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By Sophie Pumphrey COMMUNITY | BREAST CANCER STORIES “I miss being normal,” I tell my therapist. I miss not having to deal with the fallout of breast cancer. I used to feel like I had no time to myself as a mom and full-time employee. Then I got cancer and added another role. Cancer Patient. Your initial introduction to this role, to use corporate speak, is like drinking from the fire hose. It requires excellent multitasking skills, like trying to seem normal at work while feeling the hot breath of mortality on your neck. And exceptional organization skills, like remembering to give all the teachers at preschool a holiday gift while contemplating major surgery, chemo, and radiation. When you get a diagnosis like cancer, your brain tries to reason and blame. What could it have been that caused this?! Breast cancer has been rising at an alarming rate in women under 40, and I’m sure there is research underway trying to pinpoint exactly what could be going on. But for the next few years while we wait for the result of their research, I am left wondering. Was it the Four Loko? For those of you who can’t remember (who can blame you), Four Loko was a malt beverage with caffeine. You may still see Four Loko in your local corner liquor store, but this is a weakened caffeine-free version. Original strength Four Loko, along with Sparks, paired very well with sweaty warehouse parties, punk shows in basements, and frat parties. Four Loko was a blip of time in my life, but what about the other blips, did they cause my cancer? Was it from swimming in an almost certainly polluted lake every summer from prepubescence until my late 20s? Was it the cigarettes I bummed outside of shows? Was it eating hot dogs for breakfast, lunch, and dinner on that camping trip with my friends? Of course, there are the regular culprits that run through my mind. Alcohol? Birth control? Processed foods? But those themselves don’t really tell the story of a life lived. Yes, I went water-skiing in the Ohio River next to barges filled with coal. Yes, I ate gas station fried chicken after a night of staying up late with my fellow 20-somethings. Yes, I did say yes to another beer. Yes! I’m very familiar with the keyboard warrior types. The type that would leave a comment here to say, “Yes! You did it to yourself!” There is a special kind of judgment that only someone hiding behind a keyboard can have. News outlets love to publish articles like “5 Ways to Prevent Breast Cancer” with prudent lifestyle choices like: exercise, don’t drink, don’t be stressed, eat less meat, and don’t smoke. I can imagine that there are people out there that adhere to these rules like a religion. Nothing bad can happen to you as long as you follow these 5 holy tenants. And for the rest of us scumbags, we got what we deserved. I’m not sure about you, but I wasn’t thinking about almost 40-year-old me when I was drinking a 40. I wasn’t all bad, though; I did cook at home. I did go to the gym and go jogging. I used aluminum-free deodorant. I drank seltzer instead of soda. And I ate a lot of salad. I posted my Four Loko question on my breast cancer online support group, and the comments that followed were an exposé on women who were out living life fully. One commented, “Once in college I accidentally spilled a little Ajax in the kofta that I served to my study group. That was what did it for sure.” Many commenters suggested that it could have been from putting phones in their bras when they didn’t have pockets. That thread went as far as to blame the patriarchy for their lack of pockets and therefore their breast cancer. Doctors hate this one weird trick to prevent cancer. Pockets! The comments were almost like a confessional of stupidity, and it warmed my heart. There was so much to blame. Like rolling cigarettes in toothpaste, having an older sister who punched you in the boob, getting nipples pierced, and being from Wisconsin. The post and the question struck a chord in a space that is often full of not-so-fun questions. What do I need to buy to be comfortable after my double mastectomy? Should I get nipple reconstruction? The side effects from this drug are wearing me down, is it worth staying on it? What happens if I don’t do chemo or take endocrine therapy? Is it coming back? The post-cancer diagnosis life is hard. Before the cancer diagnosis, I felt healthy. I didn’t feel sick at all. I had a lump that was kind of painful, but not at a level that made me very concerned. I was reassured countless times by my doctors that I was too young for breast cancer, and besides, I didn’t have the family history. Now, one double mastectomy and 15 rounds of radiation later, I’m taking endocrine therapy drugs that cause intense pain in my feet and hands, and I feel like I’m 100 years old. I’ve been thrown headfirst into medically-induced menopause. Yes, I have less estrogen than your grandma. I am so achy every time I stand up, I hobble for the first 10 or so steps. I get hot flashes, my hair is thinning out and my skin all over is dry as sandpaper. I’m. So. Tired. Don’t ask me if I’m irritable. I am on these therapy drugs for 10 YEARS, and I had the thought recently that my youthful painless days are numbered. By the time I get off these drugs, I’m going to be old and in pain again. These drugs aren’t prescribed only to torture me, though; doctors and science have saved my life. Even having the ability to reduce my risk of recurrence is a miracle that women of the past would have certainly wished for. Believe me when I say, I will gladly take the pain of being on endocrine therapy over certain death, and I would do it 100 times. I will push through the pain and work hard to stay on my medications. As grateful as I am for the medicine to prevent recurrence, I am not without complaints. The treatments for hormone-positive breast cancer are almost like they are designed to destroy your love life. If you have a partner, you’re up to your own devices on how to have sex with a withered, dry vagina. It’s your responsibility to figure that out. Your oncologist may not tell you about this side effect. “Have you tried coconut oil?” Coconut oil: the multi-tool of the wellness world. Moisturizer, hair mask, salad dressing, and apparently, marital aid. Does it reverse vaginal atrophy? No! But thank you to my radiation oncologist for the friendly suggestion. If you are dating, well, now you have to figure out when to tell someone you had breast cancer. The first date? The third? Do you tell someone you just started seeing, “By the way, I’m infertile, and also I might get cancer again and die. How’s your soup?” The cruelty never stops. So, we are left wondering. As other commenters on my support group post asked, “Was it because my favorite party trick was sticking two lit cigarettes in my nostrils?” “Because I got my nails done every three weeks?” “Was it because in college I carved a hole in my couch’s arm and made it into a giant bong using empty baby food jars?” “Because I wasn’t vegan?” “Because I didn’t love the lord?” The answer is yes, we did do this to ourselves. It was caused by our life decisions as much as it was by random bad luck. Humans do not live in a vacuum; we live out in the world in an environment that we can’t always control. Everyone I know is trying to do the right thing for their health. They drink the green juice, they fast, they try the keto diet and walk 10,000 steps a day. They think that if they do this or that, they will be protected from an early demise. But we are fragile, and sometimes fate intervenes. We want to use science and facts to find blame because blame feels safe. Blame is the answer to the unanswerable. But blame doesn’t change reality, and it does not make cancer go away. As a cancer patient, we are often a victim being blamed for something that we did not entirely cause. If you got lung cancer after decades working in a printing shop, is it your fault? Should you have found a better job? I’ve seen reports that say even sitting at a cushy desk job all day may cause rectal cancer. What could be the least cancery career? We live in reality and can’t 100% adhere to the perfect lifestyle. Even if we could eat 10 cups of blueberries a day and exercise 300 minutes a week, your cancer risk is never 0%. Biology is always a factor. One maladjusted cell and poof, cancer. At one unpleasant visit with my oncologist, she revealed to me that cancer is really only cured if you die from something else first. How uplifting! I can’t wait to put that on a bumper sticker with a pink ribbon. I see the narrative that cancer is preventable. It gives the illusion that we have control over our meat sack bodies in ways that we don’t. They can tell us that we have cancer but can’t say exactly what caused it. But, if I knew what caused it, would it make a difference? I wouldn’t be able to go back in time and take back the naughty things I did, and I would still be sitting here with menopause-induced insomnia and breast implants, and scars, and radiation tattoos and pain. It was never just from microwaving soup in a plastic bowl or loving the smell of fresh gasoline in the morning. It was life. Being alive may cause cancer. Being alive may also cause family, friends, or pets. Being alive may cause drowsiness, weird rashes, and grief. Being alive may cause love. Ask your doctor if Four Loko is right for you. Read More: The Role of Hormones in Breast Cancer Addressing the Unique Challenges of Breast Cancer in People Under 40 The Power of Knowledge (My BRCA Story) Breast Cancer and Fertility Navigating Relationships After a Breast Cancer Diagnosis Managing Fatigue During Breast Cancer Treatment Questions to Ask Your Doctor After a Breast Cancer Diagnosis On the Podcast: Breast Cancer Conversations Episode 299. The Messy Middle of Breast Cancer: Chemo, Surgery, Side Effects, and Survivorship Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Melinda Stumpp COMMUNITY | BREAST CANCER STORIES There comes a moment when your life divides into before and after. For me, it was a shower on September 7, 2024. The water was running. Steam blurred the mirror. It was an ordinary morning until it wasn’t. I rinsed my hair and my hand paused. I felt a lump. I had breast augmentation at nineteen. I knew my body. At thirty-seven, I knew this was different. It was not panic. It was not fear. It was instinct. A steady, undeniable knowing. My GP told me it was nothing. He told me not to worry. But something inside me was louder than reassurance. Louder than dismissal. And here is the defining moment of my life: I listened to it. I asked for the mammogram prescription. I walked into the cold imaging room wearing a paper gown that never quite closes. The machine hummed. The technician adjusted angles. Silence stretched between images. Then the phone rang. Phones do not ring in those rooms for good reasons. Before anyone said a word, I knew it. On October 1, 2024, the first day of Breast Cancer Awareness Month, I was diagnosed with triple negative metaplastic breast cancer, a rare one percent subtype. The words were clinical. Aggressive. Limited data. I did what everyone did. I googled it! And what I saw looked like a verdict. Survival curves. Statistics. Very little that felt human. Sitting there staring at that screen, I felt the weight of those numbers. And then I felt something else. If this is what women see when they search, then we need to change what they see. Cancer could change my body, but it would not take my identity. It would not take my voice or my chance to contribute to research. Chemotherapy tested that promise. It stripped me down physically and emotionally. There is nothing glamorous about chemo. Humor became my armor. If I could laugh in the infusion chair, I could survive almost anything. Four months after finishing treatment, just as I was beginning to feel steady again, my house burned down. Not metaphorically. Literally. I stood outside watching flames swallow everything physical. Documents. Photos. The proof of who I had been. Smoke in the air. Sirens cutting through the night. A life reduced to ash in real time. For a moment, it felt like everything was being taken. And then something settled inside me. If I could survive cancer and stand here watching this, I could survive anything. People say I shouldn’t be here. That statistically, medically, situationally, the odds were not in my favor. But I am standing here. No evidence of disease. Alive after a fire that could have taken more than possessions. I do not believe in luck alone. I believe it is mentality. It is instinct. It is a community. It is people who show up. It is laughter when everything feels heavy. Triple negative metaplastic breast cancer is rare. But rare does not mean hope. Rare means we speak. Rare means we study. Rare means we refuse to let Google define our future. I am participating in research. I am building advocacy. I am choosing, for the rest of my life, to contribute to this subtype so that the next woman who feels that lump does not open her laptop and feel doomed. Statistics are data. They are not destiny. The most defining moment of my life was not the diagnosis. It was the decision. The decision to trust myself when I was dismissed. The decision to speak when the room was quiet. The decision to rebuild when everything burned. You can lose your hair. You can lose your home. You can lose the life you thought you were living. But you do not have to lose yourself. I trusted my instinct, and that choice is why I am still here. Read More: The Role of Hormones in Breast Cancer The Impact of Breast Cancer on Self-Image Scheduling Worry Time: A Technique to Control Your Anxious Mind On the Podcast: Breast Cancer Conversations Episode 308. Can a Blood Test Detect Breast Cancer Recurrence? Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Jessi Lord COMMUNITY | BREAST CANCER STORIES How cancer ended my lifelong habit of leaving myself There are myriad ways to experience an awakening. I don’t believe we have just one during our lifetime, but many moments when the life we’ve built can no longer contain the truth of who we are becoming. This is because we are living not only as bodies moving through the material world, but as souls continually remembering who we have always been. Some awakenings arrive as quiet, almost imperceptible whispers of recognition. Others come as seismic shifts shaking us awake in a way that alters the course of our life forever. But both provide energetic rememberings of who we have always been. What followed my breast cancer diagnosis was not just survival - it was an unraveling, a reckoning, and ultimately, an awakening. What I couldn’t have known was that breast cancer would uncover a life that had been waiting beneath the one I thought I was living. I thought breast cancer would ask everything of my body. I had no idea it would ask everything of my soul. I hadn’t yet realized that my body surviving a full year of treatment would only be the beginning of my healing and that I would spend the next year learning how to inhabit it again. I had faced my greatest fear while in active cancer treatment. I came to understand how I would get through the physicality of it because of the advice from a wise retired oncologist, who was a dear friend of my late mother’s. He was my first phone call after I received the pathology report from the diagnostic biopsy. I asked him to help me understand the biology of the cancer I had and my options for treatment. The report said that I had triple-negative breast cancer. Unlike many other breast cancers, mine wouldn’t respond to hormone therapy or other targeted treatments like surgery right out the gate. There were no alternative paths to weigh, no decisions between different medications. From the very beginning, the plan was six months of weekly chemotherapy and immunotherapy infusions, followed by surgery, and finally radiation. Most of us have seen the physical transformations that can happen during chemotherapy whether in the movies or in real life as so many of us know someone diagnosed with breast cancer. The hair loss, becoming nauseous and weak and frail, sitting for hours at a time in an infusion room. Yet, how would I be able to do it? After a career of treating thousands of cancer patients, the retired oncologist informed me with absolute certainty: “There is no better survivor than a young mother. This is not a fight,” he said, “this is about curing your cancer. Remember… this is not a sprint, this is a marathon.” Deafening silence and a tidal wave of awareness of what he was saying hit me straight in the heart. There it was - all the motivation that I needed accompanied by the undeniable necessity to dig deep for the endurance I would need for the year ahead. Because he was right. There is no stronger force of energy than the strength and determination of a young mother. I had a daughter to live for; I embodied that archetype. When treatment was all over and with each passing week, I found myself spending less time at the cancer center, surrounded by one of the most supportive communities that I have ever been a part of, and more time alone with myself. And as the noise of treatment quieted, something within me grew louder and impossible to ignore. I was feeling confused, lost, circling and spinning in my efforts to make it back home to myself after what I had just been through. I felt small whispers of a loss, of a grief; tears would flow uncontrollably, sometimes out of nowhere like on a drive to a dentist appointment. These small shifts of release in my nervous system gradually grew in intensity and scale and the need to express what I was feeling became louder. I had read deeply about trauma and had come to understand the ideas presented in The Body Keeps the Score, and how trauma is stored in the body. Throughout my life, I adapted to trauma by becoming exquisitely attuned to everyone else’s needs while growing increasingly disconnected from my own. Hypervigilance became my normal. My nervous system never truly believed it was safe, so I ran, exercised, numbed with substances, withheld joy, and silenced my own voice for fear that expressing it would cost me connection with, honestly, anyone. I certainly had no idea what I needed to regulate my nervous system and definitely had no idea how to express my wants and needs with words. During a somatics-based alcohol recovery program during COVID, I raised my hand in genuine confusion. “Wait,” I said. “What do you mean when you say regulation means feeling safe in your body?” The Zoom room grew quiet as I heard myself say the words that surprised me most: “I didn’t know that.” It was one thing to know I was entering a whole new chapter of healing trauma in my life. It was another thing to actually walk through it. I couldn’t wait for perfect clarity on how to begin this new chapter, so I reached for a familiar coping technique. I immediately went back to work at the tail end of treatment thinking that this is the normal thing to do. Check! I took everyone’s encouragement as confirmation that I was doing exactly what I should be doing. Check again! Boy, was I proud of myself for diving right back in! My first day of my new job was my last day of radiation! Go me! But in hindsight, I confused everyone else’s encouragement with my own readiness. It actually was not something I was ready for. I was beginning to recognize a deeply conditioned pattern within myself: I had made another major life decision based on what I believed I should do rather than what I actually needed. At this point, the bouts of uncontrollable crying were happening nearly daily. Usually I could get back to myself with breath, sound, grounding on the grass, and other somatic techniques I had learned. It wasn’t quite evident to me yet that there was something deep inside me loosening its grip on me. But I was able to verbalize that I hadn’t felt depression like this since I was a young teenager - some of the darkest and most emotionally traumatic times of my life. I could only describe it by saying: “I don’t know how to find my way back home to myself.” Every coordinate I had once used to navigate my life no longer pointed me home. I was struggling. My dysregulated nervous system escalated from being overwhelmed to an all-consuming chronic state. I could not settle. It felt as if every internal compass I had trusted suddenly stopped working. I kept searching for language, an analogy that might come close to explaining what I was experiencing. The comparison that came to mind surprised me. I almost dismissed it before I allowed myself to say it out loud. “I feel real compassion for veterans,” I heard myself saying. The words hung in the air while I found myself wondering if survivorship carried its own version of that impossible transition. “They go off to war,” I wailed to others. “They see life-changing devastation and experience incredible trauma and upon their return to civil life, they are told: ‘Thank you for your service!’ with the expectation to just navigate seamlessly back into society. Can you even imagine!?” I heard myself yelling. But, they couldn’t understand the shared psychological challenge of returning to ordinary life after an extraordinary experience that I was trying to describe. Despite having just escaped death, I was told something similar: “You must be so happy to get back to normal!” But every time I heard that, I could not believe it, not even for a second. What those around me didn’t understand (aside from my ‘breasties’ on a WhatsApp thread that we used to bare ALL the brutal details of navigating our cancer journeys) was that there is no going back to “normal.” There would be no normal. It simply did not exist. After I saw, endured, and felt all the physicality of being a cancer patient, what I was experiencing now was the emotional backlash, the PTSD of surviving breast cancer - the lonely, confusing work of finding my way home after an experience that had forever changed my internal landscape. I felt alone with those closest around me. I was having dark thoughts of what the point of life was. The trauma of the medical experience I had just survived was catching up with me; slowly sneaking up on me, quietly behind my back. I’d turn around to see what was there and it would freeze… and upon turning back around it would quietly leapfrog closer to me, anxiously reaching and grabbing for my energy to pull into its darkness. I called my doctor for pharmacological intervention. For a while, I could keep its relentless grip at bay. I could feel it rising, but I could still meet the world with composure. Until one day I couldn’t. It happened in my kitchen with my boyfriend standing just a few feet away. What unfolded is difficult to describe in ordinary language. The closest words I have are Eckhart Tolle’s. It felt like my pain body took over, as though something long buried had finally demanded to be felt. I entered a dissociative, panic-filled state unlike anything I had ever experienced. A wave of panic consumed me. My breathing became ragged. I was confused. My boyfriend later told me my eyes looked different - dark, almost vacant. I remember pleading with him to let whatever was happening run its course. I believed my body was doing something it had been trying to do for decades: release what it had carried for far too long. I remember very little of what I said that day. Only the overwhelming certainty that I could no longer outrun what had been living inside me. Whether it was trauma releasing through my body, a nervous system overwhelmed by everything it had endured, or both, I knew one thing with absolute clarity: this wasn’t only about cancer anymore. 16 months after my original diagnosis, I took a necessary retreat to step away from the demands of daily life. I spent my time focused on meditation, yoga, and a workshop on the art of future-making. The structure of the retreat allowed my nervous system to relax and helped me find the grounding and clarity I needed to see what must change in my life. As I began to gain this clarity, I felt the familiar pull of fear and the ego trying to keep me anchored in old, unhealthy patterns. That hook to remain in old unhealthy patterns is what the ego is very good at doing. When it senses that you are remembering who you have always been and are initiating any kind of move towards the seat of your soul, it bears down. Your ego will tell you to remain hidden from the world and will guide you to relapse into the toxic patterns of your suffering. This is because the ego’s greatest fear is your soul waking up. It takes immense courage to witness your ego’s thoughts without being consumed by them any longer. It’s not for the faint of heart to question the story you’ve been telling yourself. For most of my life, I allowed those false narratives to run my operating system even though for the past ten years I had been attending a Tibetan Buddhist sangha in my local community. I would dutifully go twice a week to hear dharma talks, meditate with the deities, learn about the true nature of my original mind, and practice remembering who I have always been. Despite that active spiritual practice, my ego would still interpret the motives of others as mean or harmful, my nervous system responding to their actions as if the emotional abuse I experienced as a child was occurring again. But the door to clarity was cracking open. I could hear my soul guiding me to step into this other way of being that I had dedicated my practice to. It was time I stepped into this frequency that I had always known in my wisdom mind. A place where I could open my heart, see the pure perception and recognize that truth reflected back to me. I could finally tell myself the story my heart and my soul had always known was true. I had learned to advocate for my physical needs while I was in medical treatment for cancer. I went into that journey being the best advocate that I could be for myself. It was very clear very early on that I would have to both advocate for myself and surrender to the experience and knowledge of my team of oncologists. But now I was coming face to face with the mental wounds from the cancer journey - and now the healing wasn’t about fixing what was broken. And healing wasn’t about becoming someone new. It was about becoming someone I had never been allowed to be. If I finally faced the emotional journey that cancer had uncovered, I knew it would lead me to the very roots of my trauma. It was there that I could finally apply the salve to old wounds - to lovingly tend to the little girl who had spent so much of her life believing she had to earn love by abandoning herself. In caring for her, I began learning what it meant to care for myself, to become whole. And with pure clarity, I now understood that it was only from that place of wholeness that I could truly be in right relationship with others. Once I understood that my greatest responsibility was no longer just advocating for my body, but for the little girl who had always lived within it, everything began to change. I wanted to show her that I was here now - that she would never again have to navigate the world alone. That together, we would build a life spacious enough for joy. And that, little by little, she could learn to let it in. This summer, she and I are traveling across the world together. We will sit among women devoted to healing, walk barefoot along the shoreline, and spend long days beside the ocean where she has always felt most alive. For the first time in my life, I am not trying to become someone else. I am simply becoming the safe place she has been waiting for all along. ​I am coming to terms with the hard truth that tending to my own needs affects others who were used to my self-abandonment. It will take courage to assert what I need, but I know it is the only way to refill my own cups and to maintain healthy relationships. I’ve realized that life after cancer is forcing me to stop surviving in the ways I did long before my diagnosis. Cancer stripped away my old coping strategies and exposed the ways I had learned to abandon myself. Now, as a 48-year-old survivor who navigated chemotherapy, immunotherapy, surgery, followed by radiation, and the menopause that came alongside, I am committed to structuring my life in a way that truly works for me. I used to think surviving cancer meant getting my life back. I know now that there was no life to go back to. For years I believed I was searching for myself. It turns out that she had been waiting patiently for me to come back and get her. Oh Mary, I finally get it, this is what I will do with my one precious life! Somewhere along the way, I had mistaken survival for direction. I wasn’t lost because I lacked a map. I was lost because I had spent so many years navigating by everyone else’s compass instead of my own. And perhaps that was the awakening all along - that cancer had ended my lifelong habit of leaving myself. Read More: Understanding Your Pathology Report: A Comprehensive Step-By-Step Guide The Role of Hormones in Breast Cancer The Impact of Breast Cancer on Self-Image How Cancer Trauma Can Impact Your Life and Ways to Move Forward EFT and Brainspotting: Complementary Therapies for Breast Cancer Recovery On the Podcast: Breast Cancer Conversations Episode 306. Can Breathwork & Ayurveda Support Healing After Breast Cancer? Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Jayshree Mallaya COMMUNITY | POETRY I received this news five weeks ago. It’s no longer a memory, it’s a lived reality. My life changed, but I’m still the same. I have breast cancer, but cancer is not my name. I’m dealing with something that feels alien inside of me, something that became part of my reality. From outside looking in, it looks like I’m fine. From inside looking out, I know I will be fine. I’m not questioning, why did this happen to me? There’s no family history, so how can this be? Breast cancer. Yes, it happened to me. I’m learning to listen to my body differently. To understand what it needs and what it’s trying to tell me. There are questions between appointments. Things I remember afterwards. Things I wish I had asked. Things that made sense when the doctor explained them, but were harder to remember when I got home. There are moments of fear. And moments of clarity. But through all of this, I am still me. Still a woman. Still a partner, sister, friend. Still dreaming. Still building. Still believing this isn’t where my story ends. Somewhere between the appointments, the questions, the things I remember and the things I forget, I started thinking, there must be a way to hold onto some of this. A way to remember. A way to stay connected. To my care. To the people caring for me. To the people walking this journey with me. And to myself. That thought became Mea Ola. My Life. A companion that’s growing from what I’m living and learning every day. Because breast cancer happened to me. But my life still belongs to me. And if what I’m learning can help another woman understand a little more, remember a little more, or feel a little less alone, then something good can come from what happened to me. Mea Ola. My Life. Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Nerissa Balland EDUCATION | COMPLEMENTARY THERAPIES Surviving cancer and processing the experience of cancer are two very different things. Medical teams prepare you for surgery. They prepare you for treatment, side effects, scans, and follow-up appointments. They do everything they can to help preserve your life. What very few people prepare you for is what happens after the immediate crisis begins to settle. Listen to Nerissa on the SBC podcast, Breast Cancer Conversations: Surviving Cancer Is Only the Beginning: How to Process What Comes After When treatment ends, everyone celebrates. The scans are clear. Friends tell you how strong you are. Family members are relieved. Life slowly begins moving forward. Yet many survivors discover that survival isn’t the same as feeling whole again. That was certainly true for me. I was five months pregnant when I was diagnosed with metastatic melanoma. Overnight, my world became appointments, surgeries, treatment decisions, and the uncertainty of whether I would live long enough to raise my children. When my dermatologist called to tell me the biopsy was malignant, my mind raced through every role I held—wife, daughter, artist, mother. But beneath all of those thoughts was something smaller and infinitely more fragile: a heartbeat. The heartbeat of the child I had fought years of infertility to conceive. In that moment, cancer wasn’t simply threatening my life. It challenged everything I believed about motherhood, identity, purpose, and the future I imagined for my family. Like so many people facing a life-threatening illness, my focus became singular: survive. My medical team gave me that chance, and I will always be grateful. What no one prepared me for was the emotional landscape waiting on the other side. Although my body was healing, I wasn’t returning to the woman I had been before cancer. One day I caught my reflection in the mirror and didn’t recognize the person looking back at me. That realization frightened me more than the disease itself because I understood I wasn’t simply trying to recover physically—I was trying to understand who I had become. Cancer changed my body. Survival changed my identity. Learning how to reconcile the two became the real work. I’m a professionally trained artist. Most people assume creativity naturally became my refuge. It didn’t. Years of training had taught me to focus on technique and whether something looked “good.” Even after cancer, I was still evaluating what I created instead of allowing creativity to become a place of curiosity. Everything changed when I participated in a facilitated creative experience where there was no expectation to make something beautiful. For the first time, process mattered more than product. That’s when I realized: Creativity wasn’t helping me process cancer. It was helping me process myself. Cancer was the catalyst. It changed the trajectory of my life, but it also awakened a journey I never expected to take—one of reconnecting with myself through creativity, reflection, and ultimately helping others do the same. I couldn’t stop wondering if I was alone. Over the next several years, I interviewed more than one hundred young mothers facing cancer. Those conversations became the foundation of my book, Canvas of Courage. While my own diagnosis was metastatic melanoma, approximately 80% of the women I interviewed—and nearly three-quarters of the stories featured in the book—were navigating breast cancer. Although every woman’s story was unique, the emotional themes were remarkably familiar. Identity had been disrupted. The future felt uncertain. Women carried fear, guilt, grief, hope, and the pressure to remain strong for everyone else. Time and again, I saw creativity emerge—not as artistic talent, but as a way of making sense of lives that no longer felt familiar. One woman held dance parties with her children during treatment. Another took “mental photographs” of the sky before treatment because she wanted to remember the last ordinary day before everything changed. Another knitted while waiting for scan results. None of these women were trying to become artists. They were trying to remain themselves. Those conversations eventually led me to therapeutic arts and the broader field of arts in health. I discovered that what I had experienced personally wasn’t unique. Around the world, hospitals, cancer centers, and community organizations were using creative expression to support reflection, emotional processing, coping, and meaning-making. Creativity wasn’t replacing medicine. It was addressing something medicine was never designed to do. Today, my work brings together therapeutic arts, evidence-informed practices, and reflective approaches to help people reconnect with themselves and rebuild identity and purpose after life’s most difficult experiences. People aren’t broken. They’re unprocessed. That doesn’t mean we’re flawed or need fixing. It means many of us are carrying experiences we’ve never been given the space to fully examine, express, understand, or integrate. I’ve watched women walk into workshops apologizing before we even begin. “I'm not creative,” they’ll tell me. I smile, because I’ve heard those words so many times before. An hour later, something has shifted. The room grows quiet. The pressure to make something beautiful disappears. More than once, someone has looked up and said, “I didn’t realize how much I needed that.” That’s why I often say, “Broken crayons still color.” As an artist, I find there’s something special about opening a brand-new box of crayons. Every color is perfectly wrapped. Every point is sharp. Untouched. But if you’ve ever sat beside a child making art, you know those aren’t the crayons they reach for forever. Eventually the wrappers peel away. The tips break. Some snap in half. And yet… They still color. Not despite being broken. Because they’re still crayons. Their form changed. Not their purpose. I believe the same is true for us. Cancer may change our bodies. Survival may change our identity. We may never return to the person we were before our diagnosis. But we are still capable of creating, loving, contributing, finding meaning, and beginning again. Because healing isn’t only about surviving. It’s about reconnecting with the parts of ourselves we thought were lost. We may color differently than we did before. But we still color. Read More: The Transformative Power of Art Therapy in Cancer Survivorship From Chords to Chemo and Back Again: Rediscovering My Inner Harmony Navigating Cancer Treatment With the Help of Energy Medicine Survivorship Care Plans: Life After Breast Cancer Treatment Scheduling Worry Time: A Technique to Control Your Anxious Mind Expressive Arts with SBC: YouTube Playlist On the Podcast: Breast Cancer Conversations Episode 310: Surviving Cancer Is Only the Beginning: How to Process What Comes After Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

Artificial intelligence may help doctors detect breast cancer earlier, understand each diagnosis more clearly, and recommend more personalized care. SurvivingBreastCancer.org Editorial EDUCATION | BREAST CANCER TREATMENT Key Takeaways AI-assisted mammograms can help radiologists detect more breast cancers without increasing false alarms. New AI tools may help predict a person’s future breast cancer risk. Digital pathology can give doctors additional information when planning treatment. AI supports medical professionals rather than replacing their expertise. Careful testing, human oversight, and patient support remain essential. Healthcare changes rapidly, but few fields move as fast as artificial intelligence (AI) in modern medicine. As of August 2026, artificial intelligence has moved beyond experimental promise in breast cancer care. Stronger evidence shows that AI can help radiologists find cancer earlier, estimate future risk, and give oncologists more information when they plan treatment. Doctors still make the decisions, but AI can serve as an additional set of eyes to review complex images and clinical data quickly. AI-Supported Mammograms Are Finding More Cancers Earlier A Swedish study of more than 105,000 women found that AI-supported mammogram screening helped radiologists detect 29% more breast cancers than traditional screening. The AI-supported process detected about 81% of breast cancers, compared with about 74% using the standard approach. It found more cancers without increasing false alarms, which occur when a mammogram appears suspicious but follow-up testing does not find cancer. AI also reduced radiologists’ screening workload by about 44%, allowing them to spend more time reviewing the mammograms most likely to show signs of cancer. Women whose mammograms received AI support had 12% fewer interval cancers, or cancers diagnosed after a normal mammogram but before the next scheduled screening. Researchers also found fewer invasive, large, and aggressive cancers in the AI-supported group, suggesting that AI may help radiologists detect some serious breast cancers sooner. AI does not replace radiologists. Instead, it can act as an additional tool that helps them notice possible warning signs, prioritize higher-risk mammograms, and find some cancers sooner. AI May Help Predict Future Breast Cancer Risk New AI tools can examine subtle mammogram patterns that traditional risk assessments may miss. In July 2025, the Food and Drug Administration (FDA) granted Breakthrough Device designation to Prognosia Breast, a tool developed through Washington University School of Medicine in St. Louis. It uses mammogram images and a patient’s age to estimate the risk of developing breast cancer within five years. WashU Medicine reports that developers trained the model on tens of thousands of screening exams and found that it predicted risk more accurately than a standard questionnaire-based method. The designation does not mean the FDA has approved or cleared the tool. It allows an expedited review process. With further testing in diverse populations, AI-based risk scores could help doctors personalize screening, prevention, and follow-up care. Digital Pathology Is Supporting Treatment Decisions AI can analyze digital images of biopsy or surgical tissue alongside clinical information. In May 2026, the FDA cleared ArteraAI Breast for people with early-stage, hormone receptor-positive, HER2-negative invasive breast cancer. The tool estimates whether a patient has a low or high risk of cancer spreading to distant parts of the body. The score doesn’t select a treatment, but it gives doctors more information when discussing chemotherapy, hormone therapy, and other options. Early research also suggests that it may help identify some patients who could benefit from chemotherapy, although more evidence is needed. AI Is Connecting More Types of Medical Data Researchers are developing multimodal AI systems that combine medical images with other health information, such as pathology reports, laboratory results, medical histories, and clinical notes. By reviewing several types of information together, these tools may help doctors predict cancer outcomes, estimate the risk of recurrence, and determine which treatments may work best for individual patients. However, researchers still need to test and validate these systems carefully before doctors can use them widely in patient care. Human Oversight Still Matters Researchers continue to study whether AI works safely in everyday care. The large US PRISM trial will examine whether AI-assisted mammogram review improves cancer detection and reduces unnecessary callbacks. AI won’t replace mammograms, biopsies, or medical professionals. Instead, it may help care teams recognize important patterns sooner and make more personalized decisions. Hope Powered by Innovation and Community AI may help doctors detect breast cancer earlier, understand each diagnosis more clearly, and recommend more personalized care. However, even the most advanced technology can’t replace compassionate guidance, trustworthy information, or the reassurance of connecting with people who understand the breast cancer experience. Whether you’re newly diagnosed with breast cancer, navigating survivorship, living with MBC, or supporting someone you love, SurvivingBreastCancer.org helps bridge the space between medical care and everyday life. We provide programs, including virtual support groups, as well as trusted educational resources and podcasts featuring professionals, advocates, and caregivers. Your support helps SurvivingBreastCancer.org continue providing knowledge, connection, and community to those impacted by breast cancer, every day, all year long. This article is intended for educational purposes and is not a substitute for personalized medical advice. Treatment approvals, guidelines, and research continue to evolve. Always discuss testing, medications, side effects, and treatment decisions with your oncology team. Read More: Different Types of Breast Cancer Understanding Your Pathology Report: A Comprehensive Step-By-Step Guide Addressing Breast Cancer Recurrence in High-Risk Patients On the Podcast: Breast Cancer Conversations Why Are Women Still Waiting Months for Breast Cancer Answers? With Dr. Ryan Polselli

