Clarisa with members of her City of Hope care team, Destiny Taylor (l) and Aleksandra Markowski (r)

Twins tackle breast cancer together

Clarissa Valdez | City of Hope
Clarisa, left, and Iris Valdez. Pictured above, Clarisa with members of her City of Hope care team, Destiny Taylor (left) and Aleksandra Markowski.
From early in their lives, twins Clarisa and Iris Valdez knew that there was a strong history of breast and other cancers in their family tree.
"My maternal grandmother had ovarian cancer and my mother had breast cancer," Clarisa Valdez explained. "We have quite a family history of breast cancer on my paternal side — at least two cousins, one aunt. We actually have a huge family map that details everything, all the cancers we have in the family."
The Valdez twins’ mother, who is a cancer survivor, was diagnosed with breast cancer in her forties and successfully treated, but unfortunately their aunt did not survive the same disease. Both of those facts led Clarisa and Iris to independently be proactive about their health when they were in their late twenties.
In 2015, when she was living in Boston, Clarisa mentioned her family history of breast cancer during a routine checkup. Her doctor recommended she get tested for  the BRCA1 and BRCA2 gene mutations, and referred her to an oncologist.

Early Intervention

That was when Valdez discovered she has both the breast cancer gene mutations. "I was just scared. Then I immediately called my sister," she said. Her twin turned out to also carry both mutations, and was the first to enlist City of Hope for help in managing her proactive care, working with the genetics division of the hospital.
In 2017, when Clarisa returned to live in California, she also began seeing Daphne Stewart, M.D., associate clinical professor in the Department of Medical Oncology & Therapeutics Research  and a breast and gynecologic cancer specialist, who advised her to have a preventive double mastectomy.
"I was just like, 'Oh, no, no, no!'" Clarisa said. "I mean, what if I never get breast cancer? What if modern medicine advances in 10 years, which would make me the age when my mother got it? Should I wait? You think all these things. I just didn't think I needed to jump the gun."
In fact, it took her six months to make the appointment for the MRI of her breasts that Stewart had suggested, finally having the test in January 2018. That's when they discovered that she not only had breast cancer, she had what Veronica Jones, M.D., assistant clinical professor in the Division of Breast Surgery in the Department of Surgery, who would become her City of Hope surgeon, called "an aggressive form of breast cancer, triple negative breast cancer."
At age 31, Valdez made the decision to have a double mastectomy. Jones performed the nipple-sparing mastectomies, which included doing immediate replacement implants at the same time.
"That procedure is better for patients who qualify, because they don't have to have expanders put in and then go for repeated surgeries," Jones explained. Valdez went through chemotherapy after her surgery and she is currently "cancer free," according to Jones.
Meanwhile, her sister Iris has also opted to go through a similar double mastectomy procedure, in her case choosing to do it ahead of receiving a cancer diagnosis. That's something Jones said is done on a case-by-case basis with patients who are BRCA carriers.
"While a double mastectomy is certainly indicated when you have a gene mutation, it is not mandated, nor is the timing of it. And it's something that can be discussed. And certainly waiting, doing surveillance without surgery, is another option, another perfectly valid option," she said.
The Valdez twins are so satisfied with the care they've received from City of Hope's cancer team that they are both giving back, willing to share their experiences to help allay the fears of other patients in the hospital.
"I'm on the other side now," Clarisa said, "and I want to be an advocate in helping other people who find themselves where I did. I'm in love with all of my doctors at City of Hope! So I offered, if they have patients who have any questions or want somebody to talk to who has been through it, I am happy to help."