I cannot believe it is 2018, another year of survivorship is upon us, with new resolutions, new goals, inspiring ambitions, and when the holiday cheer winds down and the excitement wears off, I realize I’m still just taking it one day at a time, and that’s OK. I fall into the category like most people around this time of year; I set new health and fitness goals, still trying to lose the “chemo” weight I put on last year, planning new financial goals, striving to be kinder each day, and to laugh more. But as the weeks go on, the overzealous plans to make this the best year ever starts to fade away like a dream. I was doing the 2017 inventory of everything I’ve been through in 2017: 12 months of chemo therapy (multiple drugs) 1 surgery 6 weeks of radiation And just a few weeks ago, I finished my last round of the oral chemo drug, Xeloda . Now that I am finished with one drug, it is time to look ahead and start taking others! As I head into 2018 I am looking at 10 years of hormonal therapies and shots , infusions to counter bone decay and osteoporosis, and additional meds to assist with joint pain, fatigue, mental health, the list goes on. The only way I can describe this is that I am 36 years old on the outside but 80 on the inside, but I’m grateful! I am alive and thriving! Can you relate? Among the breast cancer community, I hear a lot of people saying this is the “new normal” and we need to learn to live with lymphedema (or being at risk for it for the rest of our lives!), joint pain, the fear of recurrence, quarterly diagnostic testing, mammograms, CT Scans, MRI’s etc. Unfortunately, we were the ones indoctrinated (not by choice) into a lifelong club, but don’t get me wrong, the pink sisterhood is a bond like no other and for that I am grateful. While the initiation process into this “club’ is grueling, the perspective gained makes the fight worth it! Cancer has actually made me a better person! Instead of focusing on what I cannot do and settling for the “new normal”, I am approaching 2018 as my year of REDISCOVERY . Rediscovering the things that matter most Rediscovering the activities I enjoy doing Rediscovering the foods I enjoy tasting (now that my taste buds have returned) Rediscovering how I can take a devastating experience and make a difference. Follow me on my rediscovery in 2018! There is so much more to learn about breast cancer and while I have gone through the traditional steps of chemo, surgery, and radiation, no one has given me the road map for what happens next. While several amazing women with inner strength have gone down the path of survivorship for 5 years, 10 years, and decades, understanding how being diagnosed with breast cancer manifests in terms of longterm treatment continues as rollercoaster ride; I am so glad you are on this journey with me! What have your experiences been like? I’d love to hear from you! Share Your Story .

Lobular breast cancer, also known as invasive lobular carcinoma (ILC) , is a type of breast cancer that originates in the milk-producing lobules of the breast. Distinguished from the more common invasive ductal carcinoma (IDC), which begins in the milk ducts, ILC typically presents with a unique pattern of spread and growth. ILC is the second most common form of breast cancer and accounts for about 10% to 15% of all breast cancers . Most commonly diagnosed in older women, although it can occur at any age, ILC is often challenging to detect due to its diffuse nature. The treatment and prognosis for lobular breast cancer generally align with other types of breast cancer, involving a combination of surgery, radiation, chemotherapy, and hormone therapy, depending on the individual case.  Continue reading to learn how lobular breast cancer is different from other forms of breast cancer , its connections with genetic mutations, and how ILC is diagnosed and treated. How is Lobular Breast Cancer Different From Other Subtypes of Breast Cancer? Invasive lobular carcinoma (ILC) is a type of breast cancer that is recognized as biologically distinct from the more common invasive ductal carcinoma (IDC).  ILC is distinct from other forms of breast cancer in several ways: Cellular characteristics:  ILC is characterized by the loss of the cell adhesion molecule E-cadherin, leading to discohesive cells that proliferate into single-file strands. This unique growth pattern contributes to the difficulty in detecting ILC using standard imaging techniques​. Hormone receptor status:  ILC tumors are often estrogen receptor- (ER) positive, affecting treatment choices and responsiveness​. Metastatic patterns:  Unlike ductal carcinomas that form distinct lumps, ILC grows in sheets throughout the breast tissue ,  making tumors more challenging to detect. It ’s also more likely to be multifocal (occurring in multiple sites) and bilateral (occurring in both breasts). What Genetic and Molecular Factors are Associated With Lobular Breast Cancer? ILC often exhibits specific genetic mutations and molecular features distinct from IDC. For example, mutations in the CDH1 gene are commonly associated with ILC, which can affect how cells adhere to each other. Several genetic and molecular factors have also been linked to ILC, including TP53, PIK3CA, FOXA1, ZNF703, FGFR1, and BCAR4. These factors contribute to the unique molecular characteristics of ILC and may have implications for its development and progression. Here’s an overview of these factors: TP53 mutations:  TP53 is a tumor suppressor gene that plays a crucial role in preventing the growth of cancer cells. Mutations in TP53 have been associated with ILC. TP53 mutations can lead to the loss of its tumor-suppressing function, allowing cancer cells to proliferate more rapidly and evade cell cycle checkpoints. PIK3CA mutations:  PIK3CA is a gene involved in the PI3K/AKT/mTOR signaling pathway, which regulates cell growth and survival. Mutations in PIK3CA are common in various cancer types, including ILC. These mutations can activate the pathway, promoting cell growth and survival. FOXA1 expression:  FOXA1 is a transcription factor that plays a role in hormone receptor signaling. ILC often exhibits high levels of FOXA1 expression. This can influence the behavior of hormone receptor-positive ILC and its response to hormone therapy. ZNF703 amplification:  Amplification of the ZNF703 gene has been observed in some cases of ILC. ZNF703 is involved in gene regulation and may contribute to the growth and progression of ILC. FGFR1 amplification:  Amplification of the FGFR1 gene has also been associated with ILC. FGFR1 is a receptor tyrosine kinase that can promote cell proliferation when amplified. BCAR4 expression:  BCAR4 is a long non-coding RNA (lncRNA) that has been linked to the progression of ILC. It may play a role in the invasive behavior of ILC cells. These genetic and molecular factors can interact and influence the biology of ILC, making it distinct from other breast cancer types, such as invasive ductal carcinoma (IDC). Understanding these molecular characteristics is important for tailoring treatment strategies for individuals diagnosed with ILC. In practice, the presence of specific mutations or molecular alterations in ILC tumors may guide treatment decisions. For example, hormone receptor-positive ILC may respond well to hormone therapy, while targeted therapies that inhibit pathways like PI3K/AKT/mTOR may be considered for cases with PIK3CA mutations. Additionally, ongoing research continues to explore these molecular factors and their potential as therapeutic targets for ILC. How Is Lobular Breast Cancer Detected? Detecting ILC poses significant challenges given its unique characteristics, including the following challenges: Mammography limitations:  Since ILC does not usually form distinct masses, it may not appear on mammograms, or it may appear as asymmetrical tissue thickening rather than a distinctive mass. For this reason, ILC can be more challenging to diagnose early. Know what to look and feel for, especially changes in breast shape or texture and mild, diffuse pain. Pay attention to subtle changes and always report them promptly to your doctor. Breast ultrasound:   Ultrasound imaging may be used in conjunction with mammography to evaluate areas of concern in the breast. It can help distinguish between solid masses and cysts and provide additional information about the characteristics of a lesion. MRI as a superior modality:  Magnetic resonance imaging (MRI) is an exceptionally sensitive technique for detecting ILC, showcasing an impressive sensitivity range of 94% to 99%. The high level of accuracy is due to MRI’s advanced imaging capabilities, which are adept at discerning the distinct and often subtle tumor characteristics unique to ILC.  Unlike other imaging modalities, MRI excels in providing detailed images of the breast tissue , enabling it to detect ILC’s atypical growth patterns and diffuse spread, which traditional methods like mammography might miss. MRI’s superior imaging proficiency in identifying the intricate and distinct features of ILC enhances the accuracy of diagnoses, ensuring earlier and more effective treatment interventions. What Treatment Is Available For Lobular Breast Cancer? When caught early, ILC generally has a similar prognosis to invasive ductal carcinoma . Surgery is often the first line of treatment, followed by radiation, chemotherapy, hormone therapy, or targeted drugs as needed. The following procedures and therapies are medical options during ILC treatment: Surgery:  Often the first line of treatment, which may include lumpectomy or mastectomy, coupled with an evaluation of lymph node involvement​. Lumpectomy:  This involves the removal of the cancerous tumor along with a margin of surrounding healthy tissue. It is an option for early-stage lobular breast cancer. Mastectomy: In some cases, a mastectomy, which is the removal of the entire breast, may be recommended. This decision depends on factors such as the size of the tumor, its location, and individual preference. Sentinel lymph node biopsy or axillary lymph node dissection:  During surgery, a sentinel lymph node biopsy or axillary lymph node dissection may be performed to determine if the cancer has spread to nearby lymph nodes. Radiation therapy:  Typically used post-surgery to target any residual cancer cells in the breast and surrounding areas​. Chemotherapy:  Used to kill cancer cells throughout the body, either before surgery to shrink the tumor or after surgery to eliminate remaining cancer cells​. Targeted therapy:  Involves treatments that specifically target the characteristics of cancer cells, with a reduced likelihood of harming healthy cells​. Antihormone therapy:  Especially effective in ILC due to its high ER positivity, this therapy reduces estrogen levels in the body, thereby inhibiting the growth of breast cancer cells​. Endocrine therapy:  Favored due to ILC’s low chemosensitivity and reduced pathological response rates to chemotherapy​. Count On Us for Information, Resources, and Support  Understanding lobular breast cancer is crucial for effective diagnosis and treatment. Support for ongoing research and awareness initiatives is vital.  Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, etc., and podcasts  that feature professionals, advocates, and caregivers who share valuable information. Your donations  enable SurvivingBreastCancer.org , a community dedicated to empowering those affected by breast cancer with knowledge, understanding, and a network of care, to offer resources and support every day, every month, and every year. Note: This article is designed to provide general information and not replace professional medical advice. Always discuss your options with your healthcare provider. Lobular breast cancer stories from the SBC community: My Lobular Breast Cancer Story: Not a “Journey” Energy Healing from Lobular Breast Cancer From Diagnosed To Advocate On the Podcast: Breast Cancer Conversations Inflammatory and Lobular Breast Cancer: Patient Advocates Share SABCS Insights SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Breast cancer is one of the most common cancers worldwide, affecting millions of individuals annually. Understanding breast cancer stages  is crucial for patients and their loved ones to make informed decisions about treatment and prognosis. This article delves into what breast cancer is, explains the stages of breast cancer , and provides details about symptoms, treatments, and survival rates at each stage. What Is Breast Cancer? Breast cancer  occurs when abnormal cells in the breast grow uncontrollably. These cells often form tumors, which can be benign (non-cancerous) or malignant (cancerous). Malignant tumors have the potential to spread to other parts of the body through the lymphatic system or bloodstream. While breast cancer is most common in women, individuals of any gender can develop the disease. Early detection is vital for improving outcomes, which underscores the importance of understanding breast cancer staging . How Breast Cancer Is Staged The breast cancer staging  system helps doctors assess the size of the tumor, whether it has spread to lymph nodes, and if it has metastasized to distant organs. This information is critical for determining treatment options and predicting outcomes. The stages range from 0 to IV, with subcategories that further detail the cancer’s characteristics. The stages are based on the TNM system: T (Tumor):  Size and extent of the primary tumor. N (Node):  Whether cancer has spread to lymph nodes. M (Metastasis):  Whether cancer has spread to other parts of the body. Detailed Overview of the Stages of Breast Cancer Stage 0: Ductal Carcinoma In Situ  (DCIS) What It Is:  Stage 0 breast cancer is non-invasive . The cancer cells are confined to the ducts of the breast and have not spread to the surrounding tissue. Symptoms:  Typically asymptomatic and often detected through mammograms. Treatment:  Surgery (lumpectomy or mastectomy) followed by radiation therapy. Hormone therapy may also be recommended for hormone receptor-positive DCIS. Survival Rate:  Nearly 100% when treated early. Learn more about the continuum of breast cancer care  and how early intervention improves outcomes. Stage I: Early-Stage Invasive Breast Cancer What It Is:  Cancer has begun to invade nearby breast tissue but remains small (up to 2 cm) with minimal or no lymph node involvement. Symptoms:  May include a lump in the breast, nipple discharge, or skin changes. Treatment:  Surgery (lumpectomy or mastectomy) with possible sentinel lymph node biopsy. Radiation and hormone therapy are common, and chemotherapy may be considered. Survival Rate:  The 5-year survival rate for stage I is approximately 99% . Stage II: Larger Tumors or Limited Spread to Lymph Nodes What It Is:  Tumors range from 2 to 5 cm or involve 1 to 3 lymph nodes. Symptoms:  Noticeable lumps, breast swelling, or skin dimpling. Treatment:  Surgery is often combined with chemotherapy, radiation therapy, and hormone therapy for hormone receptor-positive cancers. Survival Rate:  The 5-year survival rate for stage II remains high at about 86%-99% . Explore ways to   reduce the risk of recurrence  after treatment. Stage III: Locally Advanced Breast Cancer What It Is:  Cancer has spread to 4 or more lymph nodes or invaded the chest wall or skin. Tumors may be larger than 5 cm. Symptoms:  Significant breast changes, such as redness, swelling, or skin ulceration. Treatment:  Treatment usually begins with chemotherapy to shrink the tumor, followed by surgery and radiation therapy. Targeted therapies may also be used for HER2-positive cancers . Survival Rate:  The 5-year survival rate for stage III is approximately 86% . For those with aggressive subtypes like triple-negative breast cancer , emerging therapies offer hope. Learn more here . Stage IV: Metastatic Breast Cancer What It Is:  Cancer has spread to distant organs such as the bones, liver, lungs, or brain. Symptoms:  Symptoms vary based on the location of metastasis and may include bone pain, fatigue, and difficulty breathing. Treatment:  While stage IV breast cancer is not curable, treatment focuses on prolonging life and managing symptoms. Options include systemic therapies like chemotherapy, targeted therapy, hormone therapy, and immunotherapy. Survival Rate:  The 5-year survival rate  for stage IV is about 31% , but individual outcomes vary widely. Key Takeaways on Survival Rates and Recurrence Early detection improves prognosis significantly, with stage 0 and stage I having survival rates close to 100%. Breast cancer recurrence rates increase by stage, highlighting the importance of vigilant follow-up care. Advancements in treatment, such as immunotherapy  and targeted therapies, continue to improve outcomes across all stages. Visit SurvivingBreastCancer.org  for resources, support, and updated information on managing breast cancer at every stage. Symptoms to Watch For Knowing the signs of breast cancer is essential for early detection. Common symptoms include: A lump or thickening in the breast or underarm Changes in breast size, shape, or appearance Nipple discharge, particularly if it is bloody Breast pain or tenderness Skin changes, such as redness, scaling, or dimpling Treatment Advancements and Emerging Trends Treatment strategies for breast cancer have evolved significantly, incorporating cutting-edge technologies and personalized medicine. For aggressive cancers, such as metastatic triple-negative breast cancer,   emerging therapies  offer new hope. Additionally, support networks play a vital role in helping you navigate the physical and emotional challenges of treatment. Explore resources such as SurvivingBreastCancer.org ’s weekly support groups . Understanding breast cancer stages  empowers you to take control of your health and advocate for the best possible care. From early detection to advanced treatment, knowledge is a powerful tool in the fight against breast cancer. By staying informed about the stages of breast cancer , recognizing symptoms, and seeking appropriate care, you can improve your outcomes and quality of life. For more information about risk reduction, treatments, and survivorship, visit SurvivingBreastCancer.org . Count On Us for Information, Resources, and Support  If you or a loved one is experiencing breast cancer at any stage, understanding the nature of the diagnosis is crucial for navigating treatment options and establishing a support plan. Speaking with healthcare professionals, connecting with cancer support groups , and educating yourself can provide comfort and empowerment. Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on us to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, etc., and podcasts  that feature professionals, advocates, and caregivers who share valuable information. Your donations  enable SBC, a community dedicated to empowering those affected by breast cancer with knowledge, understanding, and a network of care, to offer resources and support every day, every month, and every year.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read More: Ductal Carcinoma in Situ (“Stage Zero” Breast Cancer): What You Need To Know Invasive vs. Non-Invasive Breast Cancer: Key Differences and What They Mean The Promise of the Triple Negative Breast Cancer Vaccine Metastatic Triple-Negative Breast Cancer: Emerging Therapies Deliver Hope Metastatic Breast Cancer: Understanding the Significance of Stage IV Advances in Immunotherapy: A New Frontier in Breast Cancer Treatment On the Podcast: Breast Cancer Conversations The Role of Advanced Imaging in Breast Cancer Diagnosis and Treatment Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Understanding connections between breast cancer and seemingly unrelated symptoms like back pain is crucial for early detection and effective intervention for those diagnosed with breast cancer. Dr. Yolanda Tammaro , a board-certified general surgeon with distinguished fellowship training in breast surgery, offers insight into the potential link between breast cancer symptoms  and back pain.  Continue reading to learn about the possible links between breast cancer and back pain, how back pain is diagnosed and treated, and tips for managing back pain with breast cancer. Exploring the Connection Between Breast Cancer and Back Pain While back pain is not typically an early sign of breast cancer, it can be a concerning symptom in the later stages of the disease due to bone metastasis, tumor location, or treatment-related side effects. As breast cancer progresses to an advanced or metastatic stage (stage 4) , it can spread to other parts of the body, including the bones. When breast cancer spreads to the bones, it can weaken the bones and cause pain or even fractures  in the ribs, spine, and hips. According to Dr. Tammaro, this bone metastasis of breast cancer can ultimately lead to back pain. In some cases, a breast cancer tumor can directly press on the spinal cord or surrounding tissues in the back, causing direct back pain. Additionally, certain medications and therapies used to treat breast cancer, such as hormonal therapies like Faslodex and Femara, and chemotherapy drugs like Novantrone, can potentially cause back pain as a side effect. Back Pain Symptoms Accompanying Breast Cancer Those with a breast cancer diagnosis  experiencing any new or worsening pain should be evaluated by a doctor promptly. If you notice any of the following symptoms that persist for more than a few days, you should seek medical attention: Persistent or severe back pain Back pain accompanied by other breast cancer symptoms, such as a breast lump, nipple discharge, or changes in breast appearance Back pain along with fatigue, nausea, constipation, irritability, thirst, or confusion Headaches, dizziness, or seizures Shortness of breath Jaundice or abdominal swelling Diagnosing and Treating Back Pain with Breast Cancer If you are experiencing back pain, especially in conjunction with other concerning symptoms or a prior breast cancer diagnosis, Dr. Tammaro recommends that you undergo several diagnostic tests. A physical examination can help identify the nature and location of the back pain. Imaging tests like X-rays, CT scans, MRI, or bone scans can reveal if there are any abnormalities, fractures, or lesions in the spine or other bones that could indicate metastatic spread from breast cancer.  Blood tests can also provide clues, as elevated levels of certain biomarkers like alkaline phosphatase or calcium may signal bone metastasis. If the imaging tests show a suspicious area, a biopsy of the spine or other affected bone may be performed to definitively differentiate between a benign cause and cancerous lesions from metastatic disease. Clinical History and Breast Cancer-Induced Back Pain In cases where an individual has a known breast cancer diagnosis, their clinical history is also a key factor. Dr. Tammaro shares that physicians will consider the breast cancer type, stage, previous treatments, and any new or changing symptoms holistically. Sudden onset of severe back pain in someone with metastatic breast cancer would raise high suspicion for disease progression, compared to someone with no cancer history presenting with typical musculoskeletal back pain. “Breast cancer patients experiencing back pain from metastatic disease face a complex array of physical and emotional challenges,” says Dr. Tammaro. “In my practice, I firmly believe that a multidisciplinary treatment approach provides the most comprehensive and effective way to alleviate their suffering.” By integrating conventional therapies like targeted chemotherapy, radiation, and bone-modifying agents with complementary modalities such as massage, acupuncture, and mindfulness practices , Dr. Tammaro shares, you can holistically address not just the cancer itself, but also the debilitating pain symptoms.  Tips For Managing Back Pain with Breast Cancer Dr. Tammaro recommends taking a multidisciplinary approach to managing back pain. Some tips for managing back pain associated with breast cancer include: Staying active with gentle exercise  and stretching, as tolerated, to reduce stiffness and improve mobility Applying hot or cold packs to the painful areas to provide temporary relief Maintaining a healthy diet  with adequate calcium and vitamin D to support bone health Considering complementary therapies like massage, acupuncture, or yoga  to help relax the muscles and promote healing Practicing relaxation techniques such as deep breathing, meditation , or guided imagery Following instructions carefully when using medications for pain relief, whether over-the-counter or prescription, to avoid interactions with cancer treatments Consulting a physical therapist  for specific exercises and postural advice to ease back strain Using supportive devices like braces or orthotics to stabilize the spine Seeking emotional support from counselors, therapists, or cancer support groups  to cope with chronic pain Communicating openly with your cancer care team about the severity and nature of your back pain to adjust treatment plans as needed Combining medical interventions with self-care strategies and alternative therapies can help manage breast cancer-related back pain. Note: This article is designed to provide general information and not replace professional medical advice. Always discuss your options with your healthcare provider. Learn more about Dr. Tammaro: https://www.premiersurgicalnetwork.com/dr-yolanda-tammaro/ Learn More: Tips for Pain Management with Cancer Breast Cancer Symptoms Newly Diagnosed Metastatic Breast Cancer: Understanding the Significance of Stage IV Exercise and Breast Cancer The Importance of Physical Therapy During and After Cancer Treatment SurvivingBreastCancer.org  Resources & Support: Join us for yoga, Pilates, and other mindfulness and movement programs! Weekly Support Groups On the Podcast: Breast Cancer Conversations The Benefits of Pilates for Breast Cancer Recovery

