When we first met Sarah in 2019, she was 30 years old and had received two kinds of life-changing news all in the span of a single week. Since that time, she has continued to juggle work, school, marriage, motherhood, and breast cancer. This is her story.
2019 was off to a hot start.
I was finishing up my master’s in nursing to become a nurse practitioner and working part-time as an oncology nurse. My husband and I also had big hopes for starting a family soon.
Things escalated quickly after I felt a lump in my left breast. My fear quickly became a reality when the radiologist confirmed I had DCIS.
I remember receiving the call and not being able to comprehend the letters DCIS. “Ductal Carcinoma in Situ. Breast Cancer,” she repeated. Tears were streaming down my face. I was having trouble catching my breath and was shaking like a leaf. My husband and mom met me at home and held me while I cried.
At first, I wasn’t sure how I could go to work and care for my oncology patients. Finding separation between their journey and mine was so hard.
Then, literally three days later, the most beautiful thing happened: We found out we were expecting our first baby.
I could feel my whole energy shift. My initial feelings of shock, fear, anger, and grief shifted towards hope, determination, and refusal to let my diagnosis define me.
Fighting for a family of three
I was fighting for myself, my family, and, most importantly, my sweet baby.
At 21 weeks pregnant, our miracle baby helped us successfully get through a left mastectomy without complications. The post-op pain and irritation of my breast expander got easier over time. Knowing we would soon be a family of three kept me going—one foot in front of the other.
I feel lucky my DCIS was managed surgically. The hope was that this would be “one and done.” We chose mastectomy after many discussions with my surgical oncologist because there simply wasn’t evidence to support lumpectomy during pregnancy, waiting six months to start radiation post-partum, and then beginning hormonal therapy.
My situation was unique—so many women have unique situations, though—right? It’s rarely black and white. My hope is that women, including my patients, feel empowered to be a part of their treatment plan. Having conversations with our healthcare teams about what is important to us can help providers recommend the most individualized plan of care.
It wasn’t always pretty. There were many tears but setting realistic goals helped get me through. It was definitely survival mode. Work, work, school, study, exercise, doctors’ appointments, work, work, school, and so on. Baby kicks, family, the best friends in the entire world, neighbors, coworkers, and home-cooked meals were a recipe for success.
Our beautiful baby girl, Jane Katherine, arrived October 11, 2019. How fitting that she made her debut during Breast Cancer Awareness Month. She is the fiercest light we have ever known and is the sweetest, most loving, giggly, 2-year-old.
A mother’s love and a woman’s wisdom
I was able to breastfeed Jane from my right breast, which was very important to me. I also started my new career as a Medical Oncology Nurse Practitioner, but being a mom was—and is—my favorite title.
I had a decent amount of ongoing discomfort from my breast expander and was thankful to see this go when it was time for breast reconstruction.
My initial surveillance imaging was all clear, showing only benign breast changes. “Scanxiety” is no joke. I think we all literally hold our breath until we get those imaging results. The fear of recurrence is something I think most cancer survivors deal with and likely suppress quite often.
Fast forward to this past summer. Life was good! My work-life balance was a beautiful thing. Jane was a blast. Ethan and I were expecting our second little love.
As my body changed with pregnancy, so did my left breast and scar tissue. I started questioning myself: “Is this always how my scar tissue felt? Is this a new lump? No way! Don’t be crazy.” But I hadn’t had my routine surveillance imaging because I was pregnant. Mammograms and MRIs are not typically recommended during pregnancy from a risk-benefit standpoint, but exceptions can be made.
Return of “my least favorite letters in the alphabet”
I remember laying there, super pregnant and uncomfortable, with the ultrasound probe searching for any suspicious findings in my breasts. Nothing showed up but my radiologist said, “Just to be safe, let’s get a mammogram.” My belly was heavily protected with lead shields and off I went.
Through divine intervention and four biopsies, stubborn little calcifications were found: three specimens consistent with lactation changes, and one with my least favorite letters in the alphabet, DCIS.
The cancer was found beneath my remaining nipple where a small amount of breast tissue remained post-mastectomy. Words simply cannot express how thankful I am for my doctor’s persistence, vigilance, and patience. She made me feel comfortable and hopeful when it seemed impossible.
Again, we found ourselves in survival mode. Our priority was to have a healthy baby. Ellen Anne was born November 5, 2021. She is our little angel!
When Ellen was four weeks old, I had a lumpectomy and am thankfully cancer-free again.
Juggling many doctor’s appointments with a newborn was super stressful. One thing that made life a lot easier was a hands-free breast pump. Being able to pump while driving or in doctors’ offices sitting in waiting rooms was a game-changer.
Finding strength in the present and hope for the future
One of the hardest things to cope with regarding my recurrence was the notion that we may not be able to have more kids.
I feel incredibly lucky to have a wonderful relationship with my medical oncologist, who has provided the guidance we needed. Not only is she a colleague, but she’s a brilliant physician who advocates for each of her patients. She helped develop an individualized plan of care for my family and me.
I am thankful to have breastfed Ellen for a few months before starting Tamoxifen with the goal to prevent a new breast cancer in my remaining breast. My doctor has given us hope that we can continue to have children, if we choose.
This experience has helped me find clarity in who I am as a young woman:
- Strength, I didn’t know I had
- Inner peace, I have strived to find through years of anxiety
- Joy, in the day-to-day organized chaos we call motherhood
- Thankfulness, for my loving husband, family, and friends
- Appreciation, for each and every member of my medical team. Healthcare is an art. It should embody compassion, empathy, brilliance, patience, tolerance, bravery, and resilience.
I hope I can provide my patients with the same care I have been shown over the past three years. This journey has taught me many invaluable life lessons. I have learned to stay confident, listen to my body, lean on my biggest supporters, and never, ever give up hope.
My girls and my husband Ethan have been my light through some dark and scary days. Terrifying, in fact. But I’m here, cancer-free, living with grace and a fierceness I didn’t know I had.