A Team Approach to Advanced Breast Cancer

Kristen Vengler received collaborative, personalized care at Scripps during pandemic

A mature woman in lavender clothing, walks along La Jolla shores and is happy about her breast cancer care at Scripps.

Kristen Vengler received collaborative, personalized care at Scripps during pandemic

Less than a year after she moved just minutes away from Scripps Cancer Center, Kristen Vengler learned she had breast cancer.

“I was born and raised in San Diego, moved to Austin, got married, raised my son, and came back 26 years later,” says Kristen. “I landed literally six miles from Scripps in La Jolla.” Little did she know she would spend much of the next year there.

Kristen, 57, noticed while showering that her nipple felt “kind of numb” and saw a dimple in the skin beneath it. After having a mammogram, ultrasound and biopsy, Kristen was diagnosed with stage 3B cancer – an advanced cancer that had spread to her lymph nodes. Though she had a family history of cancer, this one wasn’t genetic.

“I spent my whole life being afraid of ovarian cancer because my mom had it, and doing everything I could to avoid it, and ended up with breast cancer instead,” she says. 

Cancer during COVID-19

Cancer during COVID-19

“I had stage 3B cancer and I really didn’t think I was going to make it, but these people saved my life.” 

Kristen Vengler, breast cancer patient

Kristen was diagnosed in December of 2020, when the COVD-19 pandemic was in full swing. “It was such a crazy year already, and I felt like, of course this is happening now,” she says. “I grabbed a pencil and paper and went into automatic action mode.”

Kristen’s nurse navigator coordinated the additional diagnostic tests and treatments she would need. The next few weeks were a blur of appointments, including a port placement, an MRI and echocardiogram. After consulting with the rest of her team, Kristen’s doctor, Sonia Ali, MD, a medical oncologist and hematologist at Scripps Cancer Center and Scripps Clinic, recommended starting with chemotherapy to shrink the tumor before surgery.

“I was starting chemo on a Monday and the chemo pharmacist called the Friday before to review the medications. It was super helpful because she guided me through what to expect and what I could do for nausea and all of that,” Kristen says.

Because of COVID restrictions, Kristen could not have anyone accompany her to chemo treatments, and it wasn’t easy to go through alone. Then a friend from Texas told Kristen she was starting a podcast company and asked Kristen to share her experiences in real time.

“After that first chemo treatment, I did a Zoom with my friend and was talking about what happened during chemo and what that day entailed,” she says. “I think it helps people to hear about someone else going through the same things they’re going through.” The Breast Cancer Stories podcast has already helped hundreds of women and their families all over the world.

Collaborative, personalized care

Kristen completed five months of chemotherapy in June of 2022, and Louis Rivera, MD, a surgical oncologist at Scripps Cancer Center, performed a double mastectomy later that month. The 3.5 cm tumor and several lymph nodes were successfully removed. At the same time, Salvatore Pacella, MD, a plastic surgeon at Scripps Clinic Del Mar and Scripps Clinic Rancho Bernardo, began the reconstruction preparation.

“What I love most about cancer care is the opportunity to create partnerships. The patient partnership is the most meaningful and rewarding. Patients face different degrees and types of challenges and Kristin’s care was a bit more complex,” says Dr. Rivera.

“I love the opportunity to work together in the operating room with other surgeons. I really enjoy working with Sal Pacella. He’s super thoughtful about how to have a safe and rewarding outcome for patients. I appreciate the opportunity to be part of the team tending to patients like Kristin,” says Dr. Rivera.

Kristen then began radiation therapy with Kenneth Shimizu, MD, a radiation oncologist at Scripps Cancer Center and Scripps Clinic, to target any remaining cancer cells, especially those in the deep lymph nodes.

She estimates she had between 30 and 35 radiation treatments.

“Kristen is a very strong woman, and she came into treatment with a fighting attitude and stayed positive throughout, which I think really helped her do really well throughout it all,” says Dr. Ali.

Dr. Pacella finished Kristen’s breast reconstruction exactly one year after her mastectomy.


“What was really amazing was the coordinated care at Scripps. I didn’t have to go find an oncologist and a surgeon and a radiation specialist and try to put all those pieces together,” Kristen says. “I had a team of specialists who all worked together and spoke so highly of each other. Everybody was top-notch.”

Kristen also appreciated the personal care she received throughout her diagnosis and treatment. “I’ve never had the level of care and compassion from a medical team like I did at Scripps. It was coming from the heart,” she says. “I had stage 3B cancer and I really didn’t think I was going to make it, but these people saved my life.” 

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