Thank you for supporting Survivingbreastcancer.org throughout Breast Cancer Awareness Month (BCAM)! It was a very busy 31 days but our work doesn't stop just because it's no longer, BCAM. In fact, we are just gearing up! Before we jump into where we are heading, let's take a quick inventory of successes this October: Survivingbreastcancer.org's Breast Cancer Awareness Month Impact: 10K visitors came to our website to ready survivor stories, gain information via our news and blog articles, and access our resource pages 286 people attended at least one of our October virtual programs ranging from Survivorship Workshops and Thursday Night Thriver Meetups to Chair Yoga and webinars on grief & loss. Our podcast Breast Cancer Conversations was downloaded 2639 times with the number one episode being episode #60, Mastectomy Recovery Tips. We took a strong stance this October, moving beyond just awareness, and turned the spotlight onto Metastatic Breast Cancer, Going Flat, Informed Consent, and Breast Cancer Recurrence. All topics that make us one of the most unique, diverse and inclusive breast cancer communities out there! We are YOUR community! We take your words, your emails, your suggestions and turn them into blogs, podcasts and programming. Because of you, we have created our Breast Cancer Book Club which already has 51 members! Because of you, we are bringing in experts to talk to us about precision medicine and why our genes matter! Because of you, we are teaming up with organizations to bring you clinical trial matching! But our work is not done. We need your support now more than ever in these times of, not just breast cancer, but COVID-19 as we continue to provide necessary community, education and resources to those diagnosed with breast cancer and their families from day one and beyond. Did you know that roughly 30% of annual giving occurs between November and December, with about 10% of all annual giving concentrated in the last three days of the year? Asset Based Giving is a brilliant way to maximize your donation to charity, and reducing your tax payments. By donating non-cash assets, instead of selling them, paying taxes (if required) and then donating the proceeds, it typically allows you to receive a fair market value tax deduction, versus selling and paying a capital gain. For example: Bill and Judy have a small farm in Northern New England. It has been in their family name for 30 years. Bill and Judy purchased the farm for $35,000 and just this year it appraised at $350,000 market value. Bill and Judy are getting on in years and don't really spend much time away from their South Carolina Retirement Community. Judy was diagnosed with Stage II breast cancer 10 years ago, and was successfully treated at a Cancer Clinic. Since then, the couple have been partial to the breast cancer community and they wished to sell this farm and donate the proceeds. But doing so would have sent thousands of dollars to the federal government in the form of taxes, versus to the breast cancer community they were so supportive of. The couple learned through their accountant that one of their favorite charities, SurvivingBreastCancer.org was able to accept innovative, non-cash gifts such as real estate, business interests, jewelry, autos and boats, and they were thrilled to make their gift before the sale. Why would this be a brilliant choice? • Bill and Judy avoided paying capital gains tax, saving many thousands of dollars. These dollars went to support the breast cancer community work of SurvivingBreastCancer.org. • Higher charitable income tax deduction: They received a tax deduction of $350,000, the fair market value of their property. This created a considerable tax savings and allowed SurvivingBreastCancer.org to maximize the benefit. With the Asset Based donation, in this example, SurvivingBreastCancer.org would be able to own and operate the farm as a retreat and nutritional learning center for the breast cancer community. So how can we serve you? SurvivingBreastCancer.org would be honored to speak with you to explain how we can help you give in new, creative, and tax-smart ways. Please call us at (603)361-7018 or email William@SurvivingBreastCancer.org Background Out of the need to navigate the uncertainty and the strong desire for connection, support, and resources, surivingbreastcancer.org was born. A fundamental piece of the breast cancer journey revolves around well-being and quality of life.  This translates into how community, education, support, and wellness complement one's treatment plans and continues not only through survivorship, but thrivership! SurvivingBreastCancer.org, Inc., Employer Number 82-2953427, is a non-profit 501(c)(3), dedicated to empowering breast cancer survivors, their families and caregivers, from day one. At Survivingbreastcancer.org, we believe that an integrative approach to a breast cancer diagnosis plays an important role during treatment and  throughout survivorship.  Our virtual educational and patient care community meets you where you are.  Whether you are undergoing chemotherapy, radiation, or surgery, you are several years with no evidence of disease, or you are living with metastatic breast cancer, SurvivingBreastCancer.org is a complement to your care.​

