• Research

    BEAUTY trial charts an individualized path to breast cancer treatment

Article by Julie Janovsky Mason

Watch Elena’s story here:


Elena Blevins and her grandchildren

Six years ago, Elena Blevins discovered a lump on her right breast as she was getting dressed.

"At first I thought it was cyst," she says, initially dismissing the lump as she focused on her job and family. After several months, she became increasingly tired. And the lump appeared to get larger and harder.

At the urging of her daughter, Elena, who is a member of the Tohono O'odham Nation, scheduled an appointment with Indian Health Service at Phoenix Indian Medical Center (PIMC). It would be the first of a series of medical appointments that would bring medical experts from Phoenix Indian Medical Center and Mayo Clinic together to coordinate Elena's care.


A coordinated approach

A mammogram and biopsy at PIMC revealed Elena had triple-negative breast cancer - an aggressive form of the disease that often is challenging to treat.

Donald Northfelt, M.D.

"We recognized immediately that Elena had a serious breast cancer problem that needed immediate attention,"  Donald Northfelt, M.D., associate medical director of Mayo Clinic's Breast Clinic, says of Elena's diagnosis.
"Triple negative is a form of breast cancer in which there is no expression of estrogen receptor, no expression of progesterone receptor and no overexpression of the HER2 [human epidermal growth factor receptor 2] protein," he explains. "Because none of these proteins are expressed in the cancer, we are lacking specific targets for that type of cancer."

Elena, a home health aide, was at work when she learned the news.

"I hung up the phone and finished up my shift," she says. "I don't know how I was able to maintain it. I had maybe another half hour to go until my shift was over. I didn't tell my client anything. I told her, 'I will see you tomorrow.'"

Elena burst into tears once she got into her car.

When she arrived home, she told her daughter first. Then she sat down with her son, who was only 12 at the time. Friends and family started arriving at her home as the news spread. "Everyone was crying," Elena says. "It was very traumatic."

The Mayo Clinic and Phoenix Indian Medical Center teams felt Elena would be a good candidate for a clinical trial at Mayo as part of her overall treatment plan.


A Pivotal Clinical Trial

Elena recalls that her care team explained to her that she qualified to be part of a clinical trial and what it would entail. She liked the fact participating in a clinical trial potentially could help other women with this type of cancer.

"I thought if I could help people and the clinical trial could help me, it was a win-win," she says. So Elena continued her cancer treatment at Mayo Clinic's Arizona campus and was enrolled into the Breast Cancer Genome Guided Therapy, or BEAUTY, study which was sponsored by the Mayo Clinic Center for Individualized Medicine.

"The BEAUTY trial employed a very sophisticated genetic and molecular analysis to help us understand the nature of Elena's cancer and make a better plan for her treatment," says Dr. Northfelt, one of the researchers on the trial.

As part of her treatment protocol, Elena received several months of preoperative chemotherapy, and it shrank her tumor. Then Elena had a lumpectomy at Mayo Clinic, performed by surgeon Richard Gray, M.D., who was also a researcher on the clinical trial. The area of the original tumor was removed and lymph nodes were extracted from her armpit for testing.

"We were grateful at the time of her surgery to find out all the cancer had disappeared from her breast, which was our goal and our hope," Dr. Northfelt says. Elena then received conventional postoperative whole-breast radiation therapy to complete her care.

Elena has been cancer-free for more than five years. She credits her strong faith and the support of her family and friends for helping her get through. She's thankful that she had access to the clinical trial and is grateful to her care teams at Mayo Clinic and Phoenix Indian Medical Center.

"It was a true blessing to have people care about me so much," Elena says of having two care teams. "It was a huge team. It was like a big family."

October is Breast Cancer Awareness Month, a time to call attention to this type of cancer, which affects 1 in 8 American women. Mayo Clinic Center for Individualized Medicine, along with colleagues within the Mayo Clinic Cancer Center, are researching new, individualized ways to detect and treat breast cancer early, when it is most curable.


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Coverage from the 2018 Individualizing Medicine Conference: