant she only had a 20% chance of a complete response if she continued with standard therapy.

Yam told her about a clinical trial he was leading. It uses immunotherapy and an antibody drug conjugate called sacituzumab govitecan to treat early-stage triple-negative breast cancer that has not responded well to other treatments.

“This meant I would not have to get the red devil chemo, which I’ve heard is pretty intense and has a lot of side effects,” she says. “And there was a better chance that the treatment offered through the clinical trial would shrink the tumor, so I could have surgery.”

Alejandra agreed to enroll in the clinical trial even though it meant she would need to fly to Houston to get infusions. She started treatment on Aug. 13, 2024.

“It took a lot of commitment from my family,” she says. “My husband would come with me to appointments some days; other days, my dad would fly with me. But I wanted to get the best treatment I could in order to survive.”

Alejandra felt most fatigued two days after every infusion. At times, she had constipation and diarrhea, and she started losing her hair after the second infusion. She decided to shave her head bald; surprisingly, she found that stopped her scalp from itching.

“I had some side effects, but I still don’t think it would have been as bad as if I were on the red devil chemo,” she says. “I’m a stay-at-home mom, so I was able to cook and do chores around the house on the days I felt well enough.”

Alejandra received her last infusion on Oct. 22, 2024. She achieved a pathological complete response.

“It was a huge relief to hear that, mostly because I’m a mom,” she says. “So, this gives me the chance to be with my son longer – hopefully many more years – and see him grow.”

Support and gratitude after metaplastic breast cancer treatment

On Nov. 20, 2024, Alejandra had a segmental mastectomy performed by breast surgical oncologist Nina Tamirisa, M.D. On the same day, plastic surgeon David Adelman, M.D., Ph.D., performed breast reconstruction surgery.

She started radiation therapy on Jan. 7 and completed treatment earlier this year.

She said it was important for her to keep a positive mindset during treatment, especially as she experienced mood changes due to the medications she was taking. She is grateful for the support from her family and close friends.

“Cancer treatment not only affects you; it also affects your loved ones – especially the people who live with you,” she says. “Having family and friends who understand what you’re going through and are compassionate makes a huge difference. It’s important to have people who can help you with the basic things because you have to focus on yourself during treatment.”

Alejandra found comfort through prayer and by reading the stories of other women with cancer through Facebook groups.

“Reading what they were going through made me feel like I wasn’t the only one,” she said. “I knew that it would get better.”

She’s thankful she was able to participate in a clinical trial at MD Anderson and hopes more women with metaplastic breast cancer can benefit from the treatment.

“It’s taken several years of research to get to the point where we know what we do about metaplastic breast cancer treatment,” she says. “The clinical trial worked for me, and my hope is that this treatment can be the solution for other women facing the same diagnosis.”

Request an appointment at MD Anderson online or call 1-877-632-6789.

Alejandra with her husband, Saul, and their son, Sebastian