By Silke Pflueger, It’s late summer in 2013. I’m 48. Having drinks with my man and a friend. They talk shop. My thoughts drift. Until they stop drifting. My fingers feel something that doesn’t belong there. I race into the bathroom, and yes, there is a hard mass in my left boob. Doctor’s appointment the next morning. They find a place that takes me for a mammogram that afternoon. Need ultrasound, too. Ultrasound says that I need a biopsy, and I smooth talk my way into a biopsy that same afternoon. The phone call comes a few days later. It’s cancer. There are a lot of foreign words. Hormone positive. HER2 negative. More words. Colors become technicolor around me. Why me? I opt for a double mastectomy. Two lymph nodes involved. Onco score is low, so I opt for no chemo. Tamoxifen for a year, then chemically induced menopause and Arimidex. I’ll be fine. It won’t be me. I got this. Fast forward. It’s late summer of 2019. We are in Germany for work. My sciatic nerve has been a problem half my life, but it’s incredibly bad on this trip. I can barely walk. Everything hurts. Laying down. Sitting. Standing. Walking. Everything hurts so bad. I go to an ER. X-Ray shows the usual herniated disk, but the doc says it’s not bad enough for the pain I feel, and recommends I get an MRI when I’m back home. We are back home. I see my GP, get an MRI, go back to her. MRI says something about large lesion in sacrum. I have no idea what that means. All I know is that my back still hurts. My GP hugs me. Shit, I think. She doesn’t hug me unless it’s cancer related. I ask a little more. Will have to do a biopsy to find out. But it likely is. I walk out numb. Why me? I manage to snag an appointment for a biopsy the day before I travel back to Europe for a week in Athens with my mom. Biopsy confirms my cancer has spread to my bones, and I’m now metastatic. Dr. Google says it’s somewhere around a 25% chance that I’ll live 5 years. WHY ME? I have so much more living to do. Why me? That’s the question so many of us ask throughout this journey. Why me? I’ve lived a healthy life. I eat healthier than 90% of people I know. Why me? I have slight weight issues, but nothing bad. Why me? I love working out. Show me a mountain and I’ll hike up or bike up or ski down. Why me? The short answer is that we don’t know. My dad’s side of the family seems to have a lot of breast cancer, but we are a pretty small family. No genes that point to breast cancer - yet. “Why me?” is a question a lot of us ask, but very few of us have answers. Since I can’t answer it, I’ve settled on “It is what it is, and I’ll live the best life in the time I have left.” I suggest you do, too. Silke is a laser engineer, lover of the outdoors, foodie, and recent American. She was first diagnosed with early breast cancer in 2013. After a year of never ending, but not unusual sciatic nerve pain she found out that it was a metastasis in her sacrum that was pressing on the nerve, and not the slipped disk that had caused her a lifetime of back pain. She tries to keep on smiling, helped by antidepressants and being outdoors as much as possible, all to enjoy the time she has left.

I used to think that August was one of the hottest, most humid months of the summer. But this weekend proved me wrong. Boston was overcast, high 70's, no humidity, and actually a bit chilly. A sign of things to come. Can summer really be over? Are we already in the mindset of the next school year? For some of us, that means our kids are getting ready to return to college. The move-in process is starting several weeks earlier than usual enabling students to return home by Thanksgiving and not having to risk traveling in November/December during a health pandemic. For others of us, we continue to attend PTA meetings and town halls trying to figure out what our school district will decide. In a given academic year, we try to coordinate school pick up and drop off while we attend chemo and plan for surgery. But this year is overly complicated. Does it have to be? Are we over thinking this because it's new?  We can remember many other obstacles and challenges that we overcame and yet somehow this fall, we are facing the tallest and steepest mountain yet. Let me reassure you, you will scale this mountain! It will not be easy, but you have the ropes, carabiners, helmet and an entire team of supporters on the ground belaying so you won't fall. How to Scale Mt. September Map the course. Write out your list of essentials and tasks that must get done leaving aside all of the "nice to haves" for another time. We just need to focus on the path of least resistance. Pack your hiking bag accordingly. Hand sanitizer is a given, along with mask. Then add your fruits and veggies because you know you'll need fuel. Healthy proteins like beans that you know will not go bad. Choose your belay team accordingly. These are the people that will have your back as you begin to ascend Mt. September. Who is in your inner Covid circle? Who are the friends and family you can trust to come to your rescue at a moment's notice. Put your list together and let them know they are your team! They'll feel honored and even take extra health precautions knowing they could be called upon at any moment. Synchronize your watch and activate your GPS. With all of the health apps out there, we know technology is playing a larger rule in our day to day. Speak with your doctors and learn what appointments you can attend virtually via telehealth. This will certainly save you time on the commute and needing to secure child care and even save you a few buck on parking! Start your hike.  One foot in front of the other. Do not try and tackle the entire fall season at once. Take it one day at a time. Be willing to adapt. Be kind to yourself and know that it doesn't have to be perfect. You need to take care of you. If you get off the trail and into the "puckerbrush", no problem, readjust that compass and carry on! Most importantly, you are not in this alone. If you are looking for community to talk about everything you are going through, now is the time to reach out. Join one of our Thursday Night Thriver Calls and we will all get behind you and hoist you up Mt. September

