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Lisa Marshall wants women to know how important it is to prioritize their own health.

“One thing I would say is that I encourage women to get their mammograms,” she said. “Like so many of us, I work full-time. We get so busy and we don’t put ourselves first.”

For several years, Marshall focused on her work commitments and serving on the Henrico County School Board. By age 57, a busy schedule occupied most of her time, and mammograms were not a main concern despite national guidelines that recommend them annually for women at that age.  

“I actually went four years between mammograms,” said Marshall. “That’s something I really regret, that I didn’t go sooner.”

In late 2017, she decided it was time to finally arrange a routine screening. The result was abnormal. A follow-up ultrasound and biopsy confirmed HER2-positive breast cancer.

“I was shocked because I don’t have a family history of cancer,” said Marshall.

In February 2018, within three days of her diagnosis, she had her first appointment at the Breast Cancer Collaborative Care Clinic at VCU Massey Cancer Center.

“It’s a great program,” said Marshall. “You get to meet with everyone in your care team: the nurse navigator, social worker, surgeon and the medical and radiation oncologists. I was extremely anxious, and over the course of meeting with them, my anxiety came down. You leave with a plan, and I came out of there feeling so hopeful.”

She also learned that her tumor was located under the axillary lymph nodes, and even though it tested HER2-positive, there was no evidence of disease in either breast. This phenomenon, known as occult cancer, occurs when the origin of a malignancy is unknown. It affects less than 1 percent of breast cancer patients, according to the American Cancer Society.

Marshall’s treatment plan began with chemotherapy under the care of Massey medical oncologist Mary Helen Hackney, M.D., and she was pleased with the care she received.

“Everybody at Stony Point was great and so caring,” said Marshall. "Several of the nurses shared their personal stories of breast cancer survivorship, and that gave me hope. It was just a really good experience.”

Upon completion of chemotherapy treatments, she underwent surgery to remove the remainder of the tumor and surrounding lymph nodes. The procedure was performed by Kandace McGuire, M.D., chief of breast surgery and director of the Breast Cancer Collaborative Care Clinic.

Lisa with her daughter Emily, husband Lem, and son Jack at Emily's VCU School of Medicine graduation in May 2019

“Dr. McGuire has such a warm personality; she’s so caring,” said Marshall. “I was very lucky that she called to say the lymph nodes were clear and that they didn’t find any remnants of the cancer.”

After surgery, Marshall had radiation treatments under the care of radiation oncologist Todd Adams, M.D. Radiation was followed by regular infusions of drugs designed to block HER2 receptors and decrease the chance of recurrence.

Prior to concluding infusion treatments, Marshall had a clear mammogram. She is currently not showing any signs of cancer, but she will continue seeing her oncologists for regular follow-ups.

“I’m so very grateful for Massey and have completed my treatment plan with a good prognosis,” she said.

Marshall credits her family – husband, Lem, and children Emily, Jack and Lauren – as being a source of encouragement. She found an additional layer of support from Emily and Jack, who were both medical students at VCU School of Medicine during her treatment.

“It has been a comfort having my children nearby in medical school as I battled my cancer this year,” she said. 

Emily Marshall, a recent M.D. program graduate, is now beginning a family medicine residency at the Medical University of South Carolina, and Jack Marshall, a rising fourth-year M.D. student, is interested in pursuing a sports medicine fellowship.

An interesting twist to her story is that two childhood friends of the Marshall siblings are also VCU School of Medicine students.

Hannah Shadowen, a rising second-year M.D.-Ph.D. student, and her sister Carrie Shadowen, a rising third-year M.D. student, attended elementary school with Emily and Jack at Saint Bridget Catholic School in Richmond, VA. Their parents also worked with both Marshall and her husband at different times.

“I just think it is an extraordinary coincidence that they would all be accepted to VCU and end up attending at the same time,” said Marshall. “My children are receiving excellent medical training in such a supportive, caring environment, for which I am grateful.” 

In terms of her health, Marshall maintains a similar positive attitude.

“The message of hope is so great,” she said. “What I’ve tried to do is look at each phase that I’m at as one day at a time. You have to make that mental commitment.”

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Massey’s chief of breast surgery, Kandace McGuire, recommends that women of average risk of breast cancer should begin annual screening mammograms starting at age 40 and that women over 25 should undergo a formal risk assessment for breast cancer. Learn more about her recommendations in this Q&A.

To schedule a mammogram, please call VCU Health Breast Imaging at (804) 237-6666.

To make an appointment with Massey Cancer Center’s Breast Cancer Collaborative Care Clinic, please call (804) 828-5116.

Written by: Melissa Mitchell