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The Tests of a Lifetime, A Community of Support: Tanner Doctor Leans on Colleagues in Bout with Breast Cancer

The Tests of a Lifetime, A Community of Support: Tanner Doctor Leans on Colleagues in Bout with Breast Cancer

About two years ago, Kilsy Cuello, MD, was gearing up for one of the biggest certification exams of her medical career when she was faced with one of the biggest tests of her life: breast cancer.

It was during the summer of 2018, nearing the end of July, and Dr. Cuello was fresh into her career as a nephrologist at Carroll County Nephrology. At 33, she was just days away from taking her nephrology board-certification exam when she felt a lump in her breast during a self-examination.

As a physician, she knew that finding this lump was concerning and that she would soon be preparing for yet another important exam — a mammogram — as soon as possible.

“At the beginning, I didn’t pay too much attention to the lump because of my age, since I was young,” Dr. Cuello said.Dr. Cuello and team

Like genetics and family history, a woman’s age can put her at an increased risk for breast cancer.

Dr. Cuello had just turned 33 — a rare age to develop breast cancer — so she said there should not have been much cause for concern.

“I said I would give it a few weeks and, if it’s still there, I would go and see my doctor,” she said. “A physician can take the board exam only once a year, and we need to be certified in nephrology in order to keep working at the hospital — so it was extremely important, and I was under a lot of pressure. When I noticed that the lump was growing, I knew I couldn’t ignore it and I really needed to get it checked.”

She booked a flight to Puerto Rico — where she was born, where her family resides and where she chose to take the board exam, a test she’d spent more than a year preparing for. She took her exam and visited her family.

When she returned, she immediately called her OB/GYN in Carrollton to schedule an appointment. Her physician examined the lump and referred her to the Comprehensive Breast Care Center in Carrollton for a mammogram.

Dr. Cuello was growing nervous, but even with her family far away, she knew she had friends and colleagues in Carrollton who would make sure she wasn’t alone.

Thelma Lucas, MD, was one of those friends.

She helped Dr. Cuello make the call to schedule a mammogram with Raul Zunzunegui, MD, a Susan G. Komen Fellowship-trained breast specialist who is board-certified in surgery.

To his patients, he’s known as “Dr. Z.”

“I went to see Dr. Z and he already had everything set up,” Dr. Cuello said. “After the mammogram, I asked the tech if I could see the results. When I saw it, I knew right away — cancer.”

She was immediately scheduled for an ultrasound and a biopsy with Dr. Zunzunegui.

The results of those exams confirmed her suspicion.

“Going into the biopsy with Dr. Z’s expertise, we knew that it could be malignant, or cancerous,” Dr. Cuello said. “He and I sat down in the office and he told me that it was cancer. Honestly, I broke down. Even though we already knew that it could be cancer, it’s different when you hear the words. I just took a deep breath and said, ‘Now what do we do?’”

He would design a personalized treatment plan for her.

During her next appointment with Dr. Z, just three days later, he diagnosed her cancer as Stage 1, since there were no other lesions or indication of spread.

Also, her BRCA testing came back negative, which meant that the cancer was not genetic.

Dr. Zunzunegui scheduled a few more tests at the Comprehensive Breast Care Center, including blood labs, additional imaging and a relatively new diagnostic test called a MammaPrint.

MammaPrint helps doctors determine the characteristics of early-stage breast cancer so they can assign the most effective treatment plan and determine if chemotherapy would benefit the patient to reduce chances of the cancer reoccurring once it’s been removed.

“With the MammaPrint test, breast specialists are able to develop more specific and personalized treatments,” said Dr. Zunzunegui. “It’s allowing us to identify those who need chemotherapy and the timing of surgery, before or after the chemo.  This helps us create better outcomes for our patients.”

Dr. Cuello had an aggressive form of breast cancer — a combination of ductal and lobular carcinoma — and her MammaPrint results showed that chemotherapy would be necessary.  In that case, the chemotherapy was given before the operation (neoadjuvant) to give the most crucial treatment first and more promptly.

Without it, the risk was high for the cancer to return.

However, that combination of treatments would be very effective and could completely eradicate the cancer from her body.

“Going into it, I didn’t want chemo,” Dr. Cuello said. “I didn’t want the side effects, the hair loss, the potential infertility. I was fine with as many surgeries as were needed, but I didn’t want to have chemo.”

She knew that with breast cancer, like all types of cancers, the sooner the treatment is underway, the better, so she pressed on with treatment.