How I Discovered Faith, True Beauty, and Confidence During and After Cancer By Karen Rice Without questioning, when going through a serious illness, you learn to know what faith truly is, along with finding the true meaning of beauty and how you really feel about yourself. I know this all too well because I have experienced many trials and tribulations in my life. Through it all, I gain strength that I never knew I had, and much more confidence in myself, which led me to loving myself all over again. I had a new beginning, all on my own. After going through so much in my life, things were going well, until it happened. I had a head-on collision with not only breast cancer, but colon cancer as well, and it changed my entire outlook on life. I thought I had endured rough years before but going through cancer was the rest of the iceberg. There is nothing like it. You wonder, what in life had you done so wrong to have this placed upon you. You began asking, why me. Yet through my tragedies and all that I had to endure, it all became an awakening for me, in which I received and gain all the strength and encouragement I needed to conquer. Through it all, not only did I find the true meaning of life, I found the true meaning of beauty. Through all the chemo, radiation, the pain I endured, I still felt beautiful. I found myself looking in the mirror even more during this time, because I thought what I was dealing with would change me drastically, but as I viewed the imperfections I now have to live with, over time it got better, and instead of feeling sorry for myself, I embrace it all; I'm still among the living, who am I to complain. Whether we are dealing with an illness or any other negative feelings about ourselves, our lives, and our bodies, we need to be our on-cheering section. Through all my mishaps, I still feel beautiful and it is real. I have come to realize that even going through such a dark time in my life, I still have a life to be lived, and I am going to live it to the fullest. When I think about the individuals that are no longer among us due to such a horrific disease, I'm truly grateful, and I will no longer take my life for granted, life is precious, and we don't realize that, until we come close to losing it. When I think of the “gift of life” that was given to me twice over, I knew I did not have a moment to waste. I would never say having or going through cancer is a gift, surviving it, receiving a second and third chance at life, is the gift. Yet, through it all, I did not allow the disease to take away who I am, or what I stand for. I am a survivor, as well as an example to show that it can happen, and that I can go on and look and feel just as beautiful, inside, and out, and it shines brighter. Yet through my tragedies and all that I had to endure, I received and gain all the strength and encouragement I needed to conquer. I will say, that the areas of my body that was interrupted, will be a constant reminder I had cancer, and at times, it does bother me, I'm human, but within a moment or two, I look past it, because those areas could be covered up. True beauty is within and when you feel beautiful on the inside, it shows so clearly on the outside. Just because I had cancer, does not mean cancer had me. We as women should never allow anything, or any circumstance to steal our joy, nor our self-esteem. And I know with cancer, many times you are too weak to even think about your looks, because you're not always feeling your best, believe me, I know; but sometimes you must try a little bit, and fight past it and keep living. Through any tragedy, we are and always will be beautiful and unique! Women, we all know that our bodies take lickings, yet we keep on ticking. When I look back now and see how far I've came, I have to say, I thought right away that my cancer diagnoses was truly a death sentence, because you're not sure if you're going to make it or not. Cancer have taught me not to blink twice at life, my eyes are wide open, living life to the fullest. I also realized after surviving cancer both times, that I was about to face new beginnings, new hope, do and see more with a whole new prospective on life. I share my story with others hoping to make a positive impact on someone who is ill or otherwise, where they can proceed life in a whole new way. I am 63yrs of age now, and I am cherishing each day, each moment, and through it all, I feel that I am still at my best. I am confident with myself, as well as grateful. I am starting over, doing things I should have done before cancer. One day, after one of the many surgeries I had during my breast cancer period, and I could remember it as if it was yesterday, I experienced something so real, so peaceful, something of a miracle, that I had to write it down. I turned that experience into a poem, and I called it “Peace”. I took that poem, along with many others I had written, writing had become therapy for me. I am hoping that anyone who may have the opportunity to read my poems, get out of them, what I placed in them, they are as real as any could ever be. My most recent published book is titled, “Cancer, Yet Cancer Again, but I will not Die, before I'm Dead”. I titled it that , because I truly feel that you should not stop living, because you have cancer, and that is exactly what I almost did, when I heard the word cancer. I am a realist, a regular everyday woman, who have overcome many obstacles, which took me to writing, trying to produce inspirational stories. If I had not gone through all that I did, I would have never anticipated such. The scars and mishaps, that are now attached to my body, due to cancer, are just that, and they are symbols for someone else inspiration and hope. I am thankful, because if I had not struggled, I would not have found my true strengths. I am a true example that you can survive cancer, not once, but twice, providing you get to it in time. I am not saying all will be easy, I am not saying all will survive it, what I am saying, is to have faith, fight with all you have, then hold on. I honestly believe, when and if you survive a horrific tragedy or a horrible disease such as cancer, it is for a reason. You have a purpose, and through that purpose, faith, compassion and strength, true beauty is born.