By Tarah Markham COMMUNITY | BREAST CANCER STORIES Six months before I was diagnosed with stage 2 breast cancer at 38, I started working out. I wasn’t really a fitness person. I didn’t have a routine or any big goal. I just decided I wanted to feel better and started showing up when I could. At the time, it didn’t feel like a big deal. Looking back, it ended up being one of the most important things I did for myself. The Moment I Knew Something Was Off I found the lump myself in December 2024. It was one of those moments where you just know. It felt hard and it didn’t move. I remember thinking, this doesn’t feel right. I had seen someone share their story on Instagram before, saying that when you feel a lump like that, you just know. That stuck with me, and it was in the back of my mind in that moment. Still, part of me didn’t think it could be cancer. I was 38, healthy, with no family history, and two young boys at home who were just 6 and 3 at the time. When I went to my doctor, she thought it was probably a fibroadenoma because of my age and history. But she still sent me for an ultrasound and mammogram, which I’m now so grateful for. When they told me I needed a biopsy, I think deep down I already knew. But I was heading on vacation the next day, so I put it in the back of my mind and tried to enjoy the week away. I was diagnosed in January 2025, the day after I got home. When Everything Changed Once I had the diagnosis, everything moved quickly. Appointments, decisions, trying to understand what was next. At the same time, I had two young kids at home. Life didn’t slow down. School, routines, everything kept going, and I still had to show up as their mom every day while figuring out what I was dealing with. Because I didn’t need chemotherapy and didn’t really look sick, my husband and I decided not to tell them. It was something we thought through carefully, and it felt right for us. But we still wanted a way to mark what was happening. On the day of my lumpectomy, we had the kids release two balloons. We called them “Cecilia,” which is the name my husband and I gave my cancer. It was simple, but it meant a lot to us. It felt like a way to include them without having to explain everything. What Helped Me Get Through My treatment included a lumpectomy, a sentinel node biopsy, radiation, and tamoxifen. Through it all, one thing I kept coming back to was staying active. I continued strength training as much as I could. Some days it looked different. Some days it was lighter. But I kept showing up. It wasn’t about pushing myself or trying to prove anything. It just gave me something steady to hold onto. It reminded me that my body was still strong, even when everything else felt uncertain. I also worked with a naturopath to help manage side effects and support my body through treatment. Along with trying to eat well and prioritizing sleep, it all played a role in how I felt day to day. Nothing about it was perfect. It was just consistent. Looking Back Looking back, I really believe those habits made a difference. Not in a dramatic way, but in small ways that added up. I felt stronger going into treatment, and I think that carried me through it. It also changed how I approached recovery. I wasn’t trying to go back to who I was before. I was figuring out what came next and building something different. One Year Later I’ve been pretty private about my diagnosis. Only close family, friends, and work really knew. But coming up on one year since ringing the bell on June 17, I’ve been thinking about it more. Those milestones bring a lot back. I feel strong. I feel good. But I also realize there’s a lot about this part of the experience that doesn’t get talked about. You move forward, but you still carry it with you in different ways. What Stayed With Me If there’s one thing I would say, it’s this: Taking care of your body matters. Not in an extreme way, and not in a way that adds pressure. Just in a steady, realistic way. Moving your body. Eating well. Sleeping when you can. Giving yourself some structure when everything feels uncertain. For me, strength training started before cancer, but it became something I relied on through it and something I’ve carried with me after. I didn’t expect it to matter as much as it did. But it did. Read More: Exercise and Breast Cancer Recovery: A Safe and Empowering Guide to Staying Active Understanding Breast Cancer in Young Adults: A Journey of Hope and Resilience Breast Cancer and Heart Health: The Connection You Need to Know About Managing Fatigue During Breast Cancer Treatment: Tips for Conserving Energy The Role of Nutrition in Breast Cancer Recovery: Optimizing Your Diet for Healing 20 Sleep Hacks For A Better Night’s Rest A Disabled Clinical Psychologist’s 6 Tips for Living Well with Breast Cancer On the Podcast: Breast Cancer Conversations Episode 291: Breast Cancer Survivorship: Exercise, Nutrition, Sleep, and Support Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Jill Rackham COMMUNITY | POETRY Cancer has given me another reason to remember the year twenty-twenty. When the world was told to stay at home, I was having hospital visits aplenty. Rules stated I had to attend lots of appointments on my own so my husband waited outside. Although the staff were always lovely, waves of emotion overcame me just like a tide. Mammograms, an MRI scan, ultrasounds and biopsies all happened so fast. Followed by surgery, monthly injections and infusions – I wondered how long my frequent hospital trips would last. It was so hard to keep walking through the hospital doors for each of these on my own. Having cancer in times of COVID meant so much suddenly became unknown. Several days before each surgery, in the hospital car park, a COVID swab was taken. Then I had to isolate, thankfully the result was always negative, so surgery was never forsaken. Days in hospital recovering from surgery and dealing with my thoughts, all felt so long. Not being able to have loved ones near to give me much needed support, did feel so very wrong. The surgeon would come to see me to explain how proceedings had gone. In the haze of anaesthetic it was hard to take information in, but I wouldn’t have been the only one... Life is now as we knew it before COVID came along with rules no longer in place. It feels unbelievable as I reflect, about all the changes we had to face. COVID definitely added to the intensity of this trauma of mine. I had to be braver and more resilient than I had in life at any other time! Thankfully for anyone starting this awful journey now. COVID’s impact I hope will not feel as big somehow. Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Corinne Nechalova, MA, LPCC COMMUNITY | BREAST CANCER STORIES I thought finishing treatment would be the hardest part. I was wrong – it was what came after that undid me. When I was diagnosed with breast cancer, it came with bumps and challenges and a later staging than originally anticipated. It was a long road to get through physically – and of course emotionally. So much, so fast, and I had to dig so deep. When treatment ended, everyone around me seemed relieved. And I was too. The surgeries were behind me. Chemo was over. The appointments were becoming less frequent. By all accounts, I had made it through the hardest part. I thought I would finally be able to relax. Instead, I felt terrified. Before cancer, I trusted my body without even thinking about it. I assumed tomorrow would look a lot like today. I was 40, married, building a career I loved, living a full and social life. I felt like I had so much ahead of me. I trusted that if something was wrong, I would know. But when I was diagnosed with cancer, overnight, that trust disappeared. What shook me wasn’t just the diagnosis itself. It was realizing that something so serious had been happening inside my body without me knowing it. The body I had always counted on suddenly felt unpredictable. Unsafe. Foreign. During treatment, I had a job to do: survive. There were appointments to get to. Decisions to make. Side effects to manage. I stayed focused on the next step in front of me. But when treatment ended, all the fear I had pushed aside seemed to catch up with me. And I had a completely different body to add to the equation. I was not the same mentally, emotionally, or physically. After treatment, every ache got my attention. Every new sensation felt like a question I didn’t want answered. Every follow-up appointment sent me spiraling. I kept waiting for the relief everyone talked about. It never came. At least not right away. What surprised me most was how disconnected I felt. Disconnected from my body. Disconnected from my old life. Sometimes even disconnected from the people I loved. Everyone else seemed to be moving forward. I felt like I was still standing in the middle of it, trying to figure out who I was now. I remember looking around and wondering why I couldn’t just be grateful and relieved. Why I couldn’t just move on. Why I still felt so anxious when treatment was over. For a long time, I thought something was wrong with me – like, really wrong with me. So I did what I had always done. I pushed through. I tried to stay positive. I tried to get back to normal. But normal wasn’t waiting for me. Cancer had changed me. Not only physically. Emotionally. Mentally. And underneath all the pushing through, I was angry at my body. I felt trapped. I didn’t know how to take care of myself anymore – because if cancer had happened, surely I must have been doing something wrong. Looking back, I can see that cancer didn’t create all of that disconnection. Some of it had been there long before my diagnosis. I had spent years pushing through exhaustion, ignoring my own needs, treating my body as something to manage rather than something to listen to. Cancer simply made it impossible to keep doing that. And yet my body had also fought for me. It had healed, tolerated, and persevered through things I didn’t know it could. I was still here. I was getting stronger. I was learning to live inside a body that had been through something frightening – trying to hold both of those things at once: the anger and the gratitude, the fear and the awe. I had guided people through exactly this kind of recovery for years. Apparently that doesn’t make you immune to needing it yourself. But I wasn’t ready to hold any of that yet. I just kept moving, kept pushing, kept trying to outrun what I wasn’t ready to face. I tried to structure and discipline my way back to normal. And the harder I tried, the more exhausted I became. What finally helped wasn’t forcing myself forward. It was slowing down. Getting curious about what I was feeling. Allowing myself to grieve. To feel the feelings, the emotions, and yes, all the new sensations that came after treatment. Somewhere along the way, I realized that surviving cancer wasn’t just about healing my body. It was also about rebuilding my relationship with it. I had to learn how to listen again – to pay attention to what my body needed and what it had been trying to tell me all along. Not from my thinking mind, but from somewhere deeper. I started noticing when I needed rest instead of pushing through. When something felt like a genuine no rather than fear. When my body softened toward something instead of tightening against it. These weren’t dramatic realizations. They were small moments of learning how to hear myself again. Slowly, that became the foundation for something I thought I had lost: trust. Not trust that nothing bad would ever happen again. Not trust that life would unfold the way I planned. But trust that I could be with what was here. Trust that I could truly care for myself. Trust that I could find my way forward, even without certainty. Trust that there was a new me and a new life ahead, even if it hadn’t unfolded yet. What I was really learning was how to stop abandoning myself. How to feel the difference between anxiety and intuition. How to recognize when my body was saying no before my mind caught up. How to actually receive support instead of managing everything alone. Healing didn’t happen all at once. It happened in small moments. The morning I noticed my hair growing back and stood in front of the mirror and felt something other than grief. The day I laughed so hard I forgot about cancer for a few minutes. The first time fear wasn’t the very first thing I thought about when I woke up. The time I could change clothes and like what I saw and move my body and feel free. The changes that followed were bigger than I expected. I left my marriage. I changed my career. I overhauled the way I lived and the way I related to myself and others. None of it was easy. All of it was necessary. Little by little, life started returning. Not the life I had before, but a different life. One I never would have chosen, yet one I have learned to embrace. Today, fear still visits sometimes. I don’t think it ever completely disappears. But it no longer runs my life. If you’re in that strange space after treatment – wondering why you’re still anxious, still grieving, still waiting to feel like yourself again – I want you to know something. You are not doing survivorship wrong. Nothing is wrong with you. The fear makes sense. The uncertainty makes sense. But healing isn’t only about learning to live with fear. It’s also about learning how to come back to yourself. To your body. To your life. To the parts of you that were there all along, waiting to be heard. And that is possible too. About the author: Corinne Nechalova is a therapist, breast cancer survivor, and founder of Rise Reimagined, a program supporting women through the emotional and psychological recovery that happens after treatment ends. She is based in the Twin Cities. Learn more at corinnenechalova.com. Read More: The Psychological Impact of Breast Cancer: Strategies for Coping How Cancer Trauma Can Impact Your Life and Ways to Move Forward Scheduling Worry Time: A Technique to Control Your Anxious Mind Breast Cancer in Young Women: Common Questions Answered Navigating Relationships After a Breast Cancer Diagnosis Survivorship Care Plans: Life After Breast Cancer Treatment Grit and Grace On the Podcast: Breast Cancer Conversations Episode 299: The Messy Middle of Breast Cancer: Chemo, Surgery, Side Effects, and Survivorship with Jessica Thomas Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

Completing breast cancer treatment marks the transition into survivorship—a phase where individuals navigate life beyond active treatment. Survivorship care plans play a pivotal role in addressing post-treatment needs, monitoring health, and promoting overall well-being. Understanding Survivorship Care Plans A survivorship care plan is a comprehensive document that outlines a roadmap for post-treatment care. It provides a personalized summary of treatment received, potential side effects, recommendations for follow-up care, and strategies for maintaining health. Components of Survivorship Care Plans Treatment Summary: A detailed record of therapies, surgeries, and medications received during the course of treatment. Follow-Up Care Guidelines: Recommendations for ongoing screenings, diagnostic tests, and monitoring schedules. Long-Term Effects and Concerns: Information about potential long-term side effects or health risks post-treatment. Health Promotion Strategies: Suggestions for maintaining a healthy lifestyle, including diet, exercise, stress management, and smoking cessation. Supportive Services and Resources: Referrals to support groups, counseling, survivorship programs, and other resources. Life During and After Breast Cancer Treatment Physical Well-being: Regular follow-up appointments aid in monitoring for any recurrence or long-term side effects. Focus on maintaining a healthy lifestyle with regular exercise, a balanced diet, and adequate sleep. Emotional and Psychological Adjustment: Embrace emotional resilience by seeking support, joining support groups, or seeking counseling if needed. Coping with fears of recurrence or uncertainties about the future through mindfulness and acceptance. Addressing Long-Term Effects: Be aware of potential long-term effects of treatment, such as lymphedema, cognitive changes, fatigue, or menopausal symptoms. Seek medical advice and adopt coping strategies to manage these effects effectively. Empowerment through Self-Advocacy: Be an active participant in your health by understanding and advocating for your post-treatment care needs. Communicate openly with healthcare providers about concerns or questions. The Role of Survivorship Care Plans Facilitating Continuity of Care: Serve as a roadmap for ongoing care, ensuring a seamless transition from active treatment to survivorship. Empowering Patients: Offer patients the tools and information needed to take control of their health and well-being. Promoting Health Surveillance: Facilitate regular screenings and surveillance to detect any recurrence or new health issues early. Conclusion: Embracing Life Beyond Treatment Survivorship care plans are instrumental in guiding individuals through life after breast cancer treatment. Embracing survivorship involves addressing physical, emotional, and psychological well-being while staying proactive in monitoring health. Empowering oneself with knowledge, support, and regular follow-up care lays the foundation for a fulfilling life beyond breast cancer treatment.

