Mother with metastatic breast cancer finds hope in clinical trial

Tiffany Andrews believes in facing a challenge head on. 

“We don’t avoid things because they are hard,” she tells her children, Carter, 14, and Turner, 11. So when she was diagnosed with breast cancer at 35, she followed her own advice and sought treatment at UT MD Anderson. 

Now nine years after her initial diagnosis, Tiffany still travels to UT MD Anderson from her home in southern Alabama to participate in a clinical trial for patients with HER2 positive metastatic breast cancer. 

Choosing UT MD Anderson for breast cancer treatment 

After giving birth to Carter in 2014, Tiffany noticed unusual changes in her breasts. At first, her doctor assured her that seeing blood in her breastmilk was likely a temporary condition related to breastfeeding. But three years later, Tiffany noticed unusual pain in her armpit and discovered a lump in her right breast. Her doctor ordered a mammogram and ultrasound, which revealed suspicious masses. After a biopsy, her doctor diagnosed Tiffany with stage 2B triple-positive breast cancer, an aggressive cancer. 

“I thought: ‘Cancer, that’s the end of everything,’” Tiffany says. “My kids were so little. Why would this happen?”  

Because a close relative had been successfully treated at UT MD Anderson, Tiffany decided to request an appointment. She traveled to Houston and met with breast medical oncologist Carlos Barcenas, M.D., who confirmed the initial diagnosis and recommended HER2-based systemic therapy, followed by surgery, radiation and endocrine therapy. 

Going through chemotherapy with two small children to care for was another challenge.   

“I did my first round of the really hard chemotherapy,” recalls Tiffany. She received a treatment called TCHP, a combination of four chemotherapy drugs: docetaxel, carboplatin, trastuzumab and pertuzumab. This combination is a common and aggressive treatment for early-stage breast cancer.  

“I was so sick, and I told my mom, ‘I can’t do this,’” Tiffany recalls. Her mom told her, “You don’t have a choice: you have two little kids.” 

Tiffany completed six rounds of TCHP locally in Alabama before returning to UT MD Anderson for surgery. She underwent a mastectomy with Henry Kuerer, M.D., and spent two months in Houston for treatment and follow-up care. During the surgery, Kuerer had to remove several lymph nodes from her arm as well. They also placed a tissue expander to make reconstruction easier. 

In late 2018, Tiffany had a procedure called latissimus dorsi flap — breast reconstruction surgery using back tissue — at UT MD Anderson. Later, she received a permanent implant. Tiffany was declared cancer-free. She returned to UT MD Anderson for surveillance every six months. 

Clinical trial offers hope after recurrence 

In 2022, a routine scan revealed that the cancer had returned and metastasized to her lungs.  

“When it came back, it was horrendous,” says Tiffany. “With metastatic disease, you can be doing well for a while, then suddenly you’re not. You can feel like you’re a ticking time bomb.” 

Despite experiencing some depression, Tiffany embarked on a new treatment plan. She had a biopsy at UT MD Anderson. Barcenas revised Tiffany’s diagnosis to ER negative, HER2 positive breast cancer. “At recurrence, there is a change in ER status in around 20% of cases,” says Barcenas. 

Tiffany was able to receive chemotherapy at a hospital near her home, where her local oncologist consulted with her UT MD Anderson doctors. This time, she took a combination of pertuzumab, trastuzumab and docetaxel, also called the CLEOPATRA regimen. It worked well for 18 months, after which there was disease progression. 

When a scan in 2023 revealed a lesion in her brain, Barcenas recommended a clinical trial led by Ecaterina Dumbrava, M.D., in UT MD Anderson’s Andrew M. McDougall Brain Metastasis Clinic. The clinical trial targets HER2 positive cancer by combining an oral targeted therapy, tucatinib, with an infusion of an antibody drug conjugate called trastuzumab emtansine (T-DM1). She’s able to take the pills at home, then returns to Houston every three weeks for the infusion, with her mom or husband by her side. Tiffany says that the hardest part is relaxing while the infusion team prepares her treatment. 

Neurosurgery nurse practitioner Audrey Hartnett monitors Tiffany’s care, along with  Hussein Tawbi, M.D., Ph.D., and Dumbrava.  

“Audrey is fantastic!” says Tiffany. “She is very accessible; she helps make sure I get what I need at the pharmacy.” 

Tiffany’s side effects vary from cycle to cycle. She’s had bone pain, headaches, acne and fever. Sometimes, she also has trouble recalling or pronouncing certain words.  

“I know in my head what I’m trying to say, but the wrong word comes out occasionally or I pronounce a word the wrong way,” Tiffany explains. She says she and her family take these episodes in stride.  

Facing challenges and finding joy 

When she’s not in Houston or taking care of her family, Tiffany enjoys working out at the gym. Side effects from her treatment can cause muscle weakness and fatigue, and she has limited range of motion in her right arm from the mastectomy.  

“It’s frustrating, but I’ve learned to live with it and adapt,” she says. 

While balancing travel with her children’s busy lives can be difficult, her experience has changed her perspective on life. 

“If it’s not a benefit to me or my family, I’m not going to take part,” she says. “I say no to things that don’t bring me joy.” 

Even though it requires being away from her kids, Tiffany believes traveling to UT MD Anderson is worth it.  

“You need to find a fit, even if it’s twelve hours from home,” says Tiffany. “Find a place where you are comfortable and confident in your care team.” 

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