By Andrea Magni www.diverightincoach.com acjmagni@gmail.com I am a master of reframing … Reframing is an important skill as it takes you from a place of zero choice to being the master of your own destiny. There is a legend that Amazonian women would remove their breasts to make them a better archer and warrior. It isn’t true and yet for some breast cancer survivors it is: removing their breasts makes them much more able to fight and live on. As we navigate our treatments there are some well-meaning people who will refer to our breast surgery as a “boob job” or they’ll comment on how sore their boob job was when trying to let you know they “understand.” Our Breast Cancer survivor group meets once a week and we have no agenda. One week I discussed the fact that breast surgery was an amputation and it resonated so deeply with everyone. When I had my double mastectomy they hollowed out my body from one rib cage and armpit to the other. All the flesh under my skin was removed. I had implants placed over my pec minor muscle and under the pec major muscle and stitched into place. This was not an augmentation or “boob job”. My breasts have changed so much over my life, from pre-puberty, adolescence, young adult, overweight, pregnant, breast feeding, and after. When I learned I had breast cancer and had opted to have a double mastectomy I grieved. I grieved for the loss of naiveté and the innocence of life. I was not sure then if my cancer had spread, all I knew was I wanted to take the most extreme action. My 2.0s as I affectionately call the upgrade (only an upgrade in that they’re not trying to kill me), are big. 34DDs. I did not ask for them to be this size. The surgeon made her mind up while I was on the table. I believe she could have gone smaller but she looked at my almost 6 foot frame and thought I “could handle the scale”. There are some downsides to this: tops do not fit like they used to. The size makes them heavy. None of my old bras fitted and I have to wear bras with serious construction permits and broader straps. There is a reason the DD’s have special sections in the bra store. My breasts do not mold into the bra – the bra has to fit perfectly and even then after several hours the implant squashes my skin into the bra frame. I was hoping to be able to go bra free every now and then and this is not really possible. They are simply too large. Thankfully Sports tops are helpful. The positives still outweigh the negatives: I have breasts, they do have feeling (and this is wonderful), I did get some new lingerie, they allow me to talk about breast cancer in a refreshing way. I love the 2.0s very much. Best 2.0 moment: a few weeks after surgery we were staying at my Dad’s house and he was reading the kids and I a bedtime story. My daughter was tucked up next to me and leaned in, put her head on my chest, she looked up and said “mommy does this hurt?” I pulled her closer and said “no, it feels wonderful”. Second best 2.0 moment is how good they look in a halter neck bikini! See? Silver lining! What do you want to see differently in your world? Maybe I can help with perspective and reframing. Reframing puts the responsibility of choice back in your corner. For example: “my doctor says I have to exercise or I will have a heart attack. So I guess I had better go to gym.” Or you could take ownership of the idea and say “I want to be well and make better choices for my body. I want to go to gym”. Coaching to reframe is a powerful cognitive tool that helps develop perspectives that better serve your goals. www.diverightincoach.com acjmagni@gmail.com

The above aphorism is commonly attributed to the French philosopher Voltaire. Voltaire was the pen name under which the author, François-Marie Arouet published a number of books and pamphlets in 18th century France. He was a key figure in the Enlightenment, and notably was quite controversial in his day, due largely to the critical nature of his writing. His work drew on the many essays of Aristotle, Confucius, and other classical philosophers, who advanced, among other things, the principle of the “golden mean” which counseled against extremism. Let me explain this theory by using simple math. The 80–20 concept explains it this way: it commonly takes 20% of the full time allocated to complete 80% of a task, while to complete the last 20% of that task takes 80% of the effort. Another way to look at this theory is 20% of your surroundings (people, obstacles, health issues) yield 80% of your problems, and the corollary effect should thus allow us to focus on the greater good of 80% VS the 20% obstacles to our wellbeing. With that in mind achieving absolute perfection may be impossible, and any increase in effort will result in diminishing returns, thus any further activity becomes increasingly inefficient. So you may be asking “where are you going with this.” To my many breast cancer friends and loved ones I offer the following: We do not need the perfect when we can thrive with the good. Seeking the perfect in writing, art, cooking, appearance, relationships, health, etc., may be harmful to our ephemeral wellbeing. Keep in mind that you beat cancer by how you live your life. Therefore it’s best to live that life on your own terms.

By Donna Barrett I am a breast cancer survivor. I have been cancer free for two years. But it’s been a lonely, scary and fearful two years. While my mastectomy was able to remove the tumor and all signs of cancer, my journey did not end with that first surgery. I was never a breast girl. Since my teen years, I’ve always been a very tall, very skinny, lanky girl. My breast size was an A cup, attempting to be B’s as I grew, but failing miserably. I learned to accept my small breasts early on. I embraced fashion and style that fit my long, lean, flat features. I could proudly rock a deep-V cut top or dress that would make J-Lo proud. When I gave birth to my daughter, I found new respect for my breasts as I embraced the miracle of being able to nourish my newborn with mother’s milk. Breast feeding was never easy for me, but it became a necessity. When we discovered my child was allergic to all forms of formula, cow, goat, soy, I was the mommy milking machine. I fed and pumped the white gold until she was 18 months old. When the milk was gone, and she could sustain herself on other calcium rich natural foods like broccoli I was grateful to return to my little A cup breasts. Fast forward to Indian Summer of 2017. Now in my 50’s, while my style was age appropriate, I could still wear a bikini with pride. This awareness and respect for my body and my tiny breasts, is how I was able to save my own life. Only 11 months after an all-clear mammogram, it was when I was removing my bathing suit in the bathroom, when I noticed in the mirror, a one-inch round discoloration under the skin of my right breast. Upon closer examination, it felt like a cyst. It seemed to appear out of nowhere. I didn’t panic. It was just a cyst, I thought. However, I immediately contacted my OB/gyn office and requested to move up my previously scheduled annual exam. I even pressed to see if someone could see me the next day. I’m forever thankful, they did squeeze me in to see their Physicians Assistant. While I was in that office for an exam, this alert PA was able to schedule a mammogram at the Swedish Breast Center in Seattle that same morning. The mammogram