By Brookshire McDonald COMMUNITY | POETRY Be your own advocate You must do. Healthcare workers are great But overworked, too. Don’t accept “no news is good news” ‘Cause that’s not always so. You need to receive an answer “From the get go.” Life expectancy has increased Causing more older folks on earth, And referrals to specialists Has increased since birth. Appointments are taken For doctors galore Making the wait time A month or more. Adding your name to a call list Is sometimes a thing; But don’t hold your breath For a possible ring. Make the call yourself Every day or two To check on cancellations To find room for you. Make your case By saying you feel worse; But don’t jinx yourself By calling the hearse. Some offices get tired Of your calling so much; So by magic they have an opening Right before lunch! Don’t forget a second opinion Is always a good thing Even tho’ it’s another office You must continue to ring. It’s your body, So show it good care. It means more to you Than others anywhere! To be counted in the life expectancy numbers this year Be your own advocate To release all fear!! Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Beth Krasemann COMMUNITY | BREAST CANCER STORIES In May 2023, I went on a run and a dog bit me! I went to a doctor to have it checked out and I asked for an order for a mammogram, as I had not had one since before Covid. The mammogram revealed a fairly large tumor–I was in shock as I had no symptoms, pain, or indication that a 8 centimeter tumor was embedded in my left breast. A needle biopsy and pathology analysis revealed I had triple positive breast cancer; I had positive receptors for estrogen, progesterone, and HER2. The cancer had spread to lymph nodes, so a treatment plan was crafted. Later studies put me at stage 2. As I navigated those frightening opening days and weeks, I made a decision I would not stop moving. I ran, hiked, swam, mountain biked, road biked, gravel biked, skied uphill, skied downhill, Nordic skied, kayaked, windsurfed, sailed, climbed mountains, wrote a book, taught high school history, coached ski mountaineering, traveled, and raced in many different events through 18 months of breast cancer treatment—20 rounds of chemo, 28 rounds of radiation, and a mastectomy. I used movement as medicine; I exercised on average 900 minutes a week, far above the 150 minutes recommended by the American Heart Association. I believe movement is the fourth pillar of cancer treatment. In the middle of treatment, I completed one of the most challenging ski mountaineering races in the United States: the Power of Four in Aspen, Colorado, with my son Daniel by my side. My answer to the absurdity of the diagnosis and treatment was to move. I grew up with three older brothers and very active parents who instilled in the family a passion for movement. We spent vacations skiing or backpacking in the mountains and all four of us played a range of sports growing up. After competing as a college soccer and track runner, I continued to pursue physical fitness as a runner and biker in my adult life. So when the cancer diagnosis arrived, I made a deliberate decision to not stop moving. I would not let cancer steal my love of fitness and adventure. It did not matter the pace or how; I simply needed to move my body, every day. The “red devil chemo” (doxorubicin) made running really hard, but I kept at it. I turned to skiing in the winter months as my main focus of movement. After my mastectomy, I skied using only one arm! In the spring, summer and fall, I turned to the trails to run and bike. When I was outside moving, I did not feel like a cancer patient. I felt like a healthy and normal athlete. I wrote about my experience in my book 900 Minutes: Movement as Medicine. It recounts the ups and downs of anyone fighting cancer—or any other trauma. It demonstrates how exercise—in all its forms—serves, sustains, and nurtures us all. I dedicate my book to exercise, in all forms, and to the resilience of my body. I pushed it so hard and she always responded and made my fight through the treatment manageable. To truly mark the end of my treatment and on to what I call Beth 2.0, my husband and I climbed Mt. Kilimanjaro in June 2026. My story serves as a model of what is possible during breast cancer treatment. Now, let’s get moving! About the author: Beth Krasemann is the author of 900 Minutes: Movement as Medicine. More information: https://900minutes.com/ Read More: The Role of Hormones in Breast Cancer What is Breast Cancer Rehab? Exercise and Breast Cancer Lymphedema is a Chronic Condition & Why I Love Swimming On the Podcast: Breast Cancer Conversations Episode 214: The Benefits of Pilates for Breast Cancer Recovery Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story Connect with SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Elisa Herrera We walk through a hallway of mirrors, the same day repeating in each one— yet never looking the same. In one, the light is soft, the weight of things barely touches me. I pass through the moment as if it means nothing. In another, the glass darkens— the same scene bends inward, presses against my chest until I can hardly breathe. Nothing has changed— the room, the words, the silence— yet the mirror turns it heavy, turns it into something I cannot carry. I move from reflection to reflection, not realizing I’ve stepped into a different one. One tells me I’m okay. Another whispers: this is too much. And somewhere in between, there must be a mirror that shows things as they are— not softer, not crueler—just true. But until I find it, I keep walking this corridor, living the same life in a thousand different ways. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

PIK3CA. AKT1. PTEN. mTOR. What the PI3K/AKT/mTOR pathway means for breast cancer treatment — and the questions worth bringing to your next appointment. SurvivingBreastCancer.org. Editorial EDUCATION | BIOMARKERS Breast cancer treatment is becoming increasingly personalized, but that progress comes with an entirely new vocabulary. PIK3CA. AKT1. PTEN. mTOR. These terms may appear on a biomarker report or come up when an oncologist is discussing why a treatment stopped working, or what treatment might come next. Together, they are part of the PI3K/AKT/mTOR pathway, often shortened to the PAM pathway. Understanding this pathway will not tell you exactly how your cancer will behave, but it may help explain what is driving it, why biomarker testing matters, and whether a targeted treatment could be an option. For some people with breast cancer, changes within the PAM pathway can help cancer cells grow, survive, or become less responsive to treatment. Finding those changes through biomarker testing may help your care team identify a treatment designed to target what is driving the cancer. Key Takeaways The PI3K/AKT/mTOR, or PAM, pathway helps regulate how cells grow, use energy, and survive. Changes involving genes such as PIK3CA, AKT1, or PTEN can allow cancer cells to continue receiving growth signals. PAM pathway alterations are especially relevant in hormone receptor-positive, HER2-negative advanced or metastatic breast cancer. Biomarker testing may identify an alteration that helps guide treatment, but blood and tissue tests do not always provide the same information. A negative liquid biopsy does not necessarily rule out a mutation. In some cases, testing tumor tissue may provide additional answers. Having an alteration does not guarantee that a targeted treatment will work. Treatment decisions also depend on previous therapies, overall health, side-effect risks, and personal priorities. Side-effect prevention and early management, particularly for high blood sugar, rash, diarrhea, and mouth sores, are an important part of treatment. What is the PAM pathway? The PAM pathway is one of the communication systems cells use to control growth, division, energy use, and survival. In a healthy cell, the pathway switches on when it is needed and quiets down when the job is complete. In some breast cancers, however, a mutation or another molecular change disrupts this process. The pathway may continue sending growth and survival signals even when it should stop. Several genes and proteins play important roles: PI3K helps begin and pass along signals that tell a cell to grow. PIK3CA is the gene that provides instructions for making one part of the PI3K protein. AKT carries growth and survival messages farther into the cell. mTOR helps regulate cell growth, metabolism, and protein production. PTEN helps slow the pathway down and acts as one of its natural brakes. When PIK3CA or AKT becomes overly active, or when PTEN no longer functions properly, the cancer cell may gain another way to grow and survive. WHY IT MATTERS Why does this pathway matter in breast cancer? Changes in the PAM pathway are found across different breast cancer subtypes, but they have become especially important in the treatment of hormone receptor-positive, HER2-negative advanced or metastatic breast cancer. One of the most commonly discussed changes is a mutation in PIK3CA. A PIK3CA mutation can cause the PI3K protein to remain overly active, sending ongoing signals that encourage the cancer cell to grow. Alterations involving AKT1 or a loss of normal PTEN function can have a similar effect by activating other parts of the pathway or removing the signals that would normally slow it down. The PAM pathway may also play a role in treatment resistance. For example, a hormone receptor-positive breast cancer may initially rely heavily on estrogen to grow and respond well to endocrine therapy (also referred to as hormonal therapy). Over time, some cancer cells may begin using another signaling system such as the PAM pathway to continue growing despite treatment. Cancer cells can change over time and develop new ways to survive. That is one reason biomarker testing may need to be revisited when cancer returns or progresses. TESTING What is biomarker testing, and why is it important? Biomarker testing is different from testing for inherited cancer risk. A hereditary genetic test usually looks for changes you were born with such as certain mutations in BRCA1, BRCA2, or PALB2, among many others, that may be present throughout the body and passed through families. Tumor biomarker testing looks primarily for changes that developed inside the cancer cells. These are called somatic alterations. Most PIK3CA mutations found in breast cancer are somatic. This means they developed in the tumor and were not necessarily inherited from a parent or passed on to a child. Some people benefit from both hereditary genetic testing and tumor biomarker testing because the tests answer different questions. How is the PAM pathway tested? Testing may be performed using tissue from the tumor, from a blood sample, or both. A laboratory may test tissue collected during a biopsy or surgery. In some cases, previously collected tissue can be used, although a newer sample may provide a more current picture of the cancer. A liquid biopsy uses a blood sample to look for small pieces of tumor DNA circulating in the bloodstream. This is known as circulating tumor DNA, or ctDNA. Liquid biopsies are less invasive than tissue biopsies and may detect information released by cancer in different parts of the body. However, not every cancer releases enough DNA into the blood to be detected. A negative liquid biopsy does not always mean that an alteration is absent. If your liquid biopsy comes back negative, an important question to raise with your oncology team would be: “My blood test did not find a mutation. Could testing tumor tissue give us additional information?” TREATMENT What could a PAM pathway alteration mean for treatment? Finding a PAM pathway alteration does not automatically determine your next treatment. It does, however, provide another piece of information your oncology team can use when comparing options. Several medications target different parts of the pathway. Their FDA-approved uses currently focus primarily on specific groups of people with HR-positive, HER2-negative locally advanced or metastatic breast cancer. These medications are not interchangeable. Eligibility depends on the exact alteration, previous treatments, timing of recurrence or profession, one’s overall health, and other individual factors. Does having a mutation mean the treatment will work? No biomarker can guarantee that a medication will work. A biomarker may tell your care team that a treatment is more likely to help a particular group of patients. But every cancer is complex. A tumor may have several alterations and use more than one pathway to grow. The presence of a mutation also does not tell us exactly how long a treatment will work for one individual. Your care team will consider: The exact alteration identified Your breast cancer subtype Previous treatments How long earlier treatments controlled the cancer Where the cancer is located How quickly it is progressing Your overall health Diabetes, prediabetes, or other medical conditions Possible medication interactions Side effects and quality-of-life priorities Available clinical trials Biomarker testing can help personalize treatment, but it is one part of a much larger conversation. SIDE EFFECTS What side effects should patients know about? The PAM pathway is involved in normal functions throughout the body, including blood sugar regulation, cell growth, and metabolism. Blocking the pathway can therefore affect healthy cells as well as cancer cells. Side effects vary by medication, dose, treatment combination, and individual health. High blood sugar PI3K and AKT inhibitors can raise blood sugar, sometimes significantly. Before beginning treatment, your care team may check: Fasting blood glucose Hemoglobin A1C Current diabetes medications Personal or family history of diabetes Other factors that could increase your risk Blood sugar may need to be monitored closely after treatment begins. Contact your care team if you experience: Increased thirst Frequent urination Unusual hunger Blurred vision Headaches Weakness or extreme fatigue Confusion Having diabetes or prediabetes does not always mean that a pathway inhibitor cannot be used. It may mean that additional planning, monitoring, or support from an endocrinologist is needed. Mouth sores Mouth soreness or ulcers, sometimes called stomatitis, can occur with several pathway inhibitors. Depending on the medication, your team may recommend a specific mouth rinse or other preventive strategy. Do not assume that all mouthwashes are appropriate, since products containing alcohol may worsen irritation. Diarrhea Diarrhea can lead to dehydration and electrolyte changes if it is not controlled. Ask your team: When should I start an antidiarrheal medication? How many episodes should prompt a call? What should I drink or eat? When is diarrhea considered urgent? Rash Rash can occur with some PI3K and AKT inhibitors. Reporting it early gives your care team the opportunity to intervene before it becomes more severe. Contact your team about new itching, redness, pain, blistering, peeling, or sores involving the skin, mouth, eyes, or genital area. Other side effects Depending on the treatment, additional effects may include: Fatigue Nausea Decreased appetite Changes in blood counts Increased risk of infection Changes in liver or kidney laboratory results Inflammation involving the lungs Changes affecting the eyes This does not mean that every patient will experience every side effect. It means that having a clear monitoring and management plan matters. Managing side effects is part of treatment Side-effect management is not an afterthought. It is part of receiving cancer treatment safely. Addressing symptoms early may help prevent complications, reduce interruptions, and make it easier to remain on treatment when the medication is helping. Before starting a PAM pathway inhibitor, consider asking: What side effects are most common with this exact medication? Which symptoms require an immediate call? How often will my blood sugar and laboratory results be checked? Will I need to monitor my blood sugar at home? Should I meet with an endocrinologist before treatment? Will you recommend medications to help prevent rash or mouth sores? Are there foods, supplements, or medications I should avoid? Who should I contact during evenings or weekends? Does the PAM pathway matter in early-stage breast cancer? The pathway can be present and biologically important in early-stage breast cancer, but most established PAM-targeted treatment uses in breast cancer currently apply to locally advanced or metastatic disease. Finding a PIK3CA, AKT1, or PTEN alteration in an early-stage tumor does not automatically mean that a PAM pathway inhibitor should be added to treatment. Researchers continue to study whether these medicines could help prevent recurrence or improve outcomes in earlier-stage disease. Clinical trials are necessary to determine whether a treatment is both safe and beneficial in a new setting. What about triple-negative or HER2-positive breast cancer? PAM pathway alterations can also occur in triple-negative and HER2-positive breast cancers. However, finding an alteration does not necessarily mean that one of the currently approved PAM-targeted treatments is appropriate. Researchers are studying pathway inhibitors in different breast cancer subtypes and in combination with: Chemotherapy HER2-targeted therapies Endocrine therapy Immunotherapy Other targeted treatments A clinical trial may be an option for some patients whose tumor has a pathway alteration but who do not meet the criteria for an existing FDA-approved treatment. How might targeting the pathway improve outcomes? Biomarker testing may reveal a specific alteration that can be targeted with an available medication. Blocking the PAM pathway may help interrupt one of the routes cancer cells use to continue growing despite endocrine therapy. For some patients, combining endocrine therapy with a targeted treatment may help control cancer longer than endocrine therapy alone. Questions to ask your care team Consider bringing these questions to your next appointment: Has my cancer been tested for PIK3CA, AKT1, PTEN, and other actionable biomarkers? Was the testing performed on blood, tumor tissue, or both? Which genes were included in the test? If my liquid biopsy was negative, should tumor tissue also be tested? Could my cancer’s biomarkers have changed since my original diagnosis? Does my result make me eligible for an FDA-approved treatment? How does this option compare with the other treatments available to me? What benefit was seen in clinical trials for patients whose situation was similar to mine? What side effects should I expect, and what can we do to prevent or manage them? Will I need blood sugar monitoring or support from an endocrinologist? Is there a clinical trial targeting this pathway that may be appropriate for me? Can I have a copy of my biomarker-testing report? What This Means for Patients The science behind the PAM pathway is complex, but its relevance to patients is much more practical: it may help explain why a cancer is growing, why a previous treatment is no longer working, and whether another treatment could target a specific feature of the tumor. Most importantly, you deserve more than a list of unfamiliar letters on a laboratory report. Ask your oncology team to walk you through what was found, what was not found, and whether the results change your options.. Understanding the science does not mean carrying the responsibility for making these decisions alone. It means having the information you need to participate meaningfully in your care. ________ This article is intended for educational purposes and is not a substitute for personalized medical advice. Treatment approvals, guidelines, and research continue to evolve. Always discuss biomarker testing, medications, side effects, and treatment decisions with your oncology team. Funding from Celcuity helps SurvivingBreastCancer.org provide free, evidence-informed education to people affected by breast cancer. Sponsorship does not constitute an endorsement of any product, treatment, or company.

