When Melissa Smith became a patient at Hoag, a personalized breast screening recommendation saved her life and her children’s future.
Following the sudden loss of her husband Danny, great-grandson of George and Grace E. Hoag, Melissa Smith found herself facing new realities—raising two young children on her own while navigating overwhelming grief. Everyday tasks felt insurmountable.
But as a newly single mother and a member of the family whose legacy of philanthropy helped build one of the region’s most trusted healthcare systems, she knew she had to prioritize her health. That’s when her annual breast screening became a lifesaving turning point.
During a routine mammogram, Hoag radiologist and Medical Director of Breast Imaging at the Hoag Breast Center, January Lopez, MD, suggested something new. “She told me that because I have dense breasts and some family history, I should consider getting a breast MRI,” Melissa recalled.
Melissa almost didn’t make the appointment but reminded herself, “I have no other option than to make sure I’m okay.”
The decision may have saved her life.
In late March 2025, her MRI revealed something her mammogram couldn’t see—invasive lobular carcinoma (ILC) in her right breast. The second-most common type of invasive breast cancer, ILC often evades detection until a late stage because it can be difficult to feel and can hide beneath the normal breast tissue on mammograms.
The diagnosis was shocking. “I remember thinking, this can’t be right. How could I have a clear mammogram in December and cancer in April?”
“There was a connection I felt with my husband in that moment,” she said, “of guidance, of being at Hoag and being a part of this family.” Melissa had witnessed firsthand the transformative power of philanthropy at Hoag. Now that legacy would impact her own personal journey.
Melissa became a patient of fellowship-trained Breast Surgeon and Medical Director of the donor-funded Hoag Early Risk Assessment Program (HERA), Heather Macdonald, MD, and after careful assessment of her options, decided to undergo a bilateral mastectomy.
The procedure took place on April 23, 2025—her mother’s birthday. “Dr. Macdonald told my mom, ‘We’re giving you your daughter cancer-free for your birthday,’” Melissa said.
The decision to remove both breasts may have been lifesaving, as pathology revealed there were also many precancerous cells in her left breast. Fortunately, her cancer hadn’t spread beyond her breast tissue.
Even during surgery, her care team celebrated with her. “Dr. Macdonald told me they had a little dance party in the OR when they found out my lymph nodes were clear.”
Today, Melissa doesn’t need chemotherapy or radiation. Instead, she continues hormone suppression therapy and is scheduled for reconstructive surgery later this year.
Being treated at the hospital her husband’s family helped build is an experience Melissa struggles to put into words. “I feel incredibly blessed to have the support that I have. Every time I go to a Hoag event, I cry. The compassion, the innovation, the people—it’s unlike any other hospital,” she said. “Dr. Lopez’s recommendation saved my life. It saved my kids’ lives because they still have their mom. It saved all of us.”
Now, Melissa is determined to turn her experience into advocacy. She shares her story openly with friends, encouraging them to talk to their doctors about their breast health. “Early detection really does save lives,” she said. “If I hadn’t made that phone call, if I hadn’t gone in for that MRI, who knows when this would have been found?”
As a licensed clinical social worker and long-time mental health advocate, Melissa sees this as a new chapter in her life’s work. “My whole career has been about helping others,” she said. “Now I get to do that in a new way—by encouraging women to take their health seriously, be proactive, and never ignore that voice inside that says, ‘Take the next step.’”
Women interested in learning more about their breast cancer risk can connect with the Hoag Breast Center to find out if supplemental screening may be right for them. Thanks to the Hoag family’s legacy of support and generous donors throughout the community, Hoag is committed to ensuring every woman has access to early detection technology.
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