results were significant so that they scheduled a biopsy for that afternoon. Within 48 hours of my noticing this dark discoloration on my breast in the mirror, I got the diagnosis: Stage 1A Invasive Ductal Carcinoma in Situ. Invasive Ductal Carcinoma is the most common form of breast cancer. Common? Believe me, hearing the word, carcinoma, does not feel common. It is unfamiliar. It is frightening, like the shadow of death just did a fly over. Beyond the fear, this was my own body attacking me and this becomes so personal, I’ve never felt so incredibly alone. I’m a planner, and so I began my plan of attack. Like a “World War Z” zombie virus, I needed to get this cancer cut out of my body as soon as possible. Meeting with the breast cancer surgeon, I was given options. Option one was lumpectomy plus lymph node biopsy, then 6-8 weeks daily radiation and chemotherapy pending lymph node results. Option two was single right mastectomy with no radiation and the lymph nodes could be taken during the same surgery. I was also offered that an implant could be inserted during same surgery directly after the mastectomy. As a multi-tasker by nature, this was an option I liked and so I took it. The next part that was even more stressful than the diagnosis was waiting for the surgery. That was the longest 7 weeks of my life. I never asked, but I guess when your “only” Stage 1, there isn’t any rush to the operating table to save your life? I politely didn’t ask, and just assumed this was the norm. I’ve now learned, that with a cancer diagnosis, never assume and don’t be afraid to ask questions. I had no experience with this and in my own personal head space, I couldn’t even think of who to ask for advice. I did the Google everything about IDC. Read every page of the National Breast Cancer web sites, Mayo web sites, WebMD and more. What I didn’t know to ask the surgeons is where they would do the incision to remove my breast? When you do a mastectomy, what tissue remains intact? I know the answers now. My tumor was on the very top of my breast right next to my nipple. They cut the incision diagonally across the main part my breast making for a highly visible, 6-inch slash across my breast. The implant used was the perfect size to match my remaining left breast. However, as the skin was stretched over that “perfect” implant, it was a tight fit. After the surgery, I was given nitro-glycerin cream to rub over the skin to keep the blood circulating and basically, alive. Once home, I had help from my sister to care for my dogs and do basic home chores. I felt pretty good and was very mobile and not really in any pain. Then we got the lymph node report. The cancer was not present and thus, did not metastasize. No more cancer. They got it all. I felt so lucky. Recovery seemed like a breeze. Then 10 days after the surgery, and 1 day after my sister left, I dropped a tissue. As I reach down to pick the tissue up from the floor, my upper right pectoral muscle exploded in pain and began to swell into a baseball size hematoma. The pain was excruciating. I went to the ER and was admitted overnight for observation. As I still had one drain tube, they were able to confirm the internal bleeding stopped and decided to not operate. However, the pectoral muscle remains rigid and swollen still today. But the story doesn’t end here. This was the first post-surgery complication. 45 days after my mastectomy and implant reconstruction, the scab of my giant incision began to fall off. In hindsight, after having multiple surgeries since this, having a scab were the sutures where should have been a red flag. As the scab fell off in the shower, I looked down at my breast. Like unzipping a zipper, I could see the implant through a two-inch open seam. That scab was the only thing keeping my incision closed. Having since moved for my job, I was no longer in the same city as my original surgeons. I ended up at the emergency room at Mayo Clinic in Phoenix. Discussions occurred between Mayo ER surgeons and my original plastic surgeon. They decided to remove the implant and not replace it at that time. This was now the second complication. Now, as I mentioned early on, I am not a breast girl. I decided I would give flat a chance and applied for the insurance to get a breast prothesis. I also, spent many a night, just wishing I had done a double mastectomy and decided to go flat originally. But, there just wasn’t anyone I felt I could ask or talk too. The original cancer surgeons don’t even give you advice. The plastic surgeon’s goal is to make you look the same, normal, as if you never had cancer. It is easy to fall into the latter’s guidance because all you want post cancer is to get back to normal. After this second complication, I needed a break. The Mayo plastic surgeons explained many options to me which included a spacer to stretch the skin then replace with implant, DIEP-flap reconstruction using parts of your abdomen, or the latissimus dorsi flap which uses parts from your back. I took a year to decide. I mentioned I am a lean, athletic body type. Thus, there wasn’t a lot of fat available in my abdomen nor on my back. I chose the spacer for stretching skin and then inserting a small implant a few months later. After the spacer is inserted and the doctors ensure you are healing, the spacer is slowly filled with a saline solution to begin the process of stretching the skin. The first two saline fills went well. The third fill is when things began to go wrong. While earlier hematoma had hardened my pectoral muscle, that muscle was still muscle and it was pulling the spacer higher into my clavicle bone and pressing it into my rib cage. I basically had a giant saline filled boob sitting about 3 inches higher than my remaining left real breast. Imagine going to work, going out to events, trying to disguise this monster boob, which entailed making the left boob look as big. I felt eyes on me all the time, wondering if I had a horrible botched giant boob job. Complication number three is now in the books. This monstrosity had to come out. More surgery. With careful consideration, I finally decided to do the DIEP flap reconstruction. The surgeons convinced me there was enough tissue in my abdomen. But this is an 8-hour surgery. My fear of being under anesthesia and on an operating table for that length of time is frightening. Driven to be normal again, I went for it. When I woke up in the Critical Care unit at Mayo, the most vivid recollection was the pain in my elbows. Why the elbows you may wonder? During this surgery your arms are laid stretched out flat as if you are laying on a cross, for eight hours, and not moved thus getting stiff and sore. The abdomen was injected with a painkiller and as the skin was used for a portion of my new breast, so there was no feeling in my stomach. Additionally, the new breast with the tissue, skin, vein and artery from your abdomen is too new to feel anything. I was numb everywhere except those elbows. With DIEP flap the surgeons and nurses check on your new breast blood flow to make sure the borrowed vein and artery work in their new-found home. You also have a catheter as you cannot move to use a bathroom. If you’ve never had a catheter before, then I will spare you from describing it. Let’s just agree it’s gross. After a day once the catheter is removed, the nurses become drill sergeants getting you up and out of bed and walking. Nothing prepares you post DIEP flap surgery then the first time you attempt to stand up. You can’t stand UP, literally. There’s no give in your abdomen and so you begin your hall laps looking like the hunchback of Notre Dame. I was once again, full of fear. What had I done? I was certain I would never stand tall again. At 5’11” my mother always taught me to be proud of my height, stand tall and never hunch. It took me many weeks before I could stand tall again. 