![\"Valerie](\"https:\/\/www.saintjohnscancer.org\/blog\/wp-content\/uploads\/sites\/11\/2025\/05\/Valerie-walks-with-her-doctors-at-Saint-Johns.jpg\")
This is the story of a patient whose routine breast evaluation revealed something far more complex: three synchronous cancers—two in the breast and one in the kidney—alongside a fourth mass in the ovary that required surgical clarification. <\/p>\nCancer care is rarely straightforward, but every so often a case reminds us just how essential teamwork, coordinated diagnostics, and human-centered support truly are. <\/p>\n
This is the story of a patient whose routine breast evaluation revealed something far more complex: three synchronous cancers—two in the breast and one in the kidney—alongside a fourth mass in the ovary that required surgical clarification. <\/p>\n
Her five physicians at Providence Saint John’s in the video below share this case because it reflects the power of a comprehensive, multidisciplinary model of care. <\/p>\n
Valerie first came to the Margie Petersen Breast Center after feeling a lump beneath her arm. For many patients, such a finding is frightening but often benign. In this case, it was the critical first clue. <\/p>\n
Further evaluation revealed two distinct breast cancers in the same breast: <\/p>\n “She actually had two different breast cancers in her breast. One of them — the more aggressive HER2-positive one — had gone to the lymph node.”<\/span><\/p><\/blockquote>\n<\/div>\n –Parvin Peddi, MD<\/p>\n Because HER2-positive disease can spread early, the team proceeded with a whole-body PET scan — a decision that ultimately uncovered two more abnormalities.<\/p>\n The PET scan identified:<\/strong> <\/p>\n These findings created immediate concern. Were these new cancers? Or had the HER2-positive breast cancer spread beyond the breast and lymph nodes? <\/p>\n “Because one cancer had already gone to the lymph node, we couldn’t assume the kidney or ovary were benign. They could have been metastatic or completely different cancers. We had to treat each one until proven otherwise.”<\/strong> <\/em><\/p>\n This marked a turning point in Valerie’s care — shifting from a single diagnosis to a complex multidisciplinary evaluation. <\/p>\n HER2-positive breast cancer can be highly responsive to modern therapy. Valerie began multi-agent chemotherapy combined with HER2-targeted treatment. <\/p>\n Dr. Peddi emphasized the benefit of treating upfront: <\/p>\n After several months of therapy, breast surgical oncologist Dr. Janie Grumley<\/a> performed Valerie’s breast-conserving surgery. The results were extraordinary. <\/p>\n “The more aggressive cancer was gone — no trace of it in the breast or lymph node. That’s the best response we can hope for,” Dr. Grumley shared. <\/p>\n The smaller tumor was completely removed at surgery. <\/p>\n Next, attention turned to the kidney mass. Biopsy results were inconclusive — not unusual for renal tumors — so urologic surgeon Dr. Jennifer Linehan<\/a> evaluated the lesion further. <\/p>\n She explained how kidney cancers often behave: <\/p>\n Once Valerie completed her breast surgery and was safe to proceed, Dr. Linehan performed a robotic partial nephrectomy, removing the mass while preserving more than 85% of her kidney. <\/p>\n Pathology confirmed what the team had suspected: The kidney mass was a third, completely separate primary cancer — not metastasis. <\/p>\n This significantly changed the patient’s long-term outlook. <\/p>\n Still, Dr. Park emphasized the importance of certainty: <\/p>\n “Given her complex oncologic history, we didn’t want to leave any potential stones unturned.”<\/strong> <\/em><\/p>\n She performed a minimally invasive laparoscopic removal. Pathology confirmed a benign fibrothecoma — the final missing piece of the diagnostic puzzle. <\/p>\n Undergoing surgery or treatment for even one cancer is emotionally taxing. Learning of three separate cancers over a short period can be overwhelming. <\/p>\n![\"Her2](\"https:\/\/www.saintjohnscancer.org\/blog\/wp-content\/uploads\/sites\/11\/2025\/12\/Her2-Positive-Breast-Cancer.jpg\")
<\/figcaption><\/figure>\nHER2-Positive Breast Cancer<\/h4>\n
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Estrogen Positive Breast Cancer<\/h4>\n
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\nA Full Body PET Scan Reveals Two More Masses<\/h3>\n
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<\/div>\nTreating the Most Urgent Threat First<\/h3>\n
![\"Dr.](\"https:\/\/www.saintjohnscancer.org\/blog\/wp-content\/uploads\/sites\/11\/2025\/12\/Dr.-Janie-Grumely-explains-why-chemotherapy-may-be-needed-before-surgery.jpg\")
A Third Cancer Revealed: The Renal Mass<\/h3>\n
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Clarifying the Ovarian Mass<\/h3>\n
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Supporting the Whole Person Through a Complex Journey<\/h3>\n
![\"Dr.](\"https:\/\/www.saintjohnscancer.org\/blog\/wp-content\/uploads\/sites\/11\/2025\/12\/Dr.-Shanthi-Gowrinathan-describes-the-emotional-toll-cancer-can-have.jpg\")