In the realm of cancer treatment, discussions about fertility preservation are often overshadowed by the immediate focus on life-saving interventions. Yet, informing patients about their reproductive options is a vital part of comprehensive cancer care. The integration of fertility preservation discussions into the care continuum is essential not only for patients' emotional well-being but also for their long-term quality of life. When patients are well-informed, they are better equipped to make decisions that align with their personal desires and circumstances, ultimately improving fertility outcomes. Listen Now on Breast Cancer Conversations Podcast: 257. What is Oncofertility? How To Navigate Genetics, Fertility and Cancer Care (click below) The Importance of Fertility Discussions During Breast Cancer Treatment Involving patients in decisions about their fertility risks and preservation options is a critical component of patient-centered care. Healthcare providers must take the initiative to ask the right questions and engage patients early in their treatment planning. Guidelines from the American Society of Clinical Oncology (ASCO) and the American Society of Reproductive Medicine (ASRM) have long advocated for informing patients at risk of infertility about their options. However, despite these recommendations being in place since 2012, a significant study conducted in 2020 revealed that only 44% of oncologists were providing this crucial information to their patients. This gap highlights a systemic issue in cancer care, where time constraints, treatment urgency, and competing priorities can lead to fertility discussions being overlooked. Yet, these conversations are essential—they offer patients a sense of control during an otherwise overwhelming time and open the door for future family-building opportunities. A Multidisciplinary Approach to Oncofertility Care Addressing the issue of fertility preservation requires a multidisciplinary team approach. Oncologists, while primarily focused on treating the cancer itself, may not have the time or specialized knowledge to cover fertility risks in depth. Involving other healthcare professionals—such as social workers, nurse practitioners, fertility specialists, patient navigators, and genetic counselors—can ensure patients receive thorough and timely information. Research shows that multidisciplinary involvement improves patient understanding. However, gaps remain, and one study found that while 60% of breast cancer patients were informed about fertility preservation, only 25% of those who met with a genetic counselor received relevant fertility information. This underscores a missed opportunity. Genetic counselors are uniquely positioned to discuss hereditary risks, reproductive planning, and fertility preservation options with patients facing complex medical decisions. Addressing Disparities in Fertility Preservation Communication Fertility preservation information is not always offered equally. Studies reveal that single women without children are more likely to receive fertility preservation counseling compared to married women or women over the age of 36. This bias can have serious implications for patients' reproductive futures. It is essential for healthcare providers to recognize that every patient—regardless of marital status, age, or perceived likelihood of childbearing—deserves access to information about fertility preservation. A standardized, equitable approach ensures that no patient is denied the opportunity to make informed decisions about their reproductive future. The Role of Tailored Resources and Genetic Counseling Patients consistently express appreciation for clear, accessible, and tailored educational resources about fertility preservation. Online materials, decision aids, and personalized counseling sessions can significantly enhance patients’ understanding and confidence. Genetic counselors, trained in delivering personalized support, can play a pivotal role. Beyond addressing inherited cancer risks, they can provide crucial guidance about fertility preservation strategies, such as egg or embryo freezing, ovarian tissue preservation, and considerations related to genetic testing of embryos. By equipping patients with individualized resources and support, healthcare teams empower them to make informed choices that align with their values and life goals. Empowering Patients Through Fertility Preservation Awareness As cancer care continues to advance, fertility preservation must remain a central focus of comprehensive, patient-centered treatment. Empowering patients with knowledge and options not only improves fertility outcomes but also supports emotional resilience, reduces future regret, and enhances overall quality of life. Fertility preservation is not merely a peripheral issue; it is a fundamental aspect of compassionate and holistic healthcare. Ensuring that patients have the information they need to shape their own futures is not just a matter of medical ethics—it is a commitment to honoring the dignity, dreams, and autonomy of every individual facing a cancer diagnosis. If you or someone you love is navigating a cancer diagnosis, ask your care team about fertility preservation options. Early conversations can make all the difference.

By Liana Reznik Everyone’s journey to a nipple tattoo is different. While some feel comfortable without having the areola and nipple present, others feel more complete with a replacement of the area. It is a personal decision that should be taken seriously. Nowadays, many women opt for breast reconstruction surgery when they are fully healed. However, surgery of any kind can still add additional pain, stress, and medical bills. There is a much less invasive alternative, known as a 3-D areola tattoo. Liana Reznik is the owner and the executive creator behind Fancy Shmancy PMU in Highland Park, IL. The studio specializes in paramedical areola 3-D tattoo, breast scar treatment, nipple & areola correction, radiation mark care, and many other permanent makeup services, with financial aid and insurance coverage offered to all clients. What is a 3-D Nipple Tattoo? While a tattoo cannot produce the projection required to be truly “3-D”, a high-quality, detailed tattoo can appear to have dimension much like a real nipple/areola. The 3-D nipple or areola tattoo is a work of art that looks like an authentic nipple. Shading, shadows, and other artistic skills make the tattoos look just like real nipples and help patients feel confident in their breasts once again. The inks used for nipple tattooing are mixed to create the most realistic appearance possible for each patient's skin. The tattoo artist strives to create a shade that resembles the patient’s original nipple and complements her natural skin tone. This is one of the reasons it is important to have a tattoo artist perform the procedure — there is an art to making each nipple unique for every patient. The Difference between 3D Tattoos and 4D Nipple Reconstruction 3D nipple tattoos refer to tattoos created in the traditional sense with tattoo ink using the colors of nipple pigment. They are designed using realistic markings to give the illusion of a realistic nipple. 4D nipple reconstruction is one step up from 3D tattoos, utilizing a surgical procedure to create hyperrealistic tattoos. They add a “fourth” dimension in the form of depth to the nipple so that it not only looks like a real nipple but feels like one. While working on helping women through my PMU art, I realize the importance of hope. Hope is something we give to each other, especially to those who may be less fortunate. As an areola tattoo artist, I am happy to support and to be of genuine use to other females to make them feel "whole" again. Nipple Tattooing vs Nipple Pigmentation Areola re-pigmentation and 3D nipple tattoos are a specialty area of medical tattooing; truly an art form of its own. Nipple tattoos can help improve the appearance of both women and men who have undergone breast surgery. 3D nipple tattooing techniques “create” a natural-looking breast after reconstruction surgery. It is a special technique of semi-permanent makeup that creates a realistic image of an areola and a nipple for breast cancer survivors. 3D nipple and areola tattoos are often used instead of nipple reconstruction surgery. As a tattoo artist, I will design and perform this semi-permanent technique to recreate a nipple. Is Scar Camouflage with Permanent Makeup Possible? Scar micropigmentation is an effective way to cover up or at least minimize the visibility of scars of different origins. By injecting pigments into the tissue, the scar or discolored patch of skin is matched to the skin surrounding it. This treatment is also possibly the best way to cover up scalp scars and has become an integral part of breast reconstruction. The result is a custom, permanent makeup solution that looks natural and gives women additional confidence in their bodies going forward. Questions to Ask Your Nipple Tattoo Artist How soon can I get my Areola Tattoo? It is safe to receive this treatment once you get a "green light" from your doctor and wait at least 6 months after the date of your final surgery for necessary healing (scar camouflage 12-18 months). How long will the procedure take? Typically, there is a one-hour consultation where the tattoo artist will often perform a patch test, discuss all of the options, and answer any questions or concerns you may have. The procedure itself takes up to three hours (depending on whether you do 1 or 2 nipples). Is the procedure painful? You may experience slight swelling and redness following the procedure and the skin may feel tight. This should improve within the first week, depending on how sensitive your skin is. Will there be any downtime following the procedure? You should be able to resume normal activities immediately following the procedure. However, avoid swimming and using a sauna or jacuzzi for two weeks after the procedure, as chlorine can act as a bleach and change the appearance of the tattoo. If using the gym within the first two weeks following your tattoo, please cover the treated area with a small amount of after cream that was provided by your artist beforehand to limit friction. Please ensure the area is cleaned afterwards. What should I do if I have a problem? Infection is very rare. If you experience any of the following symptoms, please contact your permanent makeup artist: Swelling and/or heat that doesn’t resolve in the first two days. Redness spreading from the tattoo that gets worse over a few days A fever (temperature higher than 37.5C °C / 99.5 °F) Will I have a follow-up appointment? You will typically have a follow-up appointment six to eight weeks after the initial treatment. Following an assessment, the permanent make-up artist will discuss whether further pigment is necessary. It is common to need two treatments, as the color will fade over time, and another procedure may be required to maintain the desired color. Why should I go to an Areola and Nipple Tattoo Specialist (vs a regular tattoo artist)? It can be difficult to ensure the ideal color match, shape, and size for your nipple. Nipple Tattoo Specialists have studied the skillful art of recreating a real, lifelike areola and 3D nipple down to the finest details. Now, women can have breasts that appear normal and the most realistic-looking nipples possible.