By Kia Lee I was 38 years old when I was diagnosed with stage III ER+/HER2- invasive ductal carcinoma. At the time, I was doing everything “right.” I exercised daily, maintained a healthy weight, ate well, rarely drank alcohol, and had no known genetic mutations associated with breast cancer. Cancer was not something I expected to hear. Yet on October 10, 2023, my life changed. Treatment moved quickly. I underwent dose-dense AC chemotherapy followed by Taxol and Abraxane, a unilateral mastectomy with lymph node removal, proton radiation, reconstruction, ovarian suppression, and hormone therapy. Like many patients, I focused on getting through the next appointment, the next scan, the next treatment. Survival became the goal. And eventually, I survived. What I didn’t expect was that the hardest part would begin after treatment ended. People celebrate when treatment is over. They tell you how strong you are. They tell you how happy you must be. Everyone wants the story to end there. But survivorship is not the end of the story. For me, survivorship felt like standing in the middle of a life I no longer fully recognized. Before cancer, much of my identity was built around achievement, productivity, being dependable, helping others, and always moving forward. Looking back, much of my self-worth was tied to what I could accomplish and how useful I could be to everyone around me. Then cancer stripped away the ability to measure myself by any of those things. Treatment forced me to slow down. It challenged my relationship with control, perfectionism, work, appearance, femininity, and certainty. When treatment ended, I expected to return to my old life. Instead, I discovered that parts of my old life no longer fit. My priorities had changed. The pace I once lived at no longer felt sustainable. Some of the goals I had spent years pursuing no longer felt aligned. I wasn’t trying to become who I was before cancer. I was becoming someone new. That realization was both painful and liberating. For a long time, I thought healing meant getting back to normal. Now I understand that healing often means creating a new normal, one that honors who you have become because of what you’ve lived through. One of the greatest gifts of survivorship has been discovering purpose in sharing my story. Today, I write, advocate, and support other women navigating life beyond diagnosis and treatment. I have learned that many survivors quietly struggle with identity shifts, fear of recurrence, changing relationships, body image, career transitions, and the pressure to “move on” before they’ve had a chance to process what happened. If there is one thing I wish every newly diagnosed person knew, it is this: Your life is not over. Your future may not look exactly as you imagined, but there is still joy, purpose, love, meaning, and possibility ahead. You are allowed to grieve what was lost. You are allowed to change. And you do not have to become the person you were before. Surviving cancer is not about returning to your old life. It’s about creating a life that feels even more true than the one you left behind. About the Author: Kia Lee is a breast cancer survivor, author, advocate, and speaker dedicated to helping women navigate the often-overlooked realities of survivorship. Diagnosed with stage III breast cancer at age 38, Kia understands firsthand that completing treatment is not the end of the journey—it is often the beginning of a new one. Through her writing, speaking, and advocacy, she explores the emotional, physical, relational, and identity shifts that can occur after a cancer diagnosis and treatment. Kia is the author of Lighthouse: The Path Through Cancer, the Power of Becoming and a contributor to survivorship publications and patient advocacy initiatives. Her work focuses on creating honest conversations around healing, rebuilding confidence, navigating uncertainty, and finding meaning beyond survival. As a member of the survivorship community, Kia believes that while cancer changes us, it does not define us. She is passionate about helping others reconnect with themselves, rediscover joy, and create lives that feel aligned after treatment. Read More: Addressing the Unique Challenges of Breast Cancer in People Under 40 Different Types of Breast Cancer Understanding the Different Stages of Breast Cancer Survivorship Care Plans: Life After Breast Cancer Treatment On the Podcast: Breast Cancer Conversations Breast Cancer Survivorship: Exercise, Nutrition, Sleep, and Support That Actually Matter Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Sierra Hendren Content warning: death and dying Just days before my graduation, my family was celebrating what we believed would be one of the happiest moments of our lives. After two years of hard work, sacrifice, sleepless nights, clinical rotations, and balancing motherhood alongside school, I was preparing to graduate with honors and a 4.0 GPA from the Cardiovascular Sonography program at Caldwell Community College and Technical Institute. My pinning ceremony was scheduled for May 5, 2026, followed by graduation on May 8. But behind that celebration was a story much deeper than academic achievement. Just two months into my sonography program, my mother was diagnosed with metastatic breast cancer while she was already battling sarcoidosis. Overnight, our lives became filled with doctor appointments, treatments, hospital visits, and the emotional weight of watching someone you love fight for their life. Recently, we received the devastating news that the cancer had spread to her brain. As her only daughter, I stepped into the role of caregiver while continuing my education, raising my two young children, and trying to hold my family together through one of the hardest seasons of our lives. Still, through every setback and every heartbreaking moment, my mother kept fighting — because she wanted to see me graduate. And somehow, despite everything, she made it there. But on the drive to my pinning ceremony, my mother suddenly lost her vision completely. What should have been one of the proudest days of our lives instantly became filled with fear and uncertainty. The woman who had fought so hard to be there could not even see the moment she had been holding on for. Over the following days, her condition worsened rapidly. Her memory began fading in and out, confusion increased, and our family suddenly found ourselves discussing palliative and hospice care instead of simply celebrating graduation. One moment, we were taking graduation photos together. The next, we were preparing ourselves for the possibility of losing her. Then everything changed again. Just recently, we rushed my mother to the emergency room because her oxygen saturation had dropped to 74% and her feeding tube needed to be evaluated. Around 2:00 AM, we were told she would be admitted and reassured that it would be okay for us to go home and rest. Then at 3:57 AM, I received a phone call from the ER doctor that completely shattered me. He explained that my mother’s lungs were failing and could no longer support her body. He told me I had two choices: To allow her to pass naturally, which he explained would happen very quickly in the condition she was in. Or to make the decision to place her into a medically induced coma and put her on a ventilator, knowing there was a very real possibility she may never wake up from it. No daughter should ever have to make a decision like that for her mother. She is now in the ICU fighting for her life. We went from trying to celebrate my graduation… to fighting for more time with my mom almost overnight. At the same time, my nine-year-old son, who is globally developmentally delayed, has also been overcoming challenges of his own. Despite everything happening around him, he pushed through academically this year, began making A/B Honor Roll, and is now approaching grade level — something we are unbelievably proud of. My son and my mother share an incredibly special bond. They have been together nearly every single day since the day he was born, and years ago, he was actually the one who helped her discover the first lump in her breast when she first battled breast cancer. This story is about so much more than graduation. It is about caregiving. Motherhood. Family. Faith. Resilience. Heartbreak. Hope. And what it truly means to continue showing up for the people you love even when your world feels like it is falling apart. Read More: Metastatic Breast Cancer: Understanding the Significance of Stage IV Expecting the Unexpected: Anticipatory Grief and Breast Cancer How To Be Helpful When A Loved One Is Sick On the Podcast: Breast Cancer Conversations Palliative Care Is Not Giving Up: Patients Living With MBC Share What It Really Means Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

Imagine hearing the words: "You have Stage 0 breast cancer." Within days, you're faced with decisions that may affect your body, your future, and your quality of life. Should you have radiation? Can it safely be avoided? Is your risk of recurrence low or high? These aren't easy questions—and they deserve thoughtful, individualized answers. That's why recent news surrounding Medicare coverage for genomic testing in ductal carcinoma in situ (DCIS), also known as Stage 0 breast cancer, deserves our attention. A proposed Medicare coverage change could limit access to certain genomic tests that help estimate an individual's risk of recurrence and whether radiation therapy is likely to provide meaningful benefit. While the proposal directly affects Medicare beneficiaries in jurisdictions covered by the MolDX program, coverage decisions like these often extend far beyond Medicare. Private insurers frequently look to Medicare policies when determining what they will cover, meaning the ripple effects could impact patients of all ages. First, What Is DCIS? Ductal Carcinoma In Situ (DCIS) is often referred to as Stage 0 breast cancer, but that label doesn't capture the complexity of the diagnosis. DCIS develops when abnormal cells are found inside the milk ducts of the breast. Unlike invasive breast cancer, these cells have not broken through the duct wall or spread into the surrounding breast tissue. Because the abnormal cells remain confined to the ducts, DCIS is considered non-invasive. Today, DCIS accounts for approximately one in every five new breast cancer diagnoses in the United States, largely because routine mammograms are able to detect these early changes before they become invasive. While DCIS is highly treatable and carries an excellent prognosis, it is not one disease. Some DCIS lesions are unlikely to ever progress or return after surgery, while others have a higher risk of recurring or developing into invasive breast cancer over time. That is what makes treatment decisions so challenging. There is no universal "right" answer for every patient. Treatment recommendations may include lumpectomy alone, lumpectomy followed by radiation therapy, hormone therapy for some hormone receptor-positive tumors, or mastectomy in select situations. These recommendations are based on many factors, including the size and grade of the DCIS, surgical margins, hormone-receptor status, age, family history, personal preferences and values, and in some cases genomic or biomarker testing. The goal is to understand the biology of the tumor well enough to recommend the treatment that is most appropriate for that person. What Is Genomic (Biomarker) Testing? This is where many patients become confused. Genomic testing does not tell you whether you have cancer. It also does not replace your pathology report. Instead, these tests analyze the biology of the tumor itself to better understand how that specific DCIS may behave. In certain cases, these tests can provide additional information about the likelihood of recurrence and whether radiation therapy is likely to provide meaningful benefit after breast-conserving surgery. The current Medicare Local Coverage Determination itself acknowledges that traditional clinical and pathologic features do not always reliably predict recurrence risk and that validated biomarkers may provide additional prognostic information to help distinguish patients who may benefit from more treatment from those who may benefit from less. This is the very definition of precision medicine. Information Empowers Patients. At SurvivingBreastCancer.org, we believe that informed patients make better decisions not because they choose one treatment over another, but because they understand why a treatment is being recommended for them. Genomic testing is not a replacement for conversations with your surgeon, radiation oncologist, or medical oncologist. It is another piece of information, another data point, another tool that can help patients and physicians weigh risks, benefits, and personal preferences together. Access to information should never depend on a person's financial resources. If a validated test can help someone better understand their individual risk and make a more informed treatment decision, patients deserve the opportunity to discuss that option with their care team. Why This Matters Beyond Medicare Many people assume Medicare policy affects only older adults. Unfortunately, that's often not the case. Medicare coverage decisions frequently influence private insurance policies, employer-sponsored plans, and future payer decisions. While there is no guarantee private insurers will mirror this proposal, history suggests they often consider Medicare coverage when developing their own policies. That means today's Medicare decision could shape tomorrow's access for women diagnosed with DCIS across the country. What Can We Do? One of the questions I kept asking myself while researching this issue was: "What can we actually do?" The good news is that patients and advocates do have a voice. Here are a few meaningful ways to get involved: Learn about the proposed policy from reliable sources before sharing information. Contact your members of Congress and let them know that access to evidence-based, personalized cancer care matters to you. If public comment opportunities are open during Medicare contractor review periods, submit your perspective as a patient, caregiver, clinician, or advocate. Share your story. Real patient experiences help policymakers understand that these decisions affect people, not just policies. Talk with your healthcare team. If you've benefited from genomic testing, ask whether they're participating in professional advocacy efforts through their medical societies. Our Commitment At SurvivingBreastCancer.org, we don't advocate for one company or one test. We advocate for those impacted by breast cancer. We advocate for access to high-quality information. And we advocate for a future where treatment decisions are driven by science, evidence, and the unique circumstances of each individual, not simply by whether a diagnostic tool happens to be covered. Because every person diagnosed with breast cancer deserves the opportunity to make informed decisions with their healthcare team. Learn More If you're newly diagnosed with DCIS and want to better understand your options, we invite you to listen to our Breast Cancer Conversations episode: DCIS Isn't 'Nothing': Stage 0 Breast Cancer and the Decisions No One Explains. In this conversation, we explore why DCIS treatment is often more nuanced than people realize, what genomic testing can and cannot tell us, and why personalized decision-making matters.