6 months post DIEP flap, the scars on my abdomen aren’t healing very well and they may have to do more surgery there. The new breast scars and how the tissue lays aren’t perfect either. I don’t have matching breasts, but I have two breasts now. I have my original made by God, and I have what I like to refer as my “Franken-boob” created by man. My previously flat stomach is even flatter. And I can still manage to rock the bikini. As for my love for low V-necks, that may take more time as the breast scars are still highly visible. As a breast cancer survivor looking back my surgical history post mastectomy and reconstruction complications, I had to keep telling myself, “look, you beat cancer; they got it all; and you are the lucky one.” Through genetic testing at Mayo, I found that my breast cancer was not genetic. The oncologists believe I may only need the estrogen blocking therapy, Exemestane, for 3 years, not 10. I’m know I am one of the lucky ones. It’s hard to explain to others who have never or will never have breast cancer. While I was never one who cared about the tiny size of my breasts, and never saw a need to increase their size when I was younger, I feel now that this cancer has brought too much attention to my breasts. They're just boobs. It’s been a little over two years since my breast cancer diagnosis. It’s exactly 849 days when this unplanned journey began forcing me to become a little obsessed with my health, my breasts and my body. My body is not perfect. My boobs are not symmetrical. My stomach has huge scar stretching from hip to hip. These are just physical scars. These will diminish over time. As I am writing about my breast cancer journey today, on this rare palindrome date, 02/02/2020, which is when a date reads the same backswords and forwards, I’ve decided I don’t need to wait for the next palindrome to occur in 101 years to put this cancer journey behind me. It’s been a scary and fearful two years. It’s time to begin the healing my inner scars and leave the cancer behind me. It’s time to seek out new, happier journey. To start new journeys where I know I am lucky enough to explore because I am still cancer free and I intend to keep it that way.

By Rebecca Santos I never thought I'd be diagnosed with breast cancer. And why should I? I'm 27. I have no family history. I'm not a carrier for the BRCA genes. I'm healthy and active. But still, here I am. I hope to be a voice that raises awareness that breast cancer can happen to healthy young women too! This year has already had so many surprises, but breast cancer has been the most challenging surprise yet. I'm a Latina first generation college grad who got accepted into medical school in February, got engaged in March, and to my surprise, was diagnosed with Stage 0 Breast Cancer (DCIS) May 27, 2020. While it was hard to process my cancer diagnosis, I was not surprised because I had spent a year having my symptoms being dismissed because of my age, health, and family history. My symptoms on my left breast : During the first six months, I had a large mass on my lower left breast that was so painful, I had to stop wearing bras. I had a scab with discharge coming out of it, sometimes yellowish-clear and other times red. I was told it was most likely an abscess and was given medication, but my symptoms never went away. I also felt a piercing pain coming through to my nipple and my left breast was sensitive to touch. Telling my family and friends that I had cancer was difficult because I didn’t want to burden them with fear or worry. Everyone cried, but they were all supportive and positive that I’d get through this. Losing my breast wasn't as difficult to process as having to lose one nipple (TMI), and having to explain that to family/friends along with why I chose to remove both breasts...but I focus on the positives and what matters is that I am alive and well! I cannot stress the importance of getting a second opinion! Mainly because you want to be confident in and comfortable with the surgeon who is  doing one of your most life-altering surgeries. My first breast surgeon gave me the news that I had cancer and the choice to keep my “healthy” breast. They didn’t explain my condition or their plan of action the way that I expected. In fact, the 8 minutes I sat with them was not enough time to explain very much at all about anything. As a result, I went for a second opinion and it was a completely different experience. This breast surgeon spent over an hour explaining to my family and I the type of breast cancer I had and what it meant, gave us a detailed course of action, pamphlets with information, and was empathetic that I had to face this at such a young age. I already had my mind made up to have a double mastectomy and my new breast surgeon agreed that it was best for me because although I only had cancer in one breast, there was no guarantee that in the future I wouldn’t get cancer in my other. Had I kept my "healthy" breast, I would have had to take a medication called Tamoxifen, which has a very extensive list of negative side effects. (Disclaimer: according to my oncologist, I was not a candidate for this medication because my cancer was not genetic and both breasts were removed, so there would be no benefits for me.) Lastly, I'd live a life of mammograms and screenings every six months for the rest of my life ! Not to mention, I'd live in fear and worry of getting breast cancer again. Almost three weeks after my diagnosis, I had a double mastectomy and expanders put in, on June 15, 2020. While my breast cancer was Stage 0 (DCIS), my cancer cells were grade three (cancer cells that look abnormal and may grow or spread more aggressively ) . While I was told I would not need chemotherapy once they confirmed that the cancer had not yet developed into invasive cancer, I was told that I may need radiation. Now with medical school starting so soon, I had to discuss all of the what-if’s with my team of doctors and began to overthink and fear the possibility that I’d have to miss a semester of medical school or possibly have to delay my start for another year. Now that the cancer is out, t he chances of cancer reoccurring are extremely low and the negative long term side effects of radiation are not worth it in my case. I decided that I wouldn’t let any of this stop me from achieving my dream of becoming a doctor and due to COVID-19, my medical school classes will start online, so not only will I get to stay home and fully recover, I won’t miss a day of medical school! It's not how I imagined starting medical school, but I've seen God's hand through all of this and know that He'll be glorified! I hope to be a voice that raises awareness that breast cancer can happen to healthy young women too! Awareness and early detection are so important, so never ignore your symptoms! Know your body, and if something’s off, GET IT CHECKED OUT!