Within Breast Cancer Awareness Month throughout October, there are several specific awareness days. October 7th, for example, is "Going Flat" Day. This day recognizes the choice to go flat as opposed to having reconstructive breast surgery following a mastectomy. Additionally, some women who originally had breast reconstruction after their mastectomy may choose to have their implants removed later on. This is known as an “explant” surgery. There are numerous reasons someone may choose to go flat immediately or have their implants removed at some point. Continue reading for stories from patients who have chosen this route, the importance of using the correct language to describe your desired outcome (i.e, aesthetic flat closure ), pros and cons of going flat or removing current implants, and whether this could be a good option for you. From SurvivingBreastCancer.org Podcast Episode 48 Radical Mastectomy and Going Flat - Interview with Alicia Duncan In this episode, the surviving breast cancer team discusses Alicia’s struggle with her stage III breast cancer diagnosis and the loss of her breasts. The team highlights how a fast cancer diagnosis can take a toll on one’s mental health, along with the PTSD that may come in the aftermath of being cured of cancer. Lastly, Alicia explains her tattoos, and both Alicia and Angela discuss the strength needed to be a caregiver. Listen Now. Informed Decision Making About Going Flat In 2019, Devorah had a double mastectomy after a local recurrence. She always knew she did not want breast reconstruction, and feels fortunate that her breast surgeon – who told her about the flat movement – honored her choice. Devorah is also on the Board of Not Putting on a Shirt, a 501(c)(3) organization whose mission is to promote optimal surgical outcomes for women who choose to go flat after mastectomy and full disclosure of all post-mastectomy options. Read More. Meghan's Call To Trust You Instincts After her double mastectomy, Meghan initially opted for reconstruction. But after issues with her expanders and later the implants shifting, she also had unpleasant side effects. Known as breast implant illness (BII), she experienced fatigue, dizziness, vision problems, sleep problems and more. While little is currently known about BII, she chose to remove her implants. Read more for her story and how she shares the importance of speaking up if you're noticing any of these symptoms. Read More. Content Across The Web Going Flat: Choosing No Reconstruction ( BreastCancer.org ) Some women prefer to go flat because the recovery time after a mastectomy is typically shorter than with reconstruction. “If you have immediate reconstruction (reconstruction at the same time as surgery), the recovery time is longer than it is with no reconstruction. Depending on the type of procedure you have, there may be some muscle weakness and/or mobility issues as well, although some of the newer flap procedures minimize this risk by preserving the muscle structure at the tissue donor site. Generally, immediate reconstruction does lead to the most cosmetically pleasing results. If you choose delayed reconstruction — reconstruction 6 or 12 months or more after mastectomy — your recovery from mastectomy should be a bit easier. If you choose implant reconstruction, your doctor may need to use a device called a tissue expander, which is used to create a pocket under the skin where the implant will eventually go. If you have a tissue flap reconstruction, the skin that was removed at mastectomy will be replaced with the skin that comes with the flap (if reconstruction is performed at the time of mastectomy, this skin replacement may not be necessary).” Some patients who opt for no reconstructive surgery still want the look of their natural breasts and wear prosthetic breasts. If you’ve been using a prosthesis and are considering going without, but are uncomfortable about the idea of it, try not wearing the prosthesis while at home. Then try working your way up to going without it for short errands and see how you feel. You may realize most people don’t even notice! “If you like the idea of going flat but are worried about looking lopsided in form-fitting clothing, choose styles that draw attention away from your chest area. BreastFree has some great clothing tips: Fabrics with busy, irregular patterns that aren’t too small, such as florals and paisleys, keep the eye moving Dark colors, especially black, camouflage the lack of shadow underneath the flat part of your chest Crisp shirts with breast pockets mask your contours Jackets and sweaters layered over form-fitting t-shirts draw attention away from your chest and hide any unevenness Scarves and shawls can be used to cover part of your chest Instead of plunging necklines, choose styles that show off your other assets, such as high necklines that bare your back or shorter/slit skirts that highlight your legs.” Read More. 5 Aesthetic Options after Removing Breast Implants ( Plastic Surgery Center of Nashville ) Some common reasons that women may choose to have their breast implants removed include: An MRI has revealed a problem with your implant(s): All women with silicone breast implants should periodically undergo MRI testing to make sure their implants haven’t ruptured. Though silicone isn’t toxic, ruptured implants can cause pain, irritation, and infection if left untreated. Your Lifestyle or Preferences Have Changed: If you feel like your breast implants are too large or too heavy, they can be replaced with smaller implants or removed entirely. Health Concerns That Make Explant Surgery Necessary: Breast implant removal is medically necessary for women who have received a diagnosis of breast cancer, as they can interfere with treatment. Some women choose to have their breast implants removed because they’re experiencing non-specific symptoms, like fatigue and unexplained fevers, and they think their symptoms are related to having breast implants. This condition is known as breast implant illness, and while it’s poorly understood at present, researchers think it may be caused by an autoimmune reaction. A few options after removing implants: Implant Exchange: The original implants are removed, and new implants of your choice are placed into the existing “pocket.” The recovery time is similar to that of the original reconstruction surgery. Breast Lift with Implants: “Like large natural breasts, surgically augmented breasts often sag over time. If you’ve had breast implants for many years, normal aging and the effects of gravity may have created loose, stretched skin around your implants. To make sure your new implants sit in the correct position, surgeons may combine your implant exchange with a breast lift. They’ll remove excess skin from your breasts, insert new implants, and adjust the position of your nipples, as needed.” Implant Removal: You may choose to remove your implants altogether. Note: while this article shares that a few months after implant removal, the breasts will fill out to their natural shape, this only applies to women who have had augmentation of their existing breasts, not a mastectomy and reconstruction. Read More. From Full Reconstruction To Flat: My Decision to Explant Eight Years Later ( Anaono ) Because of a family history of breast cancer, personal history of thyroid cancer, and being BRCA1+, Samantha decided to undergo a prophylactic double mastectomy. She did not want to worry about another cancer diagnosis and wanted to know she would be there for her new daughter. “Reconstruction with silicone implants was the only option I remembered being presented with any great support or detail. ... I recall someone encouraging the implants, so as to “look normal” for my daughter and to “go as big as possible” (the infamous “reconstruction is a boob job” view). I ended up with arguably perfect, gorgeous and quite large reconstructed breasts, but was never comfortable in my body.” Eight years later she had explant surgery. “I had not been feeling well for years and hoped the explant would help, which it did. Equally importantly, I did not feel whole, sexy or connected to my implanted chest. It always felt foreign to me. The most important aspect of my decision to remove my implants was not a gallant act of bravery, nor a rejection of boobs, foobs or anything in between. It was an act of self-love and self-honoring ... Even when we are overwhelmed, scared and often rushed, it is incredibly important to ask the questions, be informed, do our homework, take our time (when possible) to digest and react, own our own bodies and make our decisions based on our own voice and not the (often negative) internal and external ones that chime in.” Read More. International FLAT Day ( Not Putting On A Shirt ) Not Putting On A Shirt is one of the organizations that spearheaded Going Flat Day a few years ago. Going Flat Day is all about advocating for flat closure as a valid choice post-mastectomy and to encourage doctors to present it as an option to their patients. By increasing awareness about the option to go flat, they hope to improve the aesthetic outcomes for women who go flat and empower them to make informed decisions about their surgery. Not Putting On A Shirt celebrates women who have chosen to go flat and helps them embrace their beauty and sensuality without their breasts. They share photos of women proudly showing off their surgery scars , and offer resources for patients and providers about this option. Read More.

Breast cancer treatment, while essential for combating the disease, often brings along various side effects that can significantly impact a patient's quality of life. Effective management of these side effects is crucial for the well-being and comfort of individuals undergoing treatment. Common Side Effects of Breast Cancer Treatment Breast cancer treatments can be extremely taxing on patients' bodies, often carrying disruptive side effects. The presence and severity of treatment side effects can vary based on the type of treatment administered and the patient's unique biology. The following are some of the most common side effects from breast cancer treatment: Fatigue :  Persistent tiredness or lack of energy that can affect daily activities Hair Loss :  Often a side effect of chemotherapy, causing temporary or permanent hair loss Nausea and Vomiting :  Chemotherapy or other medications can cause digestive issues Pain :  Aches or discomfort, especially after surgery or radiation Lymphedema :  Swelling in the arms or chest due to lymphatic system damage Cognitive Changes :  Referred to as "chemo brain," causing memory problems or mental fog Emotional Distress :  Anxiety, depression, or mood changes due to the stress of diagnosis and treatment Tips for Managing Side Effects Many breast cancer treatment side effects are inevitable realities of fighting the disease. Fortunately, you can help yourself by prioritizing side-effect management efforts to remain steadfast during your treatment cycle. The physical and psychological impact intensity of many symptoms can be mitigated through several methods, including: Fatigue Management :  Prioritize rest, practice gentle exercises like walking or yoga, and maintain a balanced diet. Hair Loss Support :  Consider wearing scarves, hats, or wigs. Opting for natural baldness can also be an empowering statement of strength for some. Nausea Relief :  Follow prescribed anti-nausea medications, eat smaller meals, and avoid strong odors and spicy foods. Pain Management :  Communicate with healthcare providers regarding your pain levels to plan appropriate pain relief strategies. Lymphedema Prevention : Wear compression garments to reduce swelling, practice gentle exercises, and avoid heavy lifting. Coping with Cognitive Changes :  Utilize memory aids, carefully organize tasks, and allow allotted time for mental breaks. Seeking Emotional Support :  Join support groups , speak with a therapist, or consider complementary therapies like mindfulness or meditation. Supportive Care Services Breast cancer side-effect management doesn't have to be a solo endeavour. Reputable care providers offer services to help you embrace effective coping strategies during your treatment. Some avenues to seek out for side-effect management include: Palliative Care :  Specialized medical care focusing on improving the quality of life for patients and their families Rehabilitation Services :  Physical therapy or occupational therapy to address functional limitations Nutritional Support :  Consulting a dietitian to maintain proper nutrition and manage side effects Psychosocial Support :  Counseling, support groups, or therapy to address emotional distress and promote mental well-being Complementary Therapies :  Integrative therapies like acupuncture, massage, or relaxation techniques to alleviate side effects Embracing Support and Self-Care Managing side effects during breast cancer treatment is a significant aspect of the journey. By adopting various strategies, seeking support, and accessing available resources, individuals can enhance their quality of life and navigate through treatment with greater comfort and resilience.

By Jill An Inspiring Story And Her Thanks To Cancer Jill's Story 2 years ago. On 1/13/2016, I heard those three little words that changed everything. “You have cancer.” (It was something like that...I was so nervous that I don’t remember the exact words). Looking back at the past 2 years, I realize how much life has changed and how much I have changed. Mostly good changes but some not so good changes too. Thanks to cancer , I’ve become a little more adventurous and have learned to spend more time with, and be more appreciative of, my family and friends. Thanks to cancer , I got my butt off the couch and started leading a healthier lifestyle. Thanks to cancer , I’ve met some pretty great people, both in person and on social media. My oncologist, my infusion nurses, my running girls and an amazing group of other survivors. I truly believe that people come into you life at the right time and for the right reason and I am so thankful for all of these new relationships. Thanks to cancer , I have learned to be thankful for every moment that adds to my story. Some days are difficult and I have a hard time thinking about anything but cancer, worried that I’m going to be so busy enjoying life that I miss some subtle sign of recurrence. Other days, I don’t think about cancer much at all. There are other days when I’m not even sure I had cancer, like it was all a dream or something. I am thankful for family and friends that are sticking with me. I know I’m more complicated than I used to be, and I know that I can be a moody pain, but you are trying to understand me as I struggle to understand myself. So here’s to another year of: Health, happiness, and embracing the hot mess that I am. Learn about supporting the Sunshine Bag Project The Sunshine Bag started out as a way to celebrate my 40th birthday by donating hats to my cancer center. Since tomorrow is never guaranteed, this has become an annual celebration. Thanks to the generosity of friends, family, and strangers, I started receiving yellow items and have been able to donate 90 Sunshine Bags to 2 cancer centers, and send a few to personal requests of people who know someone battling cancer! Thank you for sharing your story, Jill. SBC loves you. SurvivingBreastCancer.org Resources & Support: Breast Cancer Fitness Guide Breast Cancer Nutrition Guide Online Support Groups

Meet Rosa, Diagnosed At 48 With Stage 1B, ER+ HER2- Breast Cancer Hi, My name is Rosa. I was diagnosed at 48 with Stage 1B, ER+ HER2- Breast Cancer. This is my story. In April, 2018 I was diagnosed with cancer in my left breast. They found five tumors there. I had a lumpectomy and one lymph node dissection, but did not have clear margins. ​I caught an abscess (a swollen area within body tissue, containing an accumulation of pus and fluid) in the wound, which resulted in 2 months of antibiotics. I had lots of packing and it was an incredibly painful experience. In June, I had the left breast. After surgery and clear margins, I was negative for cancer. Everything was removed...Stage 1B. Onco score 30. I did 4 rounds of chemotherapy (the TC regiment), from July to September. I lost my hair... I lost my mind... I cried every day. I am on to the Aromataise inhibitor (AI) Letrozole. What a nightmare!!! I have excessive joint pain and underwent 16 rounds of radiation rads. My cancer was close to the chest wall and skeletal muscle. On my right side there was no trace of cancer... so I didn’t have it removed... But now I have fibroadenoma, which is the most common type of benign breast tumors. Most don't increase your risk of breast cancer, although women of any age can develop fibroadenomas. They usually occur in younger, premenopausal women. ​I will be removing the right breast next month, followed by reconstruction. Thought for sure I was not going to make it. I survived. I am doing OK... & I thank God every day. Thank you for sharing your story, Rosa. SBC loves you! SurvivingBreastCancer.org Resources & Support: Breast Cancer Poems Online Support Groups Writing For Healing

