At 29, woman discovers family history of cancer after diagnosis
When she was 28, Tammi Moran found a lump in her breast, but she didn’t take it seriously. She had six children at home and figured she was too young to have cancer anyway. She forgot about it.
“Young moms hit the snooze button on health,” she said.
About nine months later, she noticed blood coming out of her nipples. That woke her up. She went to her primary care provider who referred her to Dr. Colleen Silva, professor and surgeon with UTMB’s Department of Surgery and medical director of
UTMB’s Breast Health and Imaging Center in League City.
Dr. Silva ordered a mammogram and ultrasound, but neither one showed anything unusual.
“If those can’t answer the questions, a bleeding nipple still needs investigation,” Dr. Silva said.
She did an incisional biopsy, removing milk ducts from both of Moran’s breasts. Also, UTMB physician Dr. Gwyn Richardson did an MRI.
“I’m extremely claustrophobic, and Dr. Richardson was so patient with me,” Moran said.
It turned out Moran did have cancer in one breast and a possible pre-cancer condition in the other. She was 29.
Curious, Moran reached out to a family member to ask out about any family history of breast cancer.
“No one in my family talks about health,” she said. “There’s a silence.”
The family history she uncovered shocked her.
“I found out there’s so much cancer in my family.”
Not only was there a history of cancer in the family, but Moran also learned that many women in her family had died young because of it.
Processing all this new information intimidated Moran. She would need a double mastectomy, but this wasn’t just about her breasts. Her team of doctors also wanted to remove both her ovaries as soon as possible. Moran wasn’t ready for that
She researched the possibility of having her Fallopian tubes removed to delay removing her ovaries and asked her doctors about it. Dr. Richardson agreed to remove Moran’s Fallopian tubes at the same time she performed Moran’s hysterectomy
and cervix removal.
Given Moran’s condition, another UTMB Health women’s health provider
Dr. Kathleen Vincent was recruited to join the care team and monitor her health.
“Dr. Vincent performed ovarian cancer screening on me every few months for three-and-a-half years while I debated keeping my ovaries,” Moran said. “She always gave me so much of her time, and as a researcher, she helped answer my questions
about recent studies I had found. She was amazing.”
The experience was still jarring.
“It was scary,” Moran said. “But the doctors at UTMB were so calm. And they all talked to each other. Even the UTMB occupational therapist who treated my lymphedema communicated regularly with the rest of my care team, especially Dr.
After her double mastectomy, Moran decided not to have reconstructive plastic surgery. It was an unusual decision other people didn’t expect.
But it was Moran’s choice, and she had the support of her husband and her doctors. She also learned her family carried a BRCA gene variant.
“This was a ‘variant of unknown significance’ on the BRCA gene, but the genetic counselor advised me to consider it a mutation linked to cancer and act accordingly,” Moran said. “At least two other women in my family who
had cancer in their 30s had the same result.”
Moran asked a lot of questions. She took copies of articles and other information about cancer risks to her doctors, and they didn’t mind. Then, Moran got the news at a follow-up appointment that she could no longer wait to have her ovaries removed.
She still wasn’t ready for that.
“I was so worried to do this,” she said. “I was agonizing over this.”
She worried about what hormone replacement might do to her body or if she would develop cardiac problems or osteoporosis. Articles she read made her worry even more. While seeing a gynecologist for a check-up at UTMB, Moran struggled with these concerns.
During her appointment, the doctor looked at a smiling Moran and commented how she always came into her office smiling, making jokes and acting happy.
“I’m wondering if deep down you are really scared,” she asked Moran.
The smile melted away. Moran broke down crying.
“I’m way too young for this,” she said.
The doctor suggested she see a psychologist to talk about these fears. Hesitant, Moran made the first appointment. The psychologist worked with her for months on her feelings and thoughts, and he guided her to consider her best options. This helped Moran,
who decided in 2018 to have both ovaries removed when she was 34. Her doctors found a low-dose estrogen replacement she could take, which has made the surgical menopause manageable.
Moran still struggles with lymphedema, but she might have a procedure to treat it. She no longer hits the snooze button.
“I’m making sure my daughters’ primary care providers are aware they have this family history because of my diagnosis,” she said.
This feature first ran as a feature story in the 2022 Think Pink special section of the Daily News. You can view the full the publication online.
View the print story
Watch a video with Tammi, Dr. Silva and Meagan Clanahan with Houston Moms below