By Nicole Mancini Originally published in Crabbies, Jellies, and Iron by Susan DiPlacido. First Ironman Nicole Mancini has always loved running. She has found memories of her dad taking her to the track where she would ride her bike as he would run. Then, as she took it up, it always helped her clear her head. In 2015 she did her first 5K, and while there she noticed Athletes Serving Athletes, which is a non-profit that empowers those with disabilities to compete in mainstream running, and, at the time, triathlon events (ASA has since limited their scope to running events.) Nicole was impressed and intrigued. Thus, began her athletic and helping hot streak. She signed up to become a running wingman and began with 5K events. Meanwhile, she watched as some of her teammates trained for wingman positions in triathlons. Nicole didn’t even know how to swim. But something that silly wouldn’t stop her. She started swimming at the Y and attended ASA’s triathlon camp while competing on the run portion in a sprint tri in 2016. She watched as the founder of the group trained for Ironman Boulder with an athlete, and Nicole thought it was a great gift. She did her first Olympic and half distance in 2017 and was ready to sign up for her first 140.6. On December 21, 2017, Nicole was officially diagnosed with invasive early stage breast cancer. She had already endured numerous scans, tests, and mammograms to get to the diagnosis. Hormone therapy began the next day and she underwent surgery on February 28, 2018. She had a double mastectomy and her hormone therapy is still ongoing. In May of 2018 she raced Chattanooga, 70.3. In 2019, she also raced Eagleman and Atlantic City 70.3 just two weeks prior to IMMD. Though she has a small circle of supportive training friends, the long demanding training hours made her husband and 11-year-old son think she was a little nuts, and the schedule was a bit frustrating for the family at times. But she needed to do this race. Cancer is chaotic, and she wanted the structure and routine of training, . She had been drained of her spark and passion, and she was looking to reignite that! She wanted to find herself again. Training was particularly hard on Nicole’s body. She also battled a possible Lyme disease scare and enlarged heart. She was often sick, her hair fell out, her joints ached, she suffered night sweats, and insomnia, heart palpitations, and drastic mood swings that further exasperated tensions in her home. But she persevered and kept on going. She had to take some days off, but she didn’t quit. The jellyfish were a concern for her, because she’s been stung before and reacted very badly. In fact, she cried on the morning of the race. But if everything else didn’t stop her, jellyfish weren’t going to either. She suffered multiple stings, had to reapply cortisone several times along the way and her feet got swollen and purple. All through the run, painful blisters continued to worsen. She promised herself should would never do another Ironman again. Team 360 which is an organization similar to ASA was manning the aid station at the bypass. Nicole knew several people there and their hugs and cheers, along with pictures of their athletes, were just the inspiration Nicole needed. Quitting wasn’t an option. She had to do this to show others that it is possible. She wanted to inspire someone else, to give her friends who are struggling in chemo something to look forward to. To prove to others that they’re capable of so much more than they think. It was her 1 year and 7-months cancer free anniversary. She made it through that. She had been looking to reignite her spark. Something must have sparked in her that day because she set that race on fir and successfully crossed the finish line. She didn’t just find herself at the end, she found an Ironman. And plenty of others have found something else through her: Inspiration .