I never thought I would get breast cancer. In fact, the idea never crossed my mind until I felt a lump. I hear this story time and time again where women are "too young" to have breast cancer. However, according to an article published in October, 2019 from Yale Medical , 11% of women under the age of 45 develop breast cancer. In fact, breast cancer is the number one cancer among women between ages 19 and 39. Interestingly, the National Breast Cancer Foundation posits that 15% of breast cancers are triple negative breast (ER/PR and HER2 Negative) and typically occur in younger women. While we can google and read about triple negative breast cancer, we thought we'd take time today to speak with two women who have been diagnosed with TNBC in the 20's and 30's and have them share their first hand experience. SBC: Sara and Caitlin, thank you so much for taking the time and sharing your experience with triple negative breast cancer. As two women diagnosed at a young age, I would like to share with our readers a bit more about your diagnosis, your treatments, advice you have to others who are recently diagnosed and how you are doing now! Let’s dive in. Tell me a bit about your diagnosis, type, stage, age when diagnosed? Sara: I was 27 years old; 2 months shy of 28. I was initially diagnosed at stage 2a (no lymph node involvement); triple negative. This was the lump I initially found and got checked out. An MRI revealed a tiny spot in my other breast, which was biopsied. This was stage 0 due to size, but was not completely triple negative- a very low amount of one of the hormones (I can't remember which!) Treated as triple negative and the tumor board revisited my case after treatment and concluded I did not need hormone therapy for the little bit that was present. I also tested positive for the BRCA1 genetic mutation. Caitlin: I was diagnosed at age 30; 1 month before I turned 31. I Diagnosed with triple negative, stage 2b, grade 3. SBC: Did you have Chemotherapy and if so, which drugs were you on? : Sara: Yes, 16 rounds of chemo. I first did 12 rounds of Taxol, with carboplatin every 3rd treatment. I requested a few weeks off after finishing Taxol and starting the next round of chemotherapy and my oncologist was fine with this. Then, I started Adriamycin and Cytoxan (A+C) also known as "the red devil" which I completed four rounds, once every 2 weeks. Caitlin: Yes, I was on chemotherapy as well. Similarly, I had 4 rounds Adriamycin and Cytoxan followed by 4 rounds Taxol SBC: Did you have Radiation? If so, how many weeks? Sara: No. Caitlin: Yes, 5 weeks plus 1 extra boost week (30 rounds total). SBC: Radiation can be a bit confusing. We speak with Dr. Jimenez to get more information about radiation and what a boost week is. See short video below: Were you on any experimental trials? How did they go? Sara: Yes. I was on an immunotherapy clinical trial. Lasted an entire year. It went okay, I didn’t have any reactions while still in chemo but a few months after I started getting a whole-body rash. Caitlin: No, I wasn’t on any clinical trials. SBC What was your experience with Adriamycin and Cytoxan plus Taxol? Sara: I used cold caps through treatment and it actually went pretty well. I probably lost about 30-40% of my hair. While I didn't completely lose my hair, it still was an emotional rollercoaster. The hair washing routine was tough and I absolutely dreaded it thinking 'will this be the day I start to really get bald spots, etc'. So not the same hair journey as many cancer patients, but still a traumatic one. I hate washing my hair to this day. Caitlin: I did cold cap also, in fact, you can hear all about my experience on the podcast Breast Cancer Conversations we did together a few months ago. What advice do you have for someone going through treatment? For example, body changes, how to cope, health and nutrition/eating habits, etc. Sara: I ate pretty healthy before my diagnosis so I didn't make a whole lot of changes. Cold capping has you hydrating extra so I drank a lot of water. Made smoothies almost daily with greens. Still ate a crap ton of sugar - I needed junk food to cope. I also started taking Biotin. I had started weightlifting seriously a few months before my diagnosis and I tried to stay with it as much as possible. Some weeks I only made it to the gym once or twice but I did my best to keep up my strength and fitness. Caitlin: Listening to body about rest is my number 1 advice. Not the time to “push yourself”. I was able to fight fatigue because I as listening to my body and resting when needed. I designated down time for myself every day so that even if I felt “good” I rested to not push myself too hard. Honestly, I wasn’t the best with the health and nutrition piece. But I wasn’t the worst either. I tried to be moderate but also found a lot of comfort in comfort food. I luckily never lost flavor or had issues eating so being able to enjoy comfort food was something I often turned to. How did you fight fatigue and chemo brain? Sara: I don’t think I really fought the fatigue; just learned to accept it. I'd stay at my parents the day or 2 after chemo so I didn't have to do too much for myself those days. My mom would come by for a 'mom visit' to my apartment most weekends to help me with household stuff. I live alone so it was tough to keep up with things and take care of myself. Chemo brain is something I still deal with now; I forget things and find it hard to focus. I haven't really found anything to be helpful with this. How did you Manage with work, home, life balance while in treatment? Sara: I was lucky enough to have the capability of working remotely through treatment; that really made my life easier- in terms of demand on my time and financially. My apartment was a mess most of the time but in a clean way, if that makes sense. I'd go out with my friends when I felt up to it and I also went out on dates here and there. Caitlin: I was able to work throughout treatment, which isn’t for everyone, but it worked well for me. I enjoyed keeping some normalcy in my life. Socially I had people come visit me at home since my energy wasn’t always up for going out. What are the top 10 things you wish you knew before starting treatment/surgery (it’s ok if you don’t have 10!) Sara: 1.Wish I knew I could defer my student loans while in treatment!!!! Literally the top thing I wish I had known. 2. There are some organizations I've only found out about since being done with everything- like Ellie Fund and Joe Andruzzi fund. 3. I wish skincare and sexual health was better addressed. There are resources available for sexual health where I currently am a patient but it's kind of glazed over. 4. I am well aware that mental health plays a big part here but again, I wish this was an integrated component of cancer treatment. I guess the last 2 points were more things I'd like to see, not what I wish I knew. Honestly, I can't really think of much else! I felt pretty well informed in terms of what the plan was and we (my family and I) asked a lot of questions. A LOT OF QUESTIONS. Most of my appointments had 3 or 4 of my family members present. Very grateful for that. Caitlin: : I don’t really have a top 10 list of things that I wish I knew. I had great support. However, here is the advice I would give to someone just starting treatment: 1. Dr. Susan Love’s breast book is a great resource 2. Don’t google your diagnosis 3. It will take months, if not years post treatment, to have the energy to even start making changes towards coming back. How are you doing now? Sara: I still do most things I did before. Work, gym, go out, travel, all that stuff. But I do have a renewed sense of gratitude I think. Even on the most mundane, unexciting days. I think I definitely have PTSD from this experience, and I think this affects my daily life in a variety of ways. I think about cancer every day and have had a couple pretty real scares since finishing treatment, complete with biopsies and all. Having the genetic mutation..... I pretty much feel like there's a target on my back. I doubt this will be my one and only encounter with cancer. I'm still single and I don't really see that changing with everything that's happened; what's likely to happen again. Think my perspective on a lifelong partner has changed since I didn't have a partner through the worst time in my life. Caitlin: Since I found my lump through an at home self-exam and have made it my ongoing mission to bring awareness and education to other young women out there. I am so lucky to have found so much love, support and inspiration throughout the entire cancer community, but especially the triple negative gals!

By Ilene Kaminsky Something is missing. Where’s the deep emotional fallout that makes us wobble as we try our best to balance on that one wheel without handlebars to steer ourselves post diagnosis? There’s pain: Embarrassment Physical changes Sexual changes Loss of identity Once we accept that we are doing the work, we can silence our internal critic that believes that feeling pain means we’re “doing something wrong.” Instead, we begin to understand that feeling our pain is important and productive. When we understand the true nature of our work, we can summon compassion for ourselves as we move through our uncomfortable feelings on the path to healing, peace, and wholeness. The Healing Circle Framework has changed my life. I’ve applied it to my most acutely painful emotions as well as milder ones. I’ve applied it to one on one conversation and used parts of the framework in broader discussions, like support groups. Here’s a great example of applying part of the framework. I’m in a Monday night MBC support group that I attend about 90% of the time. There are weeks I’ve not got the stamina or the energy I need to keep up with all that happens in what usually runs about 1 hour and 45 minutes. The call, on zoom, felt frantic to me at times. “You’re not trying hard enough.” Then there are those darkest moments of sorrow, the moments when grief shakes even our sturdiest foundations. When we lose a loved one. When illness consumes us. When we experience a tragedy so emotionally excruciating that it redefines our very understanding of pain. In these moments, when we can’t find a single silver lining for miles, we can summon the courage to sit with our sorrow. We can find solace in the truth that there is simply nothing else to do. Experiencing our grief—if only for moments at a time—is work. This is the work of living on this Earth, of being human, and of surviving the universal rites of passage that mark our lives as we age. Somehow, the vast majority of people around me have weathered similarly painful times. The mere fact of their existence, when I’m certain I will shatter into nothingness, is strength enough to soldier on. Before I learned the benefit of sitting with my feelings, doing work of this nature didn’t appeal to me. Why wallow in sorrow when you could just do something about it? I wondered. When I felt uncomfortable, I would find a way to occupy my time and distract my heart. I’d burrow my nose in a screen until I was only dimly aware of the world around me; call one friend after another, repeating the same painful story, swimming concentric circles around my pain without ever diving in; grab a pen and scribble a to-do list to feel the rush of purposefulness at the expense of true catharsis. In retrospect, it’s easy to see that my “coping strategies” were no such thing. When we distract ourselves from our pain with a flurry of motion, we fool ourselves into thinking we’re being productive. We fall victim to the addictive high of the quick fix. Which begs the question: Given the undeniable difficulty of this brand of work, why do it at all? What is the reward for expending such mental and physical effort? Different folks will offer different answers. As for me, I’ve always believed that our purpose on this earth is to live our richest, most beautiful lives. Anything less seems like a terrible waste of the gift of conscious experience. I believe that in order to live such lives, we must live our essential truth . Living our essential truth means making the conscious effort to feel the spectrum of our pain, magnificent and minor. It means giving ourselves permission to feel emotions as they are, and rid our lives of the pressures to conform, perform, and self-delude. When we act in accordance with our deepest feelings, our lives become simpler. Instead of constantly choosing how to act or what to say—spurring waterfalls of anxiety and self-doubt –there is always one choice: the choice that is true for us. The choice that we feel in our hearts. The next time you are hurting, uncomfortable, or lonely, feel your pain . Feel as much of it as you can bear. Your pain is a necessary step on your journey towards healing. And remember: You are doing your best. You are healing at exactly the right pace. You are doing work. Your work has meaning. It can serve a purpose. It can serve you. I wanted to offer sanctuary to those who felt that they had an inner journey but down a very lonely road. So many of us do our best to heal alone with metastatic breast cancer or with any cancer. But our circle is very special. Not all circles hold together as well as ours. We began with a goal of three months or six “sessions.” I knew at first and for a while I’d be a host without a guardian but one would show up naturally out of the group and so one has. Yet as strong as the rim of our circle, it can collapse at any time if there’s no one with the je ne sai quois to shepherd the highly emotional sharing that takes place in such a confidential but safe container to dump our feelings into without fear. We all want to fix and help but this is not a forum as such. A support group and a healing circle depart ways here especially. SurvivingBreastCancer.org Resources & Support: Breast Cancer Poetry Our Podcast Online Support Groups Free, Weekly Events

By Carol Collins Early in October 2021, I was in the shower and felt a lump on my right breast . I thought it was odd but I was on my cycle so decided to wait it out and see if it went away. A couple of weeks went by and after making my husband feel the lump to make sure I wasn't imagining things, I decided to make an OBGYN appointment. I was 44 at the time but had not had a mammogram yet. In my mind I had no reason to worry. I have no history of breast cancer in my family so I was safe, right? I had my OB appointment on October 19th. My Dr. ordered a diagnostic mammogram after confirming there was a lump. However, she kept telling me it felt like a cyst. I walked out thinking I was still safe. My mammogram was on November 4th and the nurse was a breast cancer survivor. She was so positive and kept telling me to not overthink it. She completed my mammogram and walked down the hall to have results read. She came back in the room and said, "You need an ultrasound." The mammogram was inconclusive. I moved into another room and the ultrasound was completed. Again the nurse left the room to have results read. The next time the door opened the Dr. and both nurses walked in. At that moment it hit me... I might actually not be safe! I was told I needed a biopsy but that it still just looked like a cyst but the images were not clear enough to say either way. Even the doctor that did my biopsy kept trying to tell me it looked like a cyst. Honestly, all of the days between November 4th and December 1st were a blur. On December 2nd, I received a text message that test results were available in my MyChart app. I was sitting on my couch at home and my husband was in the shower. I opened the app and the results. The first word I saw was carcinoma. I read and reread the report. Invasive Ductal Carcinoma HER 2+ ER/PR- with so many other words I had to google. I was alone on my couch when I found out I had breast cancer! No one warned me not to open the app. I walked into the bathroom and told my husband that I had cancer while he was in the shower. That's how in shock I was. I couldn't even think well enough to wait until he was out of the shower. The Dr called me about 15 mins later and confirmed what I already knew - Mrs. Collins, you have breast cancer . I had only told my mom and husband that I had found a lump. I have 3 children (2 daughters and a son) that I now had to tell. How do you tell your child you have cancer? My children are all in their 20's so it's not easy to get them all in the same place at the same time. I didn't want to ruin the holiday season by waiting until our Christmas get together. I decided to call each of them that night. Those calls were the hardest things I have ever done in my life. I also decided in that moment that I never wanted another woman to make those calls. I knew nothing about breast cancer. I am a woman and knew nothing! How is that possible? Fast forward past an MRI to properly measure the tumor, an MRI guided biopsy for a 2nd area of concern, being told there were actually 7 "satellite" areas in my right breast, being told there was a significant number of "cysts" in my left breast, 6 rounds of TCHP , a double mastectomy on 6/17, and reconstruction surgery on 9/29. Not to mention all of the tests in between. Here I am today thriving! My hair is growing back thick, curly, and gray. I can eat and drink again and can't wait to start exercising to help with overall stamina. I have started a Facebook group in my local area for all cancer thrivers, survivors, fighters, and supporters. I found an in-person support group and am looking forward to continuing to build the membership. The current meeting leader is a breast cancer survivor, but she is older and wanting me to take over the group in 2023. I am co-hosting a local Breast Cancer Awareness Walk on October 29th. We have been out in the community garnering support from local businesses as well as inviting everyone to join us for a night of fun. I was recently nominated to attend a gala event hosted by another amazing cancer organization in Mississippi. I want to continue to build connections and push for more focus on early detection. My overall goal is to make sure anyone I know is aware of breast cancer and they know how to properly do self-checks and/or get mammograms. Like Gloria says, if we can make a difference in one person's life it is worth it. I have met so many amazing people through this journey and I am thankful that I am here to use my story to help others. Cancer has such a bad reputation. It doesn't have to be the end. It can lead to a path you never imagined full of hope and courage. I will always tell my story. Thank you for allowing me to share. Thank you for sharing your story, Carol. SBC loves you! SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events