By Jill Siegal Chalsty Bay of Islands, New Zealand – learning about and becoming inspired by the resilience of the Maori people I’m the founder of Overcoming Obstacles, a nonprofit organization that provides the world’s educators with free life skills curricula to teach in their classrooms. I had devoted decades to helping ensure young people learn the communication, decision making, and goal setting skills they need to lead healthy and prosperous lives. But my journey with cancer taught me that I hadn’t been practicing those same skills myself. On October 5, 2022, I left my home for twenty-four hours that would change my life forever. I had been followed for years as someone at high risk of breast cancer and then my incredible surgeon and her team at Moffitt Cancer Center stepped in when cancer was found. Leaving home for a double mastectomy would have been difficult for anyone, but I had become the full-time caregiver for my husband, John. He had been my source of strength for decades but was now entering the final stages of mixed dementia. I headed to Moffitt alone. During my time in recovery post-surgery, I didn’t have the television on. Nor did I have visitors. I lay in my bed, reliving moments of my past. I thought about a trip John and I had taken to a small island off Fiji, one of the most beautiful places we had ever visited. The sun bounced off the turquoise water. Ripe coconuts fell from the trees. That had become my happy place. Other memories surfaced too, reminding me that I was raised to be a warrior. Delivering a "packet of hope" in Mauritius My parents were fighters. My father had served with the Marines during the Korean War and taught my brother, sister, and me things that helped him make it through the most difficult times, including crossing the Han River during the Inchon Invasion and making it back to shore alive. Dad had favorite quotes that became huge in our lives. One from George W. Cecil that we were instructed to memorize was on the wall of his home office: “On the plains of hesitation bleach the bones of countless millions who at the dawn of victory, sat down to rest, and resting died.” The quote became a way of life for me. “Never hesitate! Jump on things right away!” I did that through childhood, into adulthood, in preparing for surgery, and in caring for myself and my husband as I recovered. But growing up, no one talked to us about “balance.” We all need to have balance in our lives, otherwise we’ll be stressed and burn out. And the link from stress to cancer is well documented in studies. What’s more, no one spoke to us about getting a good night’s sleep or the diet necessary to be healthy. Not even well-intentioned and caring parents were able to teach the skills I needed to stay healthy. A warrior spirit and sayings got me through the twenty-four hours away from John but weren’t going to be enough to win my battle against cancer. Fifteen months after the double mastectomy, I was diagnosed with two primary lung cancers in my left lung. I had the upper half of my left lung removed for the larger of the two cancers and then lasted only a few rounds of chemo before my kidneys cried, “Enough!” The cancer in the lower left lung is being monitored by CT scans. I’m living my life now in chunks of months. This new timetable has become the calendar for planning my life. With each report of “Stable” I move forward. During my recovery, I began writing my memoir, Packets of Hope and with that spent hours re-reading the Overcoming Obstacles curriculum. I engaged with the lessons and, best of all, connected with former students to hear how the life skills they learned in school saved their lives. Now, unlike the person who walked through the doors of Moffitt Cancer Center in 2022, I’m practicing what Overcoming Obstacles educators teach. I’m setting small goals to reach larger ones, making healthy choices, and surrounding myself with positive people. These lessons aren’t just for students. They’re lessons for us all. About the author: Jill Siegal Chalsty is the author of Packets of Hope: A Journey of Healing and Rediscovery. Read More: The Psychological Impact of Breast Cancer: Strategies for Coping A Disabled Clinical Psychologist’s 6 Tips for Living Well with Breast Cancer Grit and Grace 20 Sleep Hacks For A Better Night's Rest On the Podcast: Breast Cancer Conversations The Messy Middle of Breast Cancer: Chemo, Surgery, Side Effects, and Survivorship Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Lisa Johnson I first heard the words “you have breast cancer” in November 2014 while lying in bed praying. As I turned onto my right side, I felt a sudden pain in my breast and asked God, “What is this pain, and where did it come from?” In my spirit, I heard Him say, “You have breast cancer, but fear not, for I am with you.” Those words echoed in my heart like a broken record as I moved through the holidays carrying thoughts I had not yet shared with anyone. I waited until January to schedule a mammogram, when my new health insurance became active. By February 2015, the journey had begun, and it moved quickly. A mammogram, ultrasound, and biopsy confirmed my diagnosis: breast cancer, ER/PR-positive, HER2-negative. That single year brought overwhelming change: marital separation, moving, job loss, a mastectomy, reconstruction, chemotherapy that nearly took my life, infections requiring hospitalization, and ultimately a divorce, all while preparing my only child, who also became my caregiver, for his senior year of high school. I survived by entering what I call “lock and load mode,” pressing forward one step at a time. I trusted God, believing this season was temporary, and I declared with faith, “I am healed. I shall live and not die.” By the end of that year, treatment was complete, cancer was in remission, I had a new job, and life finally felt stable again. Although I thought I would magically snap back to “normal,” I soon realized I was so wrong. I needed to embrace this new body, new person and found myself grieving the woman I was prior to breast cancer. I faithfully followed my oncology care, took tamoxifen for a few years, and looked forward to my five-year cancer-free milestone. Then on May 25, 2020, during what I thought would be my victory oncology appointment, everything changed. A lingering cough and abnormal blood work led to scans that confirmed breast cancer had returned, this time as stage 4 metastatic breast cancer, spreading to my lungs and bones. Those words took my breath away. Fear came rushing in, I was faced with my mortality much sooner than I ever thought I would be, but I knew I had a choice. I had to declare yet again, “I shall live and not die!” Rather than shrinking back in fear, I chose to continue to have faith in God, grab life by the horns and live, now. Treatment began immediately. After one chemotherapy treatment caused a medical emergency and revealed a single brain tumor, I underwent CyberKnife radiation, noninvasive and successful. Chemotherapy was stopped, and I transitioned to a treatment plan of fulvestrant (Faslodex) injections and ribociclib (Kisqali). That decision changed everything. Today, I have been boldly living with metastatic breast cancer for five years and grateful to have been NED for about the past three and a half years. I enjoy a great quality of life with manageable side effects, work full-time and feel like myself most days. I am not merely surviving, I am learning, leading, teaching, advocating and truly thriving. My journey with metastatic breast cancer has become my mission and purpose. I am committed to learning all I can about MBC and using my voice to share my story, encouraging and educating others on what metastatic breast cancer truly is, ensuring its ribbon is recognized, and advocating for stronger resources, better legislation, and increased research funding. I am not just an MBC patient: I am a peer support and advocate. I am living proof that purpose is more powerful than prognosis. Read More: Metastatic Breast Cancer: Understanding the Significance of Stage IV The Role of Hormones in Breast Cancer Early Warning Signs of Breast Cancer On the Podcast: Breast Cancer Conversations The Hidden Trauma of Breast Cancer: PTSD, Fear, Triggers, and Healing Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Summer Owens I was forty-six when my world shifted with four words no one ever wants to hear. You have breast cancer. And the surprising part is that I did not panic. My very first thought was the same phrase that has carried me through so many of life’s hardest seasons. S.O. What!. Not as in this does not matter, but rather I can face this. Then came the next question that always follows for me. S.O. NOW what? That mindset became the foundation for everything that happened next. My diagnosis was ductal carcinoma in situ (DCIS), stage 0, found during a routine ultrasound and confirmed by biopsy. I felt no lump. No pain. No warning. Just a quiet discovery that changed everything. I am grateful it was caught early, but hearing the word cancer still takes your breath in a different way. In September, I had a partial mastectomy. I didn’t have to have lymph nodes removed, and I’m grateful I didn’t have to have chemotherapy. A blessing I do not take lightly. The scar reminded me of my C section years ago. Another physical reminder of something that changed my life and made me stronger. Radiation brought its own surprises. Twenty sessions later, my breast is so dark now that I cannot even see the scar anymore. And even in that, I found gratitude. I was still here. Still healing. Still moving forward. Fatigue, brain fog, and emotional swings showed up too. Although I like to blame menopause for most of that and keep it light when I can. There were hard days, but there was also humor, honesty, and grace. I am self-employed, which helped me schedule treatment around work, but it also means insurance and costs have been a challenge. My son is grown and out of the house, so I walked much of this alone. It was peaceful at times and painful at others. Still, I am grateful. So grateful. I looked forward to seeing my friends who are also fighting cancer when I went to my daily radiation appointments because their appointment times were close to mine. We shared stories, shared life experiences, and laughed and encouraged each other a lot. What helped me with expectations were the friends who had been diagnosed with DCIS before me. They gave me real, honest expectations, and because of them, nothing felt as terrifying as the unknown usually does. And then there was the support I received from people who surprised me. Individuals who had no idea how much their kindness meant or how deeply their messages touched me. At the same time, I had to navigate the quiet heartbreak of realizing that some people I thought would check on me never called at all. That part was hard, but even in that, I found clarity, strength, and a deeper appreciation for the people who truly showed up. Perhaps the most meaningful part of this journey has been turning pain into purpose. A few years ago, I helped my mother pass out one hundred pink crochet caps at Race for the Cure. I had no idea that breast cancer awareness would one day become personal. This year, I created my own breast cancer awareness hoodie brand to honor this chapter, bring awareness to early detection, and share the mindset that carried me through. I gave my surgical oncologist a hoodie, and she even made a video about breast cancer surgery in it! I share my story because I remember searching for stories just like this when I was first diagnosed. Stories that told the truth. Stories that offered hope. Stories that said you can get through this too. If you are in the fight, just beginning, or supporting someone you love, I am praying for you. I see you. And I believe in what you still have the strength to overcome. My journey was not what I expected, but it reminded me once again that obstacles are not the end of the story. With faith, gratitude, and the right mindset, they become the beginning of a new purpose. S.O. What!. Now, what will you do with your next challenge? Connect with Summer: www.summerowens.com https://www.youtube.com/@SummerOwensSOwhat instagram.com/summero_sowhat facebook.com/SummerO.SOwhat linkedin.com/in/summer-owens-10846625 https://www.thesowhatfoundation.org/ https://summerowens.com/product/the-s-o-what-breast-cancer-awareness-hoodie/ Read More: Ductal Carcinoma in Situ (“Stage Zero” Breast Cancer) The Impact of Breast Cancer on Self-Image Managing Fatigue During Breast Cancer Treatment The Cost of Breast Cancer On the Podcast: Breast Cancer Conversations DCIS Isn’t “Nothing”: Stage Zero Breast Cancer and the Decisions No One Explains Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Shantana Watkins Greetings, my name is Shatana Watkins. I am from Indianapolis, Indiana. I am divorced with no children. I am a 46-year-old African American woman living with stage IV advanced-stage hormone receptor-positive (HR-positive), HER2-negative breast cancer. I did recognize some of the initial signs of my cancer in my breast years before I was able to address it. I made the discovery by self exam in 2010. I was eventually diagnosed in April 2021. Since then I have learned of the advancement of my cancer. The cancer has metastasized to my right lung, rib cage area, as well as a small mass in the right side of my brain. The result of the one round of radiation to my brain has been necrosis found in that area. I have had ten rounds of radiation to my breasts, along with a mastectomy. I continue my chemotherapy treatments with various medications including everolimus, abemaciclib, tamoxifen, and letrozole. I also have a port for easier access for blood draws and chemotherapy treatments. At this time, I continue my routine health care plan as prescribed by my oncologist. I have spent the majority of my time taking care of my mother, who struggled with her own health issues, which in turn caused me to neglect my own health. I was my mother’s primary care provider from August 2006 until she passed away in December 2020, during the Covid-19 pandemic. I lost my father in 2013; he was not aware of my condition. I did not want to neglect the care of my mother as I am an only child. I did not share any of my health information with my mother; I never wanted her to worry about me and I continued to place all my focus on her wellbeing until she passed. I also did not share my diagnosis with my closest friends or the rest of my family, until I could no longer care for myself, and needed additional support. I did not want to place any worry or stress on them as they have their own lives to live. In 2014 I obtained my Associate’s degree in business and in 2016 I obtained my Bachelor’s degree in management from Indiana Wesleyan University. My father instilled in me that education is very important, so I made certain to obtain my education and to continue to learn as often and as much information as I am able to. Living with metastatic breast cancer has caused me great physical, mental and financial toxicity. The mental and physical stress of worrying about finances has taken its toll. I am struggling to make ends meet as the cost of living is steadily increasing. I have attempted to find various resources to help fill the gap in what I am lacking, but most do not assist with daily costs of living and other financial obligations that most adults have. I have worked all of my adult life and I currently receive monthly disability payments. While I am thankful for the amount I receive, I can barely afford to meet my other financial obligations. When employed, I have been without health insurance through my employer for cancer treatments as it was unaffordable. I also had to toggle between missing work or neglecting my chemotherapy treatments so I would not miss any work days. For the weekdays that were missed, I made up for it on weekends. Women with financial hardships can furthermore face challenges in completing comprehensive multidisciplinary breast cancer management, because the frequency of treatment visits will generate costs related to transportation, childcare, and time away from work. The level of care should also be a focus for those in assisted living facilities and should also be investigated more often than what I have seen in my recent experience. Those who reside in such places may not have a voice in their care or they may not have a family member to voice their concerns. In some cases, residents may be taken advantage of mentally, physically and financially. In 2023, I had to move to another city in Indiana (Kokomo), as I was no