A few months ago, Dr Charley from Cancer Tamer (cancertamer.org) contacted me at Survivingbreastcancer.org about teaming up and participating in a rafting trip scheduled for August, to celebrate life. Little did I know that a day on the river would change my life! Invitations went out to breast cancer survivors, thrivers, caregivers and advocates. The rafting trip served as a bucket list item for many participants, regardless of age. The itinerary read: Meet at location at 10am Rafting from 11-4 (lunch included) BBQ afterwards Simple. Straight forward. It sounded good. My caregiver, William, and I signed up. We made the 5-hour drive from Boston to central Pennsylvania and within minutes of being ensconced in the mountains, we heard the rippling sounds of water rushing by. After an introductory session we began buckling up our safety vests and our adventure began! 25 inexperienced thrivers and caregivers (though William would argue he is experienced) jumped into the rafts, paddles at the ready, final instructions received. We entered the water, and the current moved us quickly downstream. The river carried us away from our launch site and there was no turning back! Within minutes of starting our rafting journey we hit our first section of rapids. Our guides say it was a class two, but by the size of the waves splashing directly onto me, it felt like much more! The air was warm, the water refreshing, and women between the ages of 30 and 80 were splashing one another, smiling, and giggling like we were all 13 years old again and on a summer camp adventure! The beauty of the trip was the absolute judgment free environment. Though we all came from different walks of life, breast cancer unified us, and we established a strong bond that day on the river. The trees lining the riverbed provided fresh air for us to breathe in hope; the clouds above provided shade and coverage from a hot sun and protected us along our journey. The river was high from several weeks of rain, and cradled us as we cascaded over the ebbs and flows of the Lehigh river. The River derives it’s name from an old Lenape descriptive and means “where the forks are”. As you navigate this beautiful river you get to choose one fork or another for safe passage. As breast cancer survivors and thrivers we too get to choose from various “forks” in our medical care, nutrition options and exercise regimentations. I know how strong rivers and currents can be, the power of water, waves and rapids at the beck-and-call of mother-nature. And there we were, just as powerful as the water that carried us, fierce, strong, and courageous women who are not letting treatment nor a first or a second diagnosis of cancer defeat us. What stood out was the vibrant community forming; the immediate friendships that developed and the camaraderie and spirit these beautiful women showed. The power on the water that day was magical – breast cancer thrivers enveloped by mother-nature - two force that are undefeatable. Want to join us at our next event, check out our upcoming events for breast cancer awareness month! Hope to see you there! Xo, --The SBC Team

Now that I am on the other side of my treatment I have been much more open to reading about other people’s experiences with cancer and their treatment. A lot of people talk about their “new normal”. I have been trying to figure out if I have a new normal yet.  But it made me think, did I ever have a “normal”?  Life is full of ups and downs. When I was little I was convinced that the Brady Bunch was a “normal” family that I aspired to have. At the time it was just me and my mom, so I was on the lookout for a single dad with 5 kids. Specifically 3 boys, one girl old er than me and one younger so I could be a big and little sister.  Eventually I realized that probably wasn’t a realistic family goal for me to have, so I adjusted my view of a “normal” family. Growing-up in California, I have learned that a family is a family and no two are the same.  As I grew up, like everyone, my life was a series of unexpected events. I didn’t get into classes I wanted, friends turned into enemies and then friends again, I changed colleges twice, relationships started and ended (luckily, I did find the right person at the right time), I got my dream job that wasn’t so dreamy and changed jobs again and again. Each time there was a change, whether it be personal or professional I didn’t stop and define a “new normal” I just kept going. What else was I going to do? Just sit down and stop? That’s just not how I work.  Back to my cancer treatment. There was nothing normal about it. In fact, I am a firm believer that no two treatments are exactly the same because everyone is different, the support system for everyone is different, doctors do things slightly differently and patients react differently. That’s not to say that hearing about similar experiences isn’t helpful, it is, I’m just saying that there is not a “normal” way to experience it.  So, what’s my point? Just as there is no “normal” in the rest of life, I don’t think there is a right way to define your “new normal” at least not for me. For me that would mean looking at and analyzing things that I think I missed because of my cancer treatment or things that I might not be able to do right now as I still heal from the experience. The worst for me is thinking about the things I can’t control that might be in my future. So for me, my “new normal” is just going forward. Not defining things, not setting-up expectations or boundaries for what I can and can’t do. Just going forward adjusting and adapting on a daily basis as I have always done.  This might not work for everyone, but for some, I hope it might help. Breast cancer was just another thing that life threw at me that I had to figure out how to get through. And I did get through it. It’s time to move on and enjoy my family, my friends and the life I have.  PS: My husband and I decided to have only one child and we love her and are so proud of her. Thank goodness I got over my Brady Bunch phase :)

By Candace Bloomstrand Metaplastic breast cancer is a rare form of breast cancer. This type of breast cancer accounts for less than 1% of all breast cancers, but it can also behave more aggressively. Metaplastic tumors look and behave differently from other types of breast cancer tumors. Metaplastic tumors are often (but not always) triple-negative, meaning that they test negative for estrogen and progesterone receptors and the HER2 protein. The tumors often contain types of tissue not normally found in the breast, such as squamous cells or osseous cells. Metaplastic tumors are also often larger at diagnosis than other breast cancer tumors and more likely to metastasize. (Listen Now) To access our podcast with Jessica Duemig, author of Warrior, Challenge Accepted, please click on the image to the right to hear more about her experience with metaplastic breast cancer. Because metaplastic tumors are quite rare and often triple-negative, treatment options are limited and vary depending on the size and location of the tumor, whether the cancer has metastasized, and the patient’s overall health and age at diagnosis. Surgery, either via a lumpectomy or a mastectomy, and radiation therapy are often recommended. Metaplastic breast cancer is also more likely than other breast cancers to recur after treatment, so your doctor may recommend systemic therapy as well. Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Metaplastic Breast Cancer Global Alliance: Who Are We? This grass-roots patient organization was started by a team of women, all diagnosed with metaplastic breast cancer, who are dedicated to helping to improve the outcome for all women in this community. Upon facing the initial shock of a breast cancer diagnosis, we also found ourselves contending with a unique challenge: a form of breast cancer so rare that many of us did not even know it existed. Pre-diagnosis, most of us imagined breast cancer to be one entity, a single threat affecting mostly women (but some men as well), to be treated with the traditional approach of chemotherapy, radiation, and/or surgery. The reality is far more nuanced.