Weight gain is one of the many potential side effects of Letrozole, an Aromatase Inhibitor. In fact, “Will Letrozole make me gain weight?” is one of the most common questions asked in SBC’s weekly support groups . Not every person taking Letrozole gains weight; everyone's body responds differently to endocrine therapies. However, in today’s post, we are going to look at the most common factors associated with weight changes and provide some recommendations for combating the unwanted cushioning some develop as a result of this estrogen depletion. Join our mailing list and never miss out on great content! Why Do Some People Gain Weight from Breast Cancer Treatment? A large percentage of people report weight gain after a breast cancer diagnosis and treatment [1]. Explanations for the weight change can be attributed to lifestyle changes that normally come with a breast cancer diagnosis. For example, you may feel more fatigued and therefore reduce your level of physical activity. If you are on steroids, you may notice the feeling of being hungry more often. Increasing calories can also be associated with coping as you deal with the stresses of a breast cancer diagnosis [2]. Chemotherapy and Weight Gain Weight changes can also occur in younger women who are premenopausal during chemotherapy. The Women’s Healthy Eating and Living (WHEL) study [3] indicates that 65% of people treated with chemotherapy were more likely to put on a few extra pounds [3]. On average, women report gaining 2-5kg (approximately 4-11 lbs). However, that is not the time to worry about weight gain or to start a new diet plan. Remember, you are going through cancer treatment, and it is a time to be kind to yourself! How Does Endocrine Therapy Lead to Weight Gain? Chances are, if your cancer is hormone receptor positive, meaning that the cells have either estrogen or progesterone receptors, you will most likely be advised to take endocrine therapy as part of your longer-term treatment plan. Endocrine therapy, also known as hormonal therapy, reduces estrogen levels or blocks the estrogen receptor. In some cases, your oncologist will advise you to take Tamoxifen, or one of the Aromatase Inhibitors (Anastrozole, Exemestane, Letrozole). The goal of hormonal therapy is to reduce the chances of the breast cancer returning or progressing. However, looking into the quality of life and survivorship/thrivership, you should also be cognizant of the impact estrogen depletion has on overall health. These aromatase inhibitors can cause osteoporosis, increase cardiovascular events , and lead to diabetes [4] . It's easy to associate weight gain with being less active, one’s metabolism slowing down with age, or making poor dietary choices. Regardless, there seems to be a consensus that those diagnosed with breast cancer who utilize endocrine therapies tend to gain weight, even when they are exercising and making conscious, healthy nutritional choices. How Does Letrozole Affect Lipid Metabolism? One factor that is seldom discussed (and more research is certainly warranted) is the role that Letrozole has on lipid metabolism. While some trials and research have investigated the impact aromatase inhibitors have on the lipid profile, conclusive results have been elusive [5] . What we do understand is that aromatase inhibitors can have an adverse effect on blood levels. For example, increasing total cholesterol, meaning LDL levels (the “bad” cholesterol) and HDL (the “good” cholesterol), can lead to increased risk of cardiovascular disease [6] . Additionally, the enzyme lipoprotein lipase (LPL), which is controlled by insulin, pulls fat out of the bloodstream and into the cell. If this enzyme is in a muscle cell, it will turn the fat into energy. When the enzyme is sitting in a fat cell, it will pull fat into the cell and make it fatter [7]. Estrogen suppresses LDL, and with lower levels of estrogen in the body, this could be a reason some women gain weight during menopause or as part of breast cancer treatment. How to Combat Weight Gain During Breast Cancer Treatment As noted, several factors affect weight gain while undergoing chemotherapy or hormonal therapies. Some of these biological side effects are out of one’s control. However, there are actions you can take to maintain a healthy weight, including diet and activity level. Below are some of our favorite recommendations: Choose foods that are unprocessed and nutrient-dense Eat a diet low in added sugar Limit (or avoid) alcohol Increase fruits, vegetables, and whole grains Find an enjoyable activity that enables you to move your body daily (walking, light weights, swimming, etc.) This list is not comprehensive and you can feel free to choose. It is important to start with realistic and achievable goals. We are in this for the long haul! Dietary Recommendations for Fighting Cancer Treatment-related Weight Gain Fruits and vegetables are known to contain phytochemicals packed with antioxidants and nutrients, meaning they are rich in vitamins and minerals relative to their caloric content. Consider some of the following options: Whole grains: unprocessed foods that are high in complex carbohydrates, fiber, and nutrients, such as wheat, rye, oats, rice, bulgur, and barley. Green leafy vegetables: include spinach, Swiss chard, beet greens, lettuce, and romaine. Cruciferous vegetables: include broccoli, turnips, brussels sprouts, cauliflower, bok choy, kale, and mustard greens. Umbelliferous vegetables: include celery, parsley, fennel, carrots, and parsnips. Solanaceous vegetables: nightshades like eggplant and tomatoes. Cucurbitaceous vegetables: gourd family, including squash, pumpkin, cucumbers, and watermelon. Understanding how your body responds to cancer treatment is complex. You have been through a lot! What worked for your body pre-cancer may no longer be suitable during treatment. If you are struggling with weight gain because of breast cancer treatment or hormonal therapies, speak to your oncologist about your concerns. Ask for a referral to a nutritionist. Get confirmation on what an ideal exercise plan should look like for you! Cancer takes a toll on everyone, but continue to love yourself and your body; nurture it with compassion, movement, and wholesome food, and it will love you back in spades. References [1] Raghavendra, A., Sinha, A. K., Valle-Goffin, J., Shen, Y., Tripathy, D., & Barcenas, C. H. (2018). Determinants of Weight Gain During Adjuvant Endocrine Therapy and Association of Such Weight Gain With Recurrence in Long-term Breast Cancer Survivors. Clinical breast cancer , 18 (1), e7–e13. https://doi.org/10.1016/j.clbc.2017.11.006 [2] Gu, K., Chen, X., Zheng, Y., Chen, Z., Zheng, W., Lu, W., & Shu, X. O. (2010). Weight change patterns among breast cancer survivors: results from the Shanghai breast cancer survival study. Cancer causes & control : CCC , 21 (4), 621–629. https://doi.org/10.1007/s10552-009-9491-z [3] Lauby-Secretan, B., Scoccianti, C., Loomis, D., Grosse, Y., Bianchini, F., Straif, K., & International Agency for Research on Cancer Handbook Working Group (2016). Body Fatness and Cancer--Viewpoint of the IARC Working Group. The New England journal of medicine , 375 (8), 794–798. https://doi.org/10.1056/NEJMsr1606602 [4] Buch, K., Gunmalm, V., Andersson, M., Schwarz, P., & Brøns, C. (2019). Effect of chemotherapy and aromatase inhibitors in the adjuvant treatment of breast cancer on glucose and insulin metabolism-A systematic review. Cancer medicine , 8 (1), 238–245. https://doi.org/10.1002/cam4.1911 [5] Boutas, I., Pergialiotis, V., Salakos, N., Agrogiannis, G., Konstantopoulos, P., Korou, L. M., Kalampokas, T., Gregoriou, O., Creatsas, G., & Perrea, D. (2015). The impact of Anastrazole and Letrozole on the metabolic profile in an experimental animal model. Scientific reports , 5 , 17493. https://doi.org/10.1038/srep17493 [6] Zidan, J., Chetver, L., Hussein, O., & Zucker, M. (2010). Effect of letrozole on plasma lipids, triglycerides, and estradiol in postmenopausal women with metastatic breast cancer. The oncologist , 15 (11), 1159–1163. https://doi.org/10.1634/theoncologist.2009-0222

By Libby Riley On July 16, 2020, I received a phone call at 8:04pm that would change our lives forever. The phone call was from the Breast Center, with the results of the biopsies done two days prior, after my annual mammogram showed two suspicious masses in my right breast. I have said multiple times over the past 18 months that I NEVER ever thought I would be diagnosed with breast cancer in a million years. But, since then, I have learned that you can never say never. In the past year and a half, I have had 55 appointments with at least ten different doctors, 18+ scans, tests, or biopsy procedures, and 4 MAJOR surgeries. As a result, I have lost every organ that made me female and have had to cope with the grief that has come with those losses. In addition, I am on six different prescription medications and multiple over-the-counter medications to counteract the side effects from the prescribed meds. I am NOT the same person I was on July 16, 2020, and I never will be. Cancer has forever changed me; in some ways, it has been a positive for me, but in other ways, a negative. A cancer diagnosis tends to bring your life into perspective and cause you to separate the IMPORTANT from the TRIVIAL . It has forced me to face my mortality and to be hyper-vigilant about my health AND my husband & boys’ health as well. There have been many times that I sit at night in our family room watching TV with my husband and wonder if I need to start writing things down for him & the boys, just in case. YES, it does cross my mind. Statements that I usually prefaced with “if I ever get hit by a bus…” now get prefaced in the back of my head with “if I die from breast cancer.” I have never had a medical directive until my mastectomy surgery. Now I do. It is on file with the hospital, a copy lives in our safe, and a copy with my sister in New Jersey. Again, just in case. I have worked hard to refocus my anxiety and fear of recurrence. Cancer survivors have told me that those feelings lessen over time, but people say that about death, too; so, I’m not sure if it’s true or not. I have met many amazing women through the breast cancer community in the past year and a half and draw strength from their stories of survival, resilience, and hope . I TRY my best to live a hopeful life and not let the little “what ifs” that live in the corner of my mind come out too often. I look for the silver linings when I can. Whether by paying it forward to other breast cancer warriors or making a connection with another woman in a different part of the country, all because we both have a similar diagnosis and treatment path. I tend to appreciate the little things more - a pink sunset, my husband wearing a “Hope is Stronger than Fear” bracelet 24×7, my boys wearing pink ribbon socks, or a beautiful pink hydrangea blooming in our yard for the first time. I focus on my gratitude and being kind to myself and remembering that cancer is not a one-and-done disease. It is a never-ending story and a part of my life forever. The day that changed my life was transformative. From it was born the NEXT me because I am not NEW, I am different both physically & emotionally, and I am forever changed. On 8/31/21, we not only celebrated our 19th wedding anniversary, but we also celebrated my 1-year “cancerversary” of being NED. It was a big deal. Some people may wonder why cancer survivors celebrate these dates. They are milestones on the path of our lives and dates that will always have meaning, whether they be good or bad. My husband and I celebrated the day by taking off work, having lunch together, and just spending time alone, but we also did what I promised myself I would do if I made it through my first year as a cancer survivor – and that was by getting a new and very special tattoo. Through my plastic surgeon, we got the name of a medical tattoo artist who does traditional tattoo work and mastectomy tattoos. I did not do a mastectomy tattoo because I was still not finished with my reconstruction. Kerry did a “Warrior” tattoo and a pink ribbon tattoo, and I was able to get to know her to also plan for future work. I haven’t had to go through as much as some women do regarding treatment; and I have always been open and willing to share my experience when it comes to my journey. Breast cancer forever changed me, and I feel driven to make a difference. Do I know what the future holds for me? No….do any of us? I am just grateful for each day that I am here and that I can wake up and enjoy another day. Connect with Libby on Instagram: @libbybelzriley @lovelizard1 Diagnosed at 51, Stage 1a ER+/PR-, HER2- IDC,DCIS & LCIS bilateral mastectomy w/ reconstruction Thank you for allowing us to share your story, Libby! SBC adores you! SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events

By Mojgan Hadi Hello, my name is Mojgan Hadi, and this is my story. My Background l was born in 1969 to a middle class family in Tehran. When l was a ten years old child, the Iranian Revolution (also known as the Islamic revolution) began in 1979, and a year later in 1980, the lran and Iraq war started. ​ After eight years of fighting, I was married the day that “the end of war" was declared between Iran and Iraq in 1988. ​ At that time, I thought this day would be the best day of my life and that I would have a wonderful future ahead. ​ Within two years of being married, my son was born, and six months after that, I was pregnant with my daughter. While one of my greatest desires was to study and go to a university, I spent all my time to tending to my children. After a few years and because of a bad economic situation, I had to start working. I found work in a driving training center as a driving trainer. ​ This was a job with lots of stress and danger. When I was about forty years old, my father developed stomach cancer and passed away at sixty eight. l loved him and his death was very painful for me. ​ During this time, l still was working, doing the housework, and taking care of my family. Four years after my father's death, my thirty-eight year old brother was diagnosed blood cancer and this represented a disaster in my life. ​ For nine months, I went to the hospital to take care of my beloved brother, while still working at the driving school and managing the home and family. It was a horrible time. Unfortunately, my dear brother who was a compassionate and kind man passed away. ​ Then, life became meaningless. My Breast Cancer Story The main story happened two years after my brother’s death. Iranian people celebrate the new year in April. It was on that night (April, 2015) when I went to take a shower, and I accidentally found out a small tumor in my right breast! ​ The next day, I consulted with a doctor. At first, I did a sonogram (ultrasound) and then a mammogram, and then I found out the results. I was in shock and the world became dark to me. ​ I hadn't enough time to understand the problem exactly when I found myself in a surgery room! Immediately after the painful operation, I began the journey of chemotherapy, radiotherapy, and injections of Herceptin . When I was going to the clinic for treatment, I observed young women and even some girls who were unmarried and diagnosed with cancer. Listening to some of the patients' stories was more painful than my own sickness. Some of their husbands had left them and had even taken their children with them.​ Some of people had no health insurance and sometimes they had to forego treatment. Sometimes because the medicine's price was too expensive and they couldn't afford it and sometimes because of the sanctions that were put upon our country, we couldn't receive the drugs in a timely manor, or even at all. Some people were obliged to sell their homes and borrow the money with high prices of interest. It was misery! After Treatment After finishing my treatment, I started thinking about and reflecting upon my life. I realized that with these things that were happening to me, and especially the way that I was confronting them, catching cancer was predictable; in short, I was putting a lot of pressure on myself and my lifestyle was really wrong. ​ l decided to change my life deeply and save myself! I started to study and research about new ways of treatments. At first, I went on a vegetarian diet , and because of that, I lost a little weight and of course saved some money. Then, I went to yoga class for few months. Yoga positively affected me and gave me a much needed sense of calm. However, because of lymphedema in my right hand, I couldn't continue. Now that I was gaining more energy, I decided to learn English , which had been one of my desires for many years. Getting My Life Back I am interested in communicating with people in other countries, and I like to know about their culture and their spectacular places. ​ The best part was going to painting class . Playing with colors on canvas was amazing and was taking me to a colorful world. It was fantastic. ​ I started to travel in some beautiful places in Iran. ​ I love traveling- it is a little expensive, but wonderful. In doing these things, I came back to life, and it's a nice feeling. So What's Next I co-operate with an NGO about women's breast cancer in Iran, and I am curious to know about NGO's in others countries. I say proudly to all female patients that this sickness made a big, and positive change in my life, in my opinions, perspectives, and in my relationships with people. Now, I can solve problems and difficulties easier than before. I control my mind and try thinking positively. I don't let myself into a downward spiral of sadness. All of these accomplishments are because of my diagnosis with breast caner! ​ Thank you, cancer! Thank you for sharing your story, Mojgan. SBC loves you! SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events

By Tammy How could this happen to me? I am a personal trainer, I try my best to eat healthy foods, I eat lots of fruits and vegetables, no fast food, I don’t drink (besides an occasional sip of my husbands red wine), don’t smoke, workout 6 days a week etc… I was devastated. The thought of the surgeries and putting poison into my body made me want to run away forever. Where to begin... The long story short is I had a routine mammogram January 2017. Months later, after many more images, tests, and two surgeries (one for breast removal and one for complete reconstruction), I found myself facing my greatest fear: Chemo. Not only would I have to complete 12 weeks of chemo, but because I am triple positive, I would need a year of immunotherapy every three weeks before the treatment year will be done. I’m thankful my tumors were small and my lymph nodes were clear but I had a long year ahead. I had to accept this and move on. I had many sleepless nights. I cried many tears. I knew I had to do this for my family and friends. I really didn’t want to. How could I make this all go away? I couldn’t. So I took action! I kept working out six days a week. Some days this meant only walking or very light weights. I kept moving , and I believe this helped me recover very quickly from my surgeries and chemo. Believe me, I had days where all I could do was sit on the couch because the nausea was so extreme. I cried because I felt everyone else was living their lives and I was only watching but not living at all, I was only barely existing. The day I shaved my head was difficult. But the day I lost my eyelashes and eyebrows I went into an extreme depression. I no longer looked or felt like me. I couldn’t even recognize the person in the mirror. She was so unrecognizable and literally stayed indoors for weeks. While going through treatment, I went every three weeks for Herceptin and finished in July of 2018. My hair is slowly growing back. It was very uncomfortable to wear a wig, so I try and not stay out for too long. I was working very part-time but had to put most of my life on hold. I don’t know if I will ever feel like my old self again. Sometimes I forget, but then I see myself in the mirror and it all comes back. My body will never really look the same, but that’s ok. I have a strong faith in God, and I know He will guide me through whatever happens. I can’t wait for the day when this is all over, when I have hair again, and then, I will feel truly like I can put this behind me... Except for the fact that a reoccurrence will always be in the back of my mind. Where am I now? It’s been over a year since I completed chemo and 6 months since I completed Herceptin. I’m feeling better every day! I’m slowly getting stronger and even a little less tired! There is hope and life does go on!! My hair came back and I'm ready to celebrate life! Thank you for sharing your story, Tammy. SBC loves you! SurvivingBreastCancer.org Resources & Support: Positive Thinking for Healing Online Support Groups

Meet Krystle, Diagnosed At 27 And The True Definition Of Strength At the start of the summer in 2016, I was in the “prime” of my life. I had a prestigious research fellowship working on an HIV vaccination project at Tulane University, I was entering my last semester of graduate school, and I spent my weekends strolling down the lively streets of New Orleans. Everything was perfect, or so it seemed. Little did I know that a storm was coming. Within a few weeks, everything would change. Forever. Diagnosis And Holding On On July 15, 2016, while sitting on the same bed where I had spent countless hours studying some of the world’s deadliest diseases, I received a phone call that would throw my whole world into disarray. That day, at the ripe age of 27, I was diagnosed breast cancer. One of my very first phone calls was to my then-boyfriend. We had been together for a year, spent holidays together, and even discussed what we would name our future children. I imagined that he was going to be my primary support system- compassionate, understanding, and an impenetrable presence. A minute into the phone conversation, he hung up on me, frustrated at the notion that I might not come home to North Carolina to be treated. That should have been my first red flag, but I had seen The Fault in Our Stars , and I knew we would be okay. He even promised that he would never leave me. That means something, right? Unfortunately, this isn’t Hollywood, and I wasn’t Hazel Lancaster. Our relationship started to spiral downward, and very quickly. In fact, deep, down inside I knew as soon as a month after my diagnosis that “forever” wasn’t going to happen, but I still held on. Even after he laughed at me and called me pathetic when I had trouble getting into the car a week after my 10-hour mastectomy surgery with drains distending from my sides, I held on. Even after our fight because I had to shave my head when my hair wouldn’t stop falling out, I held on. Even after sitting through a 5-hour chemo, crying, because a fight had gotten so bad that he shoved me into the car door, 10 minutes prior to walking through the cancer hospital door, I held on. Even after he told me he would rather not spend New Years with me because I wouldn’t be any fun due to a chemo infusion I had a few days before, I held on. In retrospect, in the beginning, I do think he cared. However, ultimately, it was too overwhelming for him. Worth More Cancer is messy. It’s dark and scary. It forces you to face your own mortality. Want to know a secret? It’s like that for you AND the people around you. It is, indeed, something that not everyone can handle and you know what? That’s okay. However, over the past two years, I’ve learned that I would rather surround myself with people who CAN handle it. I would rather be with a man who understands that I’m worth more than a phone call, two days before a surgery, telling me that he no longer wanted to be in a serious relationship because the past 6 months had been too hard on him, and that he was too young to be going through such a trying ordeal. ​I WAS worth more than that and just to be clear; YOU are worth more than that. You are worth someone who will lie on the bathroom floor with you when the chemo starts to kick in, but your nausea medications don’t. You are worth someone who will parade you around a college basketball game with your bald head like a full moon shining. You are worth someone who brings you your favorite snacks during chemo, even if you end up hating them after (it’s the thought that counts). You are worth someone who tells you they will not leave you, and means it. The situation with my ex devastated me. It broke me into a million little pieces. In fact, it thrusted me into a dark depression; one I thought I’d never get out of. But you know what? Two years later, I’m still here. Thanks to people who didn’t give up on me, and still don’t. Thanks to friends who broke into my apartment when I was so sedated on Oxy and couldn’t get off the couch, much less communicate with anyone for 24 hours. Thanks to my family and closest friends who WILL sit on the bathroom floor with me when I think I’m dying. And last, but definitely not least, to a newfound faith in God and the blessing that He bestowed upon me when He removed my ex from my life. I still have “those” days; those days when I wallow in self-pity, but at the end of the day, I know a brand new one is coming. So, I pick myself off the floor, straighten my crown, and keep it moving. The Latest Here is the latest after my appointment with my oncologist today: As I’ve previously mentioned, neither one of my oncologists want me to carry a baby due to several factors including my hormone status and BRCA mutation. My BRCA mutation not only gave me a higher chance of breast cancer, but also, a much higher chance of ovarian cancer (mine is 40%, the normal population is around 1%). Ovary removal is recommended for BRCA+ mutants. After careful consideration, I’m contemplating getting mine out sooner rather than later. Sooner being May of this year. If I decide to do this, I will be giving up the chance to ever conceive naturally. I’m asking that you all please pray for guidance because this is a huge decision and one that would change my life, forever. It's May It's May, and a decision has to be made. This decision WILL change my life, forever. It’s not one I’ve made lightly; in fact, it’s been months of me going back and forth. On April 17th, I underwent a salpingo-oophorectomy, which is the removal of both ovaries and fallopian tubes. I know the risks of going into early menopause. I know the price I’m paying by doing this. I know what I’m giving up. But I also know the huge risks of me continuing to be noncompliant with my medications, and that risk could possibly mean my life. Honestly, and respectfully, I don’t need opinions or medical advice; I’ve already talked to many doctors, healthcare professionals, and other young women who have been through this. I need your prayers. Prayers for comfort, prayers to watch over the doctors who will be performing the procedure, and prayers for a speedy recovery, both physically and emotionally. I’ve been led through the fire before, and there’s no doubt in my mind that He won’t lead me through this, too. Thank you for sharing your hope and resilience, Krystle. We love you. SurvivingBreastCancer.org Support: Online Support Groups Breast Cancer Book Club

By Tracee Cole In January of 2020, I went to the doctor, for him to diagnose me with shingles. While I was there, I mentioned a lump I had felt in my breast and armpit and how painful they felt. He said it’s probably from the shingles . He scheduled me for a mammogram and an ultra sound a few weeks later after my shingles calmed down. When I had the imaging, the doctor came in and said he wanted to do a biopsy because some of the cells looked suspicious or abnormal. I came back in a couple days for the biopsies, and they said I would know in a few days. I got a call the next day saying I needed to come in right away. I immediately called my husband, said we needed to go in, and that I didn’t think it was good news. My heart just sank to the floor and I couldn’t stop shaking. I found out I had breast cancer and that it was in my a lymph node. I was diagnosed with IDC and DCIS grade 2 triple positive in February 2020. Being triple positive, I had to start with chemo right away. Things moved so fast once I found out, it was hard for the diagnosis to even really sink in. Before chemo started, I had genetic testing, a CAT scan, port placement surgery, an echo of my heart, bone scan, x-ray, more mammograms, and a breast MRI, along with surgeon and plastic surgeon appointments. Finally, I started chemo. I had my mom and husband with me at my first one. Then COVID hit, and I couldn’t have anyone with me for the rest of my treatments. I had a total of 6, every 3 weeks. It was like being on a roller coaster. I felt good, then horrible, and then I started to feel better and it started all over again. Then I had a bilateral mastectomy with expanders in July. I became cancer free. Because I had lymph node involvement, I needed to have 25 rounds of radiation. At 15 rounds in, I came down with an infection and ended up in the hospital with 4 surgeries in 5 days and lost my expander on the side that was being radiated. I wasn’t able to get an expander put back in because of the type of infection I had, so my surgeon put an antibiotic spacer in to be able to stretch my skin a little bit and to heal the infection. I healed for a couple of weeks and then continued my radiation. In February 2021, I finished my Herceptin and Perjeta , and now I’m on Anastrozole for the next 5 years (because my cancer was hormone driven ). My exchange surgery was May 7th, but the day before my surgery my plastic surgeon said she wasn’t comfortable doing that. Because my skin had tightened so much from February at my consult appointment, she didn’t feel comfortable putting an implant or expander in. She suggested doing a Latissimus Dorsi Flap surgery with an expander. This is basically taking my back muscle or part of the muscle and transferring it to under the breast, where the tightened radiated skin would be removed. I decided to try this surgery. I did have this surgery on May 7th and the plan is to have my exchange surgery along with fat grafting the end of July. I am still at higher risk to lose the expander or implant. I’m just staying positive and praying I don’t have any more issues. I am researching potentially going flat , if this doesn’t work. But for now, I’m healing again until the next surgery. Thank you for hearing my story. ️ Thank you for sharing your story, Tracee. SBC loves you! SurvivingBreastCancer.org Resources & Support: Online Support Groups Attend an Event Listen to the Podcast: Breast Cancer Conversations

By Tara Coyote My life has been a jagged, windy road and I’m grateful for every growth opportunity that comes my way. Five years ago, my best friend of 19 years died from Leukemia. I was honored to be one of her main caretakers for 22 months from diagnosis to death. Her death helped bring a valuable awareness of my own mortality. One year after she died, I was diagnosed with Stage 3 Breast Cancer. For 2.5 years I chose an exclusively natural non-toxic approach to healing. During this time, I ran a horse retreat center where people could spend healing time with horses. A very unfortunate event occurred, which forced me to sell my business, horses, and retreat center. Due to the immense stress, the cancer progressed to be Stage 4 in multiple areas in my body. After this life-changing event, I decided to move back home to my ancestral home of Kauai, Hawaii with the intention to heal. In the winter of 2019, I had cancer in my breast, lungs, liver, spine, adrenal glands, and left hip. I was referred to Hospice. I was petrified. As my body declined, I had to take a hard look at my belief system and whether or not to stay committed to healing naturally. Was I going to die for my stubborn choice of not doing chemotherapy or was I brave enough to do the thing I feared the most, which was chemotherapy? After my best friend’s death, I had an extreme amount of trauma to process, which fueled my fear of doing chemotherapy. I chose life! The mind is meant to be questioned and belief systems can be changed. I ended up doing nine months of chemotherapy. In that time, I ended up breaking my hip and having to have double hip surgery due to bone metastasis. In February 2020, I finished treatment with remarkable results! Since then, I continue to have the blood tests of a healthy, normal person. My CT scans continue to have miraculous results and the cancer continues to shrink! I am very aware how fragile life is. Living with a life-threatening diagnosis has been challenging, but I have learned the most valuable gift. I now know that every moment I’m alive is precious. I’m truly appreciative of my beautiful body, spirit, heart, and soul. It’s usually the most difficult moments that grow us and stretch us to new levels of awareness. Diamonds are birthed under pressure . I know that as deeply as I’m challenged, I will in turn be gifted with incredibly valuable insights. I choose to be grateful and enjoy every moment that I can! I wrote an Amazon bestseller titled, ‘Grace, Grit & Gratitude: A Cancer Thriver’s Journey from Hospice to Full Recovery with the Healing Power of Horses’ where I share my story. You can find it at: https://amzn.to/3lEJua3 Connect with Tara on Instagram and Twitter: @taracoyote Thank you for allowing us to share your story, Tara! SBC loves you! SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events

