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When a Hoag ER Nurse Became a Patient: How a cancer diagnosis saved her life and her family

April 15, 2025

When Amy Rudder first noticed a lump in her right breast, she wasn’t concerned. At just 27, the Hoag ER nurse thought she was too young to have breast cancer. Her perspective shifted dramatically, however, after she met with Hoag OB-GYN Brooke Hargrove, M.D., who ordered an ultrasound.  

“I made the mistake of looking over during the ultrasound, and I could see it looked like a big cloud with undefined borders,” Amy said.  “I’m not a radiologist or an ultrasound tech, but I thought, ‘Oh, I don’t know about this.’ Then the tech started taking images of my armpit, and suddenly, it got scary.”  

Amy immediately received a mammogram, then a needle biopsy. The biopsy confirmed she had triple negative stage 2 breast cancer, a very aggressive form of breast cancer.  

Genetic testing through the Hoag Family Cancer Institute would later determine that Amy was a carrier of the hereditary BRCA gene mutation, which is linked to an increased risk for breast, ovarian, melanoma and pancreatic cancers.   

Following her diagnosis, Breast Surgical Nurse Navigator Lisa Fassnacht, R.N., C.R.N., C.N-B.N., scheduled Amy’s next steps.  

As one of the few healthcare organizations to feature a nurse navigator program, Hoag directly assists patients with scheduling physician appointments, insurance approvals and other details that can become barriers to accessing care. Philanthropic support plays a vital role in sustaining and expanding programs like nurse navigation, genetic counseling, early detection, and specialized cancer care, ensuring every patient receives personalized guidance and access to leading-edge services.  

When Hoag breast surgeon Heather R. Macdonald, M.D., recommended post-mastectomy reconstructive surgery, Hoag worked with Amy’s insurance company to ensure she was covered while receiving out-of-network care.  

When Amy expressed an interest in undergoing oocyte cryopreservation (egg freezing) before beginning treatment, her nurse navigator arranged the consultation for her. Louis Vandermolen, M.D., Hoag Family Cancer Institute Oncologist, Program Director of Hoag Medical Oncology, worked closely with Amy’s fertility doctors to delay her cancer treatments long enough to allow for the egg retrieval.  

“The whole team at Hoag Family Cancer Institute, especially the nurse navigators, blew my mind,” she said. “Everyone was incredible. They truly care. I have felt so connected to every one of my doctors.”  

Though aggressive, Amy’s cancer hadn’t spread beyond her breast. She underwent 16 rounds of chemotherapy until the cancer was small enough to be surgically removed by Dr. Macdonald.  

Before undergoing the reconstructive surgery, which would include a double mastectomy and tissue transfer, Amy would require a series of radiation treatments under the care of Hoag Radiation Oncologist Kevin Lin, M.D.  

Having an accessible treatment facility in Irvine in addition to Newport Beach made the process convenient for Amy, who lives in Yorba Linda. And while the treatments were challenging, the staff at Hoag Cancer Center Irvine made them easier.  

“The front desk registration team knew my name and was always so nice to me. It’s amazing how big of a difference that makes,” she said. “When I finished treatment, they gave me a diploma and little goodies. It meant so much more to me than my college diploma.”  

As part of Hoag’s Hereditary Cancer Program, a patient’s immediate family members are offered genetic counseling and screening when a risk is discovered. Tests confirmed Amy’s father and brother were also carriers of the BRCA mutation.    

Given his age, Amy’s dad, Ken Rosenberg, was enrolled in the Anita Erickson Pancreatic Cancer Early Detection Program –the first program of its kind in Southern California to assess individuals that are at greater risk for developing pancreatic cancer.  

Immediately, doctors found a small neuroendocrine tumor on his pancreas.  

While the five-year survival rate for pancreatic neuroendocrine cancers is approximately 40 percent, the prognosis improves when caught early. Amy said her father’s enrollment in the monitoring program likely saved his life.  

“He would have never known otherwise,” she said. “Who knows when he would have caught it?”   

Amy’s brother is also enrolled in cancer screening programs at Hoag, including prostate screening.  

Reflecting on her journey, Amy’s gratitude and appreciation for Hoag began long before her diagnosis—when she was fielding job offers from several hospitals. Hoag was an easy choice.   

“You want to work at a place where you’d want to be treated. I always knew I wanted to be at Hoag,” she said. “I knew if I ever needed to be treated for something it would be at Hoag. That guided my decision.” 

Tags: Story,Cancer,Women's Health

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