“At first, I was mad and I was frustrated,” Dr. Cuello said. “But at the same time, I knew that I had to keep going. I said that it was OK to cry, but for no more than a day.”

At that time, Dr. Cuello still hadn’t mentioned anything to her family about her diagnosis, and because of the effect chemotherapy would have on her body, she would have to somehow tell many of her patients that she wouldn’t be able to see them for some time.

“I love my job, I love seeing my patients and I love going in the hospital,” Dr. Cuello said. “I wasn’t going to be able to do the thing that I love the most. That was very hard for me. It was also very hard to tell my dad. I’m usually a pretty strong person, but this — this was hard.”

Her next appointment was with Bradley Larson, MD, a board-certified medical oncologist with Northwest Georgia Oncology Centers, who would help develop her chemotherapy treatment plan.

“I didn’t want to go see Dr. Larson alone. I was still very nervous,” Dr. Cuello said. “I was so glad when Emily Massey — a certified nurse practitioner with Carroll County Nephrology — reached out and asked if I wanted her to go with me.”

At Dr. Larson’s office, there were a few questions on Dr. Cuello’s mind: Did he think her breast cancer was curable and would she lose her long beautiful hair to chemo?

“He said that I would, but I would lose the cancer at the same time — so I told him that it’s worth it,” Dr. Cuello said.

Losing her hair, she explained, paled in comparison to being rid of cancer.

Dr. Cuello started chemo the first week in November at Tanner Cancer Care’s West Georgia Infusion Center in Carrollton, and to her surprise, she was doing quite well with it — partly because she had gone into it ready to come out on the other side stronger than ever.

Coming off her board exam, a full workload seeing dozens of patients, and making plenty of rounds at the hospital every day, Dr. Cuello didn’t let cancer slow her down.

During chemo, she moved to working part-time, only seeing her patients in the office. She also often studied medical books and videos while going through treatment to keep herself sharp while she awaited a full return to her patients.

“I went through months of chemotherapy and I didn’t have many side effects, aside from some dizziness near the end and some neuropathy (a painful, numb feeling) in my legs.”

After chemotherapy ended, Dr. Cuello was scheduled for a total mastectomy with Dr. Zunzunegui in March, as well as breast reconstruction surgery with Stephen Kahler, MD, a board-certified plastic and reconstructive surgeon with West Georgia Center for Plastic Surgery, soon after.

“My last chemo treatment was Feb. 22; I’ll never forget it,” Dr. Cuello said. “I met with Dr. Kahler, another angel of mine, about a month before surgery to take my measurements and help me choose the right implant.”

Dr. Kahler reached out to schedule her reconstruction surgery in June, just days before her birthday. She was turning 34.

“I was happy because I would be done before my birthday and I could celebrate everything with my friends,” she said.

It’d been a tough road, she added, and a celebration was definitely in order — especially since she’d learned she’d passed her board-certification exam just weeks into chemotherapy.

“I was so excited. When I went back to work, all my patients, my friends and the nurses in the ICU welcomed me back with so much love,” Dr. Cuello said.

Through it all, she leaned heavily on her faith, her family and her colleagues. She said they were all a big source of encouragement, especially friends like Simone Berard, MD, an internal medicine specialist, as well as her family from Carroll County Nephrology — Myriam Ortiz, MD, Maria Orig, MD, Bryan Quinn, MD, and all the clinic’s medical assistants.

She also found comfort in her best friend, who took her to each chemotherapy treatment, as well as other close friends who were there physically or spiritually. Her patients offered support through prayer and well-wishes, and “first and foremost, my Lord, who was with me every step of the way holding me and keeping my head up into the end of the journey,” Dr. Cuello said.

“Simone was a big support — emotionally, physically, religiously, spiritually — you name it, she was there,” Dr. Cuello said. “I also had a lot of support from our medical community as well as my patients. They’d all call and visit to cheer me up when I was in for chemo.”

Dr. Ortiz even helped nudge her back onto the dating scene, where she met a wonderful gentleman whom she’s now engaged to marry in October 2020.

Now, with her cancer in remission and living life in a “new normal,” Dr. Cuello imparts a simple message to other women: get your yearly mammogram. It could save your life.

“Don’t be scared. Don’t put it off. Just do it,” Dr. Cuello said. “Sometimes being scared is our biggest obstacle. When I was going through this, some of the doctors would ask me to reach out to other patients who were afraid. I would tell them that if you never do it, you’ll never know. It can save your life. It’s all about early detection. Early detection is the key; it’s the reason I’m still alive today.”

Ready to schedule your mammogram? Visit TannerBreastHealth.org.