By Elisabeth Perucca I was diagnosed with breast cancer for the first time in 2004, when I was 42. I lived in my home city, Paris, France. I had put an end to a 10-year relationship and was working as a writer in corporate communications for 20 years. My mom had had breast cancer at the age of 51—which was cured with surgery and radiation—so I had started doing yearly mammograms. It was during a yearly exam that my tumor was detected. The surgery report said: SBR III ( Scarff-Bloom-Richardson , grade III), estrogen receptor +, HER2 1+, no cancer in lymph nodes. By the time I was diagnosed, I had spent my life doing a lot to be loved, and was constantly looking for the love and approval of others. I had also done a great deal of personal development and greatly benefited from psychotherapy (and other healing modalities) to heal. Honestly, I thought I was protected from this kind of disease. So when I heard the word “cancer,” I was shocked. The treatment started with a tumorectomy which was followed with 6 cycles of chemo (4.5 months), radiotherapy, and hormone therapy Tamoxifene; Aromasine 2007; Arimidex 2008-2010. Immediately after surgery, I felt hopeless and exhausted. To help me out of that dark space, a friend dragged me to a semi-private yoga class at the home studio of Aline Frati, a yoga teacher of 30+ years in Paris. My friend and I were the only two students. It was my first time doing yoga. And in that hour and a half, I went through a complete transformation. Incredible Intuition Aline had an incredible intuition about her. S he had the ability to sense the students in her class . And she was able to deliver exactly what each person needed, at exactly the right moment. “The yoga I teach helps a person become aware of repetitive patterns of anxiety and fear that come from early childhood, and free that energy up so it’s reintegrated in the body’s global energy,” she once explained to me. She was and still is my yoga teacher, although she passed away in 2018. Aline’s yoga practice complemented the work I was doing in therapy. With yoga, I connected deeply with my body, I inhabited it. In therapy, I named my emotions and insights—some of them came up during the yoga practice. Becoming a Yoga Teacher After my treatments, Aline saw the yoga teacher in me: “you need to teach!” I had always wanted to be a dancer. I knew Aline was right, I knew that it was my calling to teach yoga- to share with others the type of healing and transformation that I had experienced. And I was going to do everything I could to become a yoga teacher. In 2006, love made me do the big leap from Paris to Atlanta, GA. My husband was American and lived in Atlanta (he still does). Once in Atlanta, I worked as a freelance writer for corporate communications and, three years later, I started a 200-hour yoga teacher training. It was the first time I had ever stepped foot into an actual yoga studio. But soon after, I began the training process I realized that something was amiss. This yoga felt drastically different from what Aline had introduced me to during that vulnerable period of my life. Sure, there were other types of yoga that were more gentle and restorative, but they still didn’t quite unite my spirit with my body and mind in the manner that I was seeking. Staying True to Myself After my yoga teacher training, I started doubting. Should I teach a more “physical” yoga or restorative yoga to conform to what seemed to be the American way? Neither of these routes spoke to me. With the encouragement of mentors, I decided to stay true to myself, and started teaching (part-time) my own style of yoga- the type that worked for me—“my yoga.” While I was still working as a corporate writer, I continued training in the healing arts. In 2010, I trained in gestalt therapy in Atlanta—an awareness practice that helps a person focus on the present moment and express their truth. This was a natural move since I wanted to give my yoga students an opportunity to speak their truth and I was familiar with therapy. In 2011, I landed in a therapeutic yoga teacher training program in Atlanta, geared entirely to help a person heal whether physically, emotionally or spiritually, and was certified in 2013. The program trained yoga teachers to teach yoga with the sole purpose to help a person heal using yoga techniques, in one-on-one private sessions or small group classes. This yoga therapy training felt closer to what I wanted to do as a healer than what I had learned during my yoga teacher training. However more than anything else, the yoga therapy certification gave me the permission to create my own yoga-based healing modality. 2014 was the year of the “nuclear explosion.” I realized that, once again, I put the needs of others before mine. I had helped my husband to fulfill his dream—to buy a house—which had nothing to do with my own—to be seen by the man I loved. We ended up with a house and unable to connect. I separated from my husband, I got sick with a second bout of cancer, and my dad was diagnosed with lung cancer, all at the same time. Just like the first time, the recurrence was diagnosed during my yearly mammogram. A Team to Help Me Through the Other Side I returned to France to regroup with my family and to rebuild myself. Just like for my first cancer, I put together a team to help me through the other side of the ordeal. The treatment included breast conservation surgery, I refused the mastectomy, 6 cycles of chemo (4.5 months), and hormonal therapy (Arimidex for 5 years). This time, cancer had spread to 2 lymph nodes. The breast conserving surgery went well, although, the situation turned tricky. Complications brought on an infection in the incision that simply would not heal. An infection. Chemo. Those things usually don’t go well together. I had no other choice than to start chemo and hope the infection healed. I managed to get rid of the infection at the end of chemo. What a relief for both my surgeon and I! Unfortunately, another tricky turn came up. We were in the middle of winter. The incision transformed into a wound which had to heal from the bottom up so that it didn’t get infected again. This meant I needed to go to a nurse, every single day, so that they cleaned the wound and changed the dressing, until the wound closed up. No one knew how long this would take. Two months later, the wound was still wide open. I visited my surgeon for one of those frequent check-ups. I felt so discouraged, I couldn’t hide it. “For the wound to heal, I need you to have faith,” said Dr Dulaurans, my surgeon. His words woke me up . They echoed what my friend and reflexologist, Rodrigue Vilmen, was telling me for months, “You’re emotionally torn and don’t want to let go of your marriage. The wound is the physical expression of this struggle. Have faith. The wound will heal in the spring when you will feel clarity again.” Six months later, the wound closed up. The experience taught me how the body and mind are inextricably connected together. What Are Your Dreams, Beliefs, and Values? Meanwhile, I began therapy again. I knocked on the door of Laurent Malterre, a French licensed psychologist, author, and teacher of clinical psychology whose practice is niched in one of the oldest streets of Paris. We had come into each other’s lives in 2003, while I was struggling in a toxic relationship. With his help, I got out of the relationship and found meaning in my first breast cancer. When I returned to see Laurent in 2014, he urged me to see my light, to recognize who I am, instead of looking for others to recognize me. “What are your dreams, beliefs and values? What makes your soul unique?” were questions he asked me. That’s when I came up with my own vision of yoga therapy: I wanted to offer a healing modality with both the yoga practice I had learned from Aline and a space for my clients to speak their truth. That’s what was in my heart and soul! That was my light. After a year in France, I returned to Atlanta in May 2015. In August, my father passed away. A year later, I divorced and I let go of my 25+ year job as a corporate journalist to be a full-time yoga therapist. I continued to work with Laurent Malterre, both as my therapist and my mentor in yoga therapy, from Atlanta. Laurent and I started having Skype sessions, every other week, where we shared questions, challenges, and results that my yoga therapy brought. How does yoga help a person melt their barriers down and, ultimately, share their true feelings? How does yoga help feel what there is to feel? What does a specific symptom, a tension say of a person, their story and healing path? What does naming our pain bring to the table? How far can I go as a yoga therapist in inviting a person to share what they really feel? How can yoga complement verbal therapy? Our collaboration still goes on today, and we’re crafting together what my yoga therapy practice is. I started to include circle work in my yoga therapy classes. Thriving After Illness In parallel, I designed a body-mind, yoga-based 3-day workshop for people struck by physical or emotional illness. The workshop, titled “Thriving After Illness,” invites participants to experience practices that they can do in conjunction with, or after medical treatment, to improve their general health and wellbeing, and reignite their life fire. Nutrition, self-awareness exercises, and yoga are the workshop’s pillars. Every idea, concept, and practice mentioned in this workshop is there for one single reason- I’ve personally used them on my own healing journey, they’ve worked for me, and in some instances, they’ve probably saved my life. The pandemic has brought me to adapt my 3-day workshop Thriving After Illness for a broader audience. My new workshop is a live, virtual 2-hour discussion where I share the ways I have found to manage stress and take my place in the world. I also ask questions. Sometimes, difficult questions. Necessary questions. Participants share, bond. “Very thought-provoking” is a feedback I often get. I hope that’s exactly what my discussion workshop is! In addition to my discussion workshop, I facilitate one-on-one yoga therapy sessions, a small weekly group class (4 participants maximum), and workshops. Each class includes a healing circle where participants are invited to share what is truly going on with them before and after the yoga practice. My intention is to help my clients know what they truly feel in their body and in their soul, where they stand in their lives, what their true needs are, to help them be authentic with themselves and the people around them. For me, it’s the only way to wellness, true wellness. Life After a Second Breast Cancer Recurrence How am I doing now after my second recurrence? I am finally seeing the beautiful soul that I am, shining my unique light, and building my kingdom. I am feeling more authentic to myself than I have ever before. I've had the courage and possibility to leave the relationships that didn't serve me anymore. I've found new friends. I'm creating, from absolute scratch, a healing model, in which I strongly believe. So, overall, I feel joyful. Does this mean life is easy for me? Hell no. Becoming a therapist is a huge journey. It's taken me a long time to name what I do and to name it to others. I'm getting there. My mom is across the pond, far away. Relationships? Well, they're hard. Still, I see my richness now. And that alone makes me want relationships that are more equitable. Am I afraid of cancer? Yes. It can be a deadly disease. That being said, cancer can also be transformed into a path of richness and hope. That's what I want to help people do with my yoga therapy practice and why it's my life work. Elisabeth-perucca.com Elisabeth’s blog Facebook Instagram LinkedIn Thank you for sharing your story, Elisabeth. SBC loves you! SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events

By Adrea Carr I lost my mommy to breast cancer when I was 13. She was 47 years young when she died, just 5 days shy of her 48th birthday. Since the age of 26/27, I’ve gotten mammograms FAITHFULLY every year, knowing that early detection is key . In December 2020, I had an abnormal mammogram. I have the BEST primary care doctor here in South Florida where I live. She ordered me to get rechecked six months later, and in June, I did just that. The results were not what she wanted to see. After having a double biopsy done, the results came back, July 2021, Stage 1 breast cancer in my left breast . Hearing my specialist on the phone saying those words left a lump in my throat. I have a 26 year old daughter who is phenomenal, and I have been open and transparent as I can be with her from the time she was old enough to understand illnesses. Only a few people close to me knew what was going on. I knew if I were to beat this thing, I needed to stay positive and keep positive energy around me at all times . Testing after testing, and then a decision to make on how I wanted to attack this disease. I chose to have a bilateral mastectomy even though the cancer was in just one breast. I decided to also have breast reconstruction surgery with expanders then permanent implants . I had surgery September 21st and am currently going through the expansion process. I have a bit of a journey still to go with a few more procedures. I’ve decided to document and share my journey, there is so much more testimony to give as I journey through the healing process. I know there are others who would welcome the encouragement as I did from others who went through this as well. Mustering up the courage to speak about and share my journey has been liberating. I have an outstanding medical care team, which is important, but my support system of family and friends is what is carrying and sustaining me . From daily phone calls to check on me, to going to doctors visits with me, I am humbled by the pure selfless love. My story is different from so many others, yet we share one commonality as survivor. I want to share my story, I want to uplift and encourage, and I want to advocate in a way I can be impactful and make a difference. I’m still muddling through just how. Thanks for reading my story. Thank you for sharing your story, Adrea. SBC loves you! SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events

By Stacy I remember the day I was diagnosed as if it was yesterday. The Diagnosis As a middle school teacher, I was down to my last day of my precious summer vacation, and had a long list of last-minute errands I wanted to complete that day before starting a new school year. Going to the doctor was an annoying inconvenience in my already busy day. My primary care doctor mainly wanted to go over a recent ultrasound that he had asked to have of my right breast after my recent mammogram came back abnormal. My doctor had said he was pretty sure it wasn’t anything to worry about, but since my mammogram did show something slightly suspicious, he wanted me to have the ultrasound scan just to be safe. At age 46, I have always been extremely healthy. I ate well, exercised, ...and didn’t give it a second thought. In fact, I had decided to go to the visit alone since I wasn’t the least bit worried. That’s the day (August 11, 2017), that life as I knew it would change….. During that visit, I found out that I had not one, but three highly suspicious spots in different quadrants of my right breast . I was in shock and just couldn’t believe what my doctor was saying to me. I told him that I would go for the biopsy, but I’m sure it was nothing. He then said: “Stacy, I’m not going to lie to you, but those spots have a BI-RADS score of a 5, which means that those spots are highly likely to be malignant. You will need to go for a biopsy today to confirm this diagnosis, but brace yourself , and be prepared for many upcoming appointments and major surgery.” I would not be able to have a lumpectomy like many other women because the spots were in different areas of the breast. I would also need an MRI to see if the cancer had spread. Advice That I Will Never Forget He then gave me a valuable piece of advice that I never forgot through the struggle that I was about to endure. He said: “I know this will be hard, but I want you to try to live your life in a regular way (as best that you can) as you fight this battle. It will be hard, but don’t let it become all-consuming. Keep working every day and doing your thing….meet up with friends, spend time with family, and go on trips, no matter how hard that may seem.” My Experiences After my biopsy, it was confirmed that I had invasive ductal carcinoma . All that I could think is, please let me live so that I can see my 2 kids (although they are young adults) graduate college, get married, have kids, and accomplish their dreams. So, now here I am writing this 15 months later, and life is good! I have had three surgeries this past year. After being put on Tamoxifen , which is suppose to help keep my hormone-positive cancer at bay, I had too many side effects and am now on a different medication called Anastrozole and I’m feeling so much better! I still go to frequent follow-up appointments with my oncologist and plastic surgeon every three months, and I even got a tattoo that says, “Seize the day,” as a personal reminder to live my best life! I know that I am one of the really lucky ones. When I had my mastectomy , I was told that it was early stage 1, hormone positive cancer, and that it had not spread to my lymph nodes. I also found out that I was BRCA negative. More great news followed from my oncologist that I would not need to have chemotherapy...those words were music to my ears! They say that you are only as strong as those that you surround yourself with , and I truly had an amazing team of doctors, an amazing husband, and a supportive family and friends that were there every step of the way. Sharing My Story As I fought breast cancer, I chose to share my story (as uncomfortable and private as it was) with all my friends and family on Facebook. I persuaded them to be proactive about getting those mammograms on a regular basis ( especially my teacher friends who tend to overlook self-care because they are too busy !) I shared with them that I had never had a lump or any type of sign that I had breast cancer, and had I not had that mammogram when I did, the cancer might have spread and I would have needed chemo. Many of my friends sent me private messages telling me that because of me they went and had that dreaded mammogram. It was that defining moment that I realized that when I felt up to it, I wanted to help others that were going through breast cancer! Sharing my story on social media helped me to not only heal, but may have helped others in the process. Keep Doing Your Thing To anyone reading this that is going through breast cancer , just know that it is okay to have days when you feel depressed and worry if you will survive. Allow yourself to have those brief moments, but then brush yourself off, keep doing your thing, and be the fierce survivor that you are. Then, when you are done fighting the fight, and the sunshine comes through the clouds again, go out there and do something worthwhile with all that you have learned during your journey and help others who are currently fighting breast cancer…. after all, isn’t that really what life is about anyway? Thank you for sharing your story, Stacy. SBC supports you! SurvivingBreastCancer.org Resources & Support: Positive Thinking for Healing Online Support Groups

By Zoe My name is Daniela alias Zoe, I’m 33 years old , going for 34. I have been living and working in NY for the past 6 to 7 years. In NY, I'm able to do way much more that I could ever do in my hometown in Italy. NY is a place I consider my artistic home. I can live and work in the U.S. on a 3 year artist visa. In fact, as of now, I'm busy renewing before it expires again. On July 29th 2014, I flew from JFK airport, NY to Fiumicino Rome. As usual, during the summer I go back to Italy on vacation, with the plan to come back to the States after 20 days, tops. Not having medical insurance in the U.S., it is in Italy that I do my usual medical annual check up at my breast and ovaries. There is some breast cancer history in my family but only from my father’s side, which would have been considered not really relevant. Moreover, back in 2003 , a suspicious nodule was found and I had to keep it under control by monitoring it. That year, I felt like a suspicious little ball growing on the right side of my breast. When I was raising my right arm it was popping up, stretching the skin and lightly altering the line of the breast. I was a worried. My latest medical check up didn't reveal anything alarming. How can something drastic happen in a year? My Diagnosis On August 21st 2014 , I was diagnosed a G3 Breast cancer at my right breast, infiltrating ductal carcinoma poorly differentiated ; this is the exact diagnosis. It seemed like the title of a movie or of a comic book from another dimension, from another time frame where all the serial numbers G3 of cyborg prototypes will have to be demolished by the corrupted military government cause inadequate, wrong and imperfect. Just like a Manga vision. Bottom line, I was dealing with a 2 centimeter and 7 millimeter neoplasia, chances are malignant cancer/ tumor. Could it be true? Fine needle aspiration biopsy , technically answered this question and confirmed the diagnosis. The doctors clearly told me that to allow the removal of the neoplasia, I would have to soon have a quadrantectomy surgery done, which is a cut that goes perpendicularly from the nipple to under the armpit. They also recommended possible post surgery radiotherapy sessions. These radiations are really harmful, among the many things they even have the power to change the DNA of the skin. I was stunned, yet forced to have to understand all of it and quickly learn how to find my way out of this nightmare which was just at its very genesis. Tests, Tests, Tests Before anything, I had to do a NMR (nuclear magnetic resonance) , a test that along a total body C.T. scan , would reveal possible presence of other neoplasia or metastasis. They still had to collect data on my case and they were not able to confirm that or anything with specific certainty, but some doctors already told me about the possibility of undergoing chemotherapy. Luckily, the C.T. scan didn’t reveal any metastasis but only an angioma on the liver, which initially scared the doctors, but later I learned it was congenital and therefore harmless. The NMR revealed two more neoplasia of small size. I was told they would have to take out all the mammary gland and mastectomy was the only possible solution. They would completely remove my right breast. Some lymph nodes would also have to be extracted from the armpit to see if the cancer had spread outside my breast. As if the removal of my breasts was not enough, I was told that 6 months of chemotherapy was also required. Whether this was going to happen before or after the surgery was not yet clear. A test that could allow the medical team to better understand when to do this treatment existed, but I was not aware of it at the time. Nobody had mentioned it. Thankfully the right oncologist informed me of it, which ultimately enlightened me on what to do. The existence of this important test was introduced to me only after being told all the possible consequences of the surgery. The gruesome list that attacked my womanhood was horrifying. I would be left unable to breastfeed, I would lose any sensibility, I would have to replace my mammary gland with implants. The possibility of removing my nipples was high and uncertain. It was only during the actual surgery that a test could have been performed to reveal whether tumor cells were present or not. I was doomed to have to enter the operating room without knowing if I would get out of it with nipples or not. That was a gamble I never imagined I would have ever had to experience in my life. Genetic Testing This last step might be the most important one for me. It consisted of a blood test that would inform me if the tumor was due to a genetic predisposition. If the test came positive there was a high risk of developing a tumor on both breasts, which meant that the removal of both breasts would have been likely. While waiting for the result of that test, I was left confronting the chance of a double mastectomy. As if that was not enough to fear, the doctors also informed me that if the test came back positive then in the near future, right after a potential delivery of a child, I should also have my ovaries removed. Really? Well, thanks for nothing. Fear, Panic, and Struggle The genetic test came back positive. Procedure and protocol became some of the terms my brain would have to get familiar with, as I had no chance but to accept 6 months of enduring chemotherapy and a double mastectomy: 9 months of my upcoming struggle. To console me, everybody kept saying: “Angelina Jolie did that too.” The Therapy September 18th 2014 was the day before I started the first cycle of chemotherapy. That day, a series of intramuscular injections to stop my ovaries from working and would force my body into a menopause. They inserted a PICC line in my left arm- an intravenous catheter where they would infuse the powerful chemotherapy medication and keep my veins safe. To shower, I would have to wrap that part of my arm with cellophane and tape it very securely. This lasted for 2 months. That first morning brought me a panic attack. I had many thoughts and I could not even keep up with all of them. I was sure I would have soon turned into some sort of an avatar. I would be left hairless just as a cyborg. In my creative mind, I imagined being forced in a military-like therapy of 3-4 hours of IV, and it would all be set up by fears and phobias dates and days. Days which would have only brought nothing but horror- one I would have no choice but face and confront. These injected medicines were considered smart bombs, but weren't that smart after all. They were just as smart as they could get. Chemotherapy kills the bad cells, but also kills everything else including the white blood cells that support the natural immune system, so I had weekly blood tests to monitor how my body reacted to the chemotherapy. While undergoing treatment, it was challenging to hear stories from other people. I didn’t necessarily want to hear people’s opinions. One specialist doctor provided a different perspective and information that I was forced to hear while I was in the waiting room. My own internet search even further fed the overall confusion. Reading about doctors' implications in regards to the mechanics of the human body often felt shady, murky, unclear, and untrustworthy. Wanting To Know More The stigma of Cancer still exists, supported by the thousands of taboos that surround it. I asked tons of questions to those doctors who so arrogantly seemed like carrying the knowledge of where the Holy Grail might be located. If you are not a doctor, if you are simply an ordinary human being, then how can you know or understand anything?! I grew up with a particular hate for uniforms, or any authority that pontificates absolute truths, especially when such truth implies no way out. Only death is not irreversible. I had questions! I wanted information. As an oncological patient, I felt merely allowed to be given the bare amount of knowledge. I felt like going back to being a child asking the many whys. My personal confusion came with these unanswered questions: How can I not have customized therapy? How is it possible that all these procedures are standardized and impossible to change? Why can’t I fully inform myself? How can I change this dogmatic approach? Am I a fool and a dreamer to even raise these questions? I had a hard time trusting anyone. As far as I was concerned, the conspiracy theories in my mind could have involved anyone. I never believed in pharmaceutical care alone, but rather, a holistic approach knowing that our state of mind, lifestyle, and habits, contribute to our health or sickness. Nowadays, in my opinion, eating organic food has become fashionable. We can take for granted that yoga, breathing, practicing sports, and especially being in touch with nature can help your health. It’s been since the 90’s that doctors talk about psychosomatic diseases, caused by stress: colitis, dermatitis, back pain, and so forth, to a point of actual traces of idiopathic diseases. However when you question that the mind can actually influence anything, it all becomes a new gray area that seems impossible for any, some doctors to even consider. Why? How can I suffer a psychosomatic symptom and not give my mind the same credit to do the very opposite? Body and mind are connected. I believe our minds can influence our body in both bad and good ways. Easterner philosophy and popular folk knowledge influences and supports this theory. Both for different cultural reasons even believe in the elevation of the spirit that can come through the pain, sacrifice, and penitence of such experience. My breast cancer diagnosis has allowed me to discover why I live - Why I die - Die? My intention wasn’t to die. I had never even considered dying. Double Mastectomy Luckily, early stage breast cancer is treatable, if not curable. For that I was grateful. I would not die. I had no choice but to trust what I was told. But I launched a search and collected all possible opinions to gather confidence to be doing the right thing. I called and sent emails to almost all of the best doctors in Italy. Everyone agreed: Double mastectomy was the way to go. Everybody kept saying: “Angelina Jolie did that too." My Hair Became Hats July 19th 2014, 7:30am, my first cycle of chemotherapy. 3-4 hours on a hospital bed with a series of IVs attached to the PICC line on my left arm. A nightmare with eyes wide open. I read, slept, and cried. Memories of the many movies about it kept rushing in my mind. Hell just began. I was only surrounded by women older than me. I was the junior in my nightmare. In my mind, the question was, “Why me?” and “When will I start feeling sick?” I knew well that within that same day that I would have started feeling the initial pain of the procedure. 6pm First Symptoms : Nausea Gagging without ever vomiting Headache General sickness and pain that exhausted my body in ways I never knew possible Bloated Anxiety and depression (of course) After The Therapy I alternated diarrhea with constipation. The list of symptoms is long. Here are a few: Fatigue, a burning sensation in the throat, and a lack of appetite. Chills and trembling. Hot flashes and heavy sweating every 10 minutes. A perennial chemical taste in my mouth. And I felt other things I cannot even fully describe or even knew were possible. I felt like a robot. Or maybe I wished I was a robot. I would have felt nothing if I were. I was still human. But often I was not sure what was left of me. During this time, I smoked weed and ate very healthy food. I followed the suggestions of a rather prestigious biologist and separated food from alkalizing and acidifying. No sugar, no dairy (I had already quit all of that a while ago anyway), no eggs, and no soy (contains hormones). No meat. I was also allowed only white meat but not too often. Small light blue fish was considered an even better choice, but again to be consumed rather rarely. I ate lots of cereals, seeds, sprouts, roots, and vegetables. I started meditation, and yes, I even embraced dancing again. On October 3rd , I turned 33 years old ... 2 days after my hair started falling out. This did not come as a surprise, of course. But being that in nature and for mere fashion, one of my favorite hobbies was dying my hair any possible color and since I even often shaved it by choice, I was sure that for someone like me losing it would have been the easiest part of this quest. It wasn’t. To prevent the shock of such an experience, I was advised to cut it short. I already sported a short hairdo, so I just left it alone. Unfortunately, I had to experience the horror of the first shower that left me with chunks of hair right in my hands. Each time I touched my head, my hair kept sticking to it. Each time I touched it, it horrified me. It fell out like an untangling sweater that ultimately becomes completely undone. In dismay I got out of the shower. I used my blow dryer to dry what was left of it. So much of it just blew off me. I felt like an animal in its first stage of being skinned. I had not yet accepted that the only thing for me to do was to completely shave my head. So as a solution, I just trimmed it all short. I bought hats and scarfs. But hair kept falling, all of it, including eyebrows and eyelashes. I found it everywhere. Even the shortest of my trimmed hair kept falling. It looked like a trace of me was being left behind me. I could no longer cope and completely shaved my head. When I weighed myself, I barely reached the 113 pound mark. I felt almost nil, but I kept fighting and fighting, and even when I thought I couldn’t, I did. When I couldn't fight for my own self, I fought for my mother who has always been there. Gifting me with the joy to live and relentlessly by my side all along. Motivating me to keep going. Right after the very first session, the tumor started regressing. The little ball was getting softer, thinning... and ultimately slowly disappeared. Great hope that everything will get better soon was finally plausible. Embracing My Life Again November 21st 2014 : After 4 cycles I was done with the hellish cycles. They removed the PICC line from my arm. But before doing that, I decided to indulge in an artsy nude photo shoot for my own self. I wanted to visually immortalize this moment as to respect my struggle and my relentless fight. To never forget this version of me I would never ever want to be again. I took 10 days away from it all and went to London and Berlin to try getting my mind off the whole ordeal. Once back home, I had to start a weekly therapy, but I was told it would be less aggressive. The therapy was indeed much kinder to my body, besides some fungus and pain on nails, there were less excruciating side effects, or maybe I had now gotten used to some of its discomfort. I did not dare to complain much and chose to look ahead instead. The end of the tunnel was visible at that point so I kept walking. Hair would grow back, but I felt much weaker than ever before. Christmas and New Years came and went. I finally could go back to doing yoga, because I no longer had a PICC line. I kept meditating and of course danced away as much as I could. I kept counting the weeks left until the surgery -8, -7... and so forth. I was aware that there was a chance for my white blood cells to freak out again and consequently be forced to skip some therapy cycles and slow down my way out of this tunnel. “I will not let this happen,” I told myself. Of course, I was left weak by this whole invasion of my body. I knew there was always the chance to postpone these cycles because of a cold or a flu or any other ordinary condition. I dread that chance and vowed I would not allow my body to delay nor extend this last part of this therapy. I wanted out. That was all there was in my head. I wanted out! I had to be back in NY and I had to embrace my life and creativity again. March 5th 2015 marked the end of the therapy. March 31st 2015 was surgery day: Double mastectomy. April 28th 2015 , finally back in Brooklyn, NY. Angelina Jolie was not there though! On October 26th 2021 , I had my Bilateral Salpingo-oophorectomy surgery in NYC. I have health insurance now; I got it during the pandemic. I’m in menopause, I’m on psychotherapy (it’s been 2 years), I’ve done ayahuasca twice, and I don’t take any medicine. Thank you for sharing your story, Zoe. SBC loves you! Connect with Zoe on Instagram: @zoemap SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events

By Danielle Brandt I would never have thought that an active 33-year-old who was doing CrossFit 6 days a week , performed monthly breast exams , had no family history would be diagnosed with Stage 2 Breast Cancer . The day before I found my lump, I was snowshoeing in the Berkshires and loving life and just remember a constant irritation with my sports bra on my left breast and that was it. It wasn’t until we got home that Sunday night (Valentine’s Day) that I felt a hard small lump that was not palpable. After watching my mom fight colon cancer, my sisters and I have always taken our health very seriously and first thing Monday morning I called and got an appointment with my primary. My hospital is a teaching hospital and a resident examined me initially and asked the nurse practitioner to come in and share her thoughts. She didn’t like how it felt and knowing that I never had kids or had been pregnant concerned her more. She ordered a rush mammogram and ultrasound for that afternoon. As I was waiting in the waiting room for my mammogram , I just remembered looking around the room of women of all ages and wondering what their story was. The mammogram was painless and then it was time for my ultrasound . It felt like my heart was racing and about to jump out of my chest. I kept looking at the monitor trying to figure out if it was anything serious. The tech finished my scan and said the radiologist just needed to check as it was routine. It was not routine and again a medical student came first and scanned my chest again and spoke to the radiologist before she repeated the scan. It was at that moment she told me it was 90 percent likely cancer due to all the calcifications they were seeing . To say, I was a complete mess would be an understatement, but I knew after watching my mom go through cancer what I needed to ask for. Somehow, I found my voice and asked for a biopsy that day and explained that my grandmother had just passed the day before and that Wednesday I was leaving for New York for her funeral. That Wednesday was also the 7-year anniversary of my mom’s passing. The radiologist was amazing and asked people to stay late and perform my biopsy that day and I actually met my breast surgeon as well (at the time I didn’t know who she was as I was in complete shock). After meeting my breast surgeon, they put me in a room while I waited for my biopsy, and I called my husband and just broke down. Covid was still very active at this time, and they didn’t like visitors or spouses with you, but the nurse allowed my husband to meet me. As we were walking out of the hospital, the only thing I could say was “I don’t want to die.” I had always thought that if I got the big “C” I wouldn’t tell anyone right away and give myself time to process, but the issue with that is I am putting my family at risk. I decided on the way home to have my identical twin sister set-up a family zoom call and I told my sisters, my dad, my uncle, and my aunt. If I had tested positive for any of the gene mutations it would have meant that my twin sister had a 100 percent chance of getting cancer as well. By telling my family, it allowed my sisters to get checked along with my cousin. That Wednesday February 17th, my dad and little sister flew in, so we drove to my grandmother’s funeral together and it was also the day I got my biopsy results confirming it was cancer. My cancer is ER+, PR+, and Her2- with grade 3 cells and no genetic mutations. I met with my breast surgeon again in person and told her I wanted a double mastectomy ; it wasn’t even a thought for me. I just wanted my breast gone as they were trying to kill me. I really liked my breast surgeon and now it was the time to build the rest of my team. I met with an oncologist initially and didn’t really connect with her as I found her cold. Living in Boston gave me access to some of the top hospitals in the country and I got multiple second opinions to make sure I was happy with my game plan and team. It was at this point that I researched and asked for the Director of Oncology to be my oncologist and my plastic surgeon was chosen. It is so important that you feel comfortable with your team of doctors and their game plan. My plastic surgeon was diagnosed with Colon Cancer at the age of 38 and understood my fears which made me feel like I was being heard. My breast surgeon and plastic surgeon told it me that due to schedule issues I wouldn’t be able to get my double mastectomy for another month, but I just wanted my breast gone and for the next week I would call daily and speak to both of their admins and asked if there were any cancellations. It was a Friday, and I was on a work call when I received the call from my plastic surgeon admin that they had a cancellation for March 10th (the next Tuesday) and asked if that was too soon and I responded absolutely not! I immediately called my manager and HR department and told them that I would be going out on medical leave beginning that Tuesday. Again, due to Covid, my husband couldn’t be with me, and I had to face the biggest scariest surgery of my life all alone. I woke up on March 11th boobless and in tremendous pain ... not exactly how I thought I would be spending my 34th birthday. After my double mastectomy, my oncologist told me that my oncotype score was a 15 which usually doesn’t recommend chemo but due to my age and the grade of my cancer the cancer board felt like I should consider it . Again, I got multiple opinions from other oncologists, and all agreed that they would have a similar treatment plan. On April 10th, 2021, I got my port and would begin TC chemotherapy the next day. Prior to starting chemo, I did a lot of research and packed my chemo bag with ice gloves, ice booties, lemonheads, a blanket, and a giant water jug. Supposedly using ice gloves and booties would help prevent neuropathy and sucking on lemonheads would help with my taste buds. I also read that keeping active during chemo would help my recovery. During my 4 cycles of chemo, I stayed active and didn’t experience any major side effects. I was lucky and grateful to get through my surgery and chemo, but didn’t realize that after you are done with all of the above is when the fear really sets in. I was no longer going to the hospital every week and being seen; I was now just going once a month for my Zoladex shot and seeing my oncologist every 6 months. This is when my anxiety took over and I started worrying about a recurrence and having to take hormonal medicine really didn’t help either as I gained weight during chemo and now felt completely uncomfortable in my own skin. I am now a year and 8 months out from my double mastectomy, and I worry constantly about the cancer coming back, but I have also learned to appreciate life more. Every day, I get to see the sunrise and set is a good day for me and I have learned to prioritize myself more. I quit my job that had me working 60 plus hours a week and found a company who focused more on work life balance. I make it a point to workout or go for a walk every day and I am still learning how to deal with my anxiety and fear of a possible recurrence , but I am living and learning to take it one day at a time. -- Connect with Danielle on IG: @life_of_a_cancer_patient Thank you for sharing your story, Danielle. SBC loves you! SurvivingBreastCancer.org Resources & Support: Our Podcast Online Support Groups Free, Weekly Events