longer able to live alone. I lived with a close friend for two years until she was no longer able to assist in care for me due to her full-time workload and parenting two children. After a recent hospital stay, my friend decided it was in my best interest to seek a nursing facility in the area. I stayed at this facility from January 2025 to August 2025. I did not select this facility, this was decided by my friend. During this time, there were issues in coverage between Medicaid and Medicare. The coverage between the two can be difficult to understand. During my stay at this facility, I experienced many issues with communication, accommodations, care plan management, social services, nutrition, and more. As I was trying to find a different assisted facility closer to my family, there were issues with locating a place that would accept me due to my age. I have learned that most assisted facilities are mainly geared to those who are 55+. I have also learned that the majority of assisted living coverage and acceptance is focused on that of 55 or older. I wanted to share my experiences as I would like to find more information on funding for those of us who are under the age of 55, but also have major health issues. Medicare is not an option for me because of my age, but I do have a terminal health diagnosis that should qualify myself and others who may face the same struggles. Many individuals fall into a gap where they cannot afford private health insurance, yet their income levels via disability payments are too high to qualify for government-supported insurance. No human being should have to decide on whether or not to seek medical care or to suffer in silence over the concern of unknown expectations, treatments, or just general care. I have spent these past years trying to not only deal with my health, but being constantly hounded to pay for treatment “not covered” with funds I do not have. The last thing a patient wants to hear when seeking treatment or waiting for test results is “You have a current balance of…” I understand that some costs will apply in some cases, but at the same time, how can a person who already has a limited income be expected to take care of their other needs on top of making countless doctor visits that will ultimately result in another financial obligation? It is a vicious, never-ending cycle. Most younger adults have financial obligations such as car and car insurance payments, credit card payments, cell phone payments etc. I am also having issues in locating housing and financially setting myself up to transition to a different location outside of an assisted facility situation because of the lack of my own “income” I am allowed to have. I find myself feeling stuck in an assisted living place for the remainder of my days. This has taken a mental and social toll on my overall well-being, in addition to living with my breast cancer diagnosis. I am currently in a position in which I have completed physical therapy expectations and am hoping to be discharged from the healthcare facility I am currently in. The biggest issue I have faced in trying to transfer to another assisted living facility is the denial from many facilities due to my age. There is a need for a healthcare program for those younger than 55. There is a desperate need for facilities that can and will accept and assist those who might not be ready to the normal standard of assisted living, but need the additional support with whatever severe illness they are facing. Another concern I have faced is challenges in attempting to regain full financial independence due to my entire disability income being already directed to a healthcare facility. An ongoing issue I am facing is the ability to leave the healthcare facility, as I am unable to financially do so. It is important to add that I am fully able to care for myself at this time, and have only received assistance with meals and medication distributions, which are things I can handle and control myself. I do not require assistance with bathing, dressing, or taking care of my room with cleaning and upkeep. The current facility does not provide transportation as often as I need it, which has resulted in me dealing directly with my patient navigator in setting up transportation for future appointments. While trying to depend on the help for the healthcare facility I am currently in, I have been asked to reschedule my chemotherapy appointments as there was a lack of communication between the chemotherapy office and the healthcare facility. In turn, I have had to mediate and correct the lack of communication to insure I would not miss any appointments going forward. Breast cancer, as well as other cancers impacting both men and women, can occur at any age, regardless of race. Being under the age of 55 does not mean those individuals cannot face any major health concerns such as cancer. How can the gap of coverage between Medicaid and Medicare meet to where the recipient can keep more of their monthly benefit that they have spent most of their life working for? How can more assistance be offered through grants regardless of race or gender? Where can those who are under the age of 55 find residency for support and care? I have found there are a lot of disparities in the care received between African American women and those of other races. I have researched grants specifically for African Americans in general and did not receive many results. The American Cancer Society states that breast cancer is the leading cause of cancer death in the U.S. for African American women. They are more likely than white women to have inadequate health insurance or access to health care facilities, which may affect screening, follow-up care, and completion of therapy. Compared to other racial/ethnic groups, Black women are more likely to be diagnosed with breast cancer at a young age (under 45) and at later stages of the disease, when it is more difficult to treat. Black women continue to die of breast cancer at an alarming rate of more than 40% as compared to white women. Unemployment rates are higher in the African American community compared with the White American community; this disparity persists during times of economic strength and is magnified in the setting of financial stresses. Socioeconomic disparities undoubtedly contribute to the 40% higher breast cancer mortality rates seen in African American women by causing delays in diagnosis and more advanced-stage distribution compared with White American women. Increased access to free or low-cost mammograms can help close the gap and ensure more Black women get timely breast cancer screening. I want to be very candid with my care, as had it not been for the care of my patient navigator, nurses and aides at St. Vincent Hospitals as well as Dr. Deng Zhang with the Hematology Oncology of Indiana over the years, this journey would have a completely different ending. While I have had many good experiences with these providers, I still feel there is a lack of empathy from some. We are seen as only patients and not as human beings. There is a need for a reminder to those who serve to be kind, we all have a battle that others know nothing about. I want to share positivity and a small token of hope. I have continued to survive with this illness due to their care and my faith in God. As I am today, at first glance, someone who does not know me personally, would have no idea what I have experienced and what I continue to face on a daily basis while still surviving this disease. I still remain as active as I can by spending time with family and friends. I also enjoy bowling as I have done so for over ten years. I would like to return to a sense of normalcy, in spite of my breast cancer. I would like to live outside of an assisted living facility as I am primarily a resident to participate in physical therapy. With the exception of receiving my medication, I am fully able to perform self-care needs. I have seen the success stories of those facing a health crisis and receiving so much support and an excellent level of care, but what type of resources are there for those who don’t know what is available? While I am happy to see the stories of those who are in remission, and those who have beat cancer altogether; where are the stories of those who still face their battles on a daily basis? What about those who don’t meet a certain demographic to even receive such support? Should it matter what stage of illness or what type of illness one is facing? I would like to be the voice for those who may face a similar situation in which they may be afraid to seek medical care or unable to due to other obligations. A person facing any serious medical condition should not have to face it alone. They should not be uninformed, nor turned away from care due to insurance paperwork. My experiences over the years since my diagnosis have been more stressful financially, physically and mentally than dealing with my terminal illness. I am certain there are individuals my age (or a range of ages 18-55) that have been or are going through a similar situation. There has to be a better solution for those who really need more support than what is provided so those with any sort of illness can focus on the importance of their care and have a better quality of life. This is not just about policies on paper; this is about human lives. Read More: Metastatic Breast Cancer: Understanding the Significance of Stage IV The Cost of Breast Cancer The Role of Hormones in Breast Cancer Understanding Breast Cancer in Young Adults Understanding the Different Stages of Breast Cancer MBC Programs: Expressive Writing for MBC Thursday Night Thrivers: MBC Support Group Video Library: MBC Webinar Series On the Podcast: Breast Cancer Conversations Insurance Denied My Cancer Treatment: What Every Cancer Patient Should Know About Medical Bills Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

By Jayant (JP) Parthasarathy Listen to JP on the SBC podcast, Breast Cancer Conversations: Revolutionizing Breast Cancer Detection with JP Parthasarathy, founder and CEO of Astrin Biosciences Updates from the SBC Team as of June 2026: In September 2024, the FDA updated mammography guidelines to include an overall assessment of breast density as part of a mammography report. In March 2025, the National Comprehensive Cancer Network updated its screening guidelines to recommend that patients with extremely dense breasts receive breast MRIs with and without contrast starting at age 50, but may start at age 40. “Do you have a family history of cancer?” is a standard question doctors ask all their new patients. It’s a crucial indicator of when, how often, and for which cancers a person should be screened. But there’s another question that both doctors and patients should consider when it comes to breast cancer: “Do you have dense tissue?” If you’re not sure what that means, or how you can find out if you have dense breasts, don’t worry. This article will tell you what you need to know about dense tissue and why this information is important for breast cancer detection. Breast density describes the type and amount of tissue someone has. While some women have almost all fatty tissue, others can have more or entirely fibrous tissue, making their breasts more dense. Breast density is not something that can be felt; it’s only determined during a woman’s first mammogram. While it’s incredibly common – over half of women over 40 have dense breasts – it can multiply someone’s chances of developing breast cancer by up to six times – more than family history. For those with fatty tissue, a typical mammogram will clearly reveal any existing tumors as white marks. For those with dense tissue, however, the fibers also appear white, obscuring doctors’ view of any tumors. In women with extremely dense breasts, the whole breast may appear white. Today, doctors use ultrasounds and MRIs as supplemental screening for people with dense breasts since they provide higher sensitivity and clarity than mammograms, but this is a band-aid on a bigger problem. Women with dense breasts need a more effective and sustainable screening option. How to Screen Dense Breast Tissue for Cancer Detecting and treating breast cancer as early as possible is one of the best ways to save lives. The American Cancer Society (ACS) reports that nearly 100 percent of women diagnosed with localized breast cancer survive five years past their diagnosis, compared to 32 percent for those diagnosed with distant spread. Screening is a powerful early detection tool, and the ACS recommends that most women start annual mammograms after they turn 40. Once they’re eligible, all women should get a mammogram – not only for early cancer detection, but also to learn whether they have dense breasts. From there, most women with dense breasts need supplemental screening. Unfortunately, this isn’t as seamless a solution as it should be. Most people with dense breasts are referred for a breast ultrasound, which can search through dense tissue to identify tumors using high-frequency sound waves. An ultrasound may find two to three more cancers per 1,000 women than mammograms, but can still miss several cases. Additionally, while ultrasounds are low-risk, painless, and usually covered by insurance, they lead to false positives more than 90 percent of the time. This can cause unnecessary distress for patients. A smaller portion of women may be referred for a breast MRI, which uses magnets and radio waves to create an image of the breast. These are even more sensitive than mammograms; however, they’re also more invasive, more expensive, more likely to yield false positives and less likely to be covered by insurance. Beyond the individual-level impact, our healthcare infrastructure and the shortage of radiologists isn’t prepared to schedule, perform, and pay for the 40 million women who would need them each year. How Blood Tests Can Improve Breast Cancer Outcomes While mammograms and ultrasounds remain the go-to standard of care for women with dense breasts, innovation in cancer screening is essential. Advances in cancer science and technology are creating new opportunities to catch breast cancer earlier than ever. Rather than waiting for a tumor to form to find it via imaging, highly sensitive blood tests can identify cancer at stage 0 by analyzing a small blood sample before any signs or symptoms are felt. While researchers have attempted to detect cancer through blood tests in the past, breast cancer has specifically been one of the most difficult to uncover. Unlike lung or colorectal cancers, experts estimate that detecting breast cancer in the blood would require technology 10 times more sensitive than what is currently available. Now, thanks to breakthroughs in machine learning, catching breast cancer through blood tests may now be made a reality through proteomics – the proteins that breast cancer cells use to communicate with one another. Proteins are the functional units of cells, meaning they reveal what cells are doing in real time. If cells are acting in a way that indicates cancer, proteins will be the first signals. Using artificial intelligence (AI), scientists have been able to sort through signals that are now 1,000 times more sensitive than previously possible to find the ones relevant to cancer, then inform the next best steps in a care plan. For women who have dense breasts, and even those who don’t, highly specific blood tests can be a revelation, increasing access to the early detection they need for better breast cancer outcomes. More accessible and less invasive than today’s screening options, highly sensitive blood tests could be the missing piece of the breast cancer detection puzzle. These innovative testing technologies are currently in development and will become more widely available to oncologists and patients over the next few years. In the meantime, it’s important to continue to advocate for better screening options for women with dense breasts. Understanding breast density and available screening options is a great place to start; then you can take those learnings to your next doctor’s appointment. Ask your doctor about your breast cancer screening options and eligibility. If you’re eligible for a mammogram, it’s time to schedule one. Whether or not you have dense breasts, talk to your doctor about blood test options that may work well for you. Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. About the Author: Jayant (JP) Parthasarathy is the founder of Astrin Biosciences, a St. Paul, Minneapolis-based cancer intelligence company transforming detection and treatment via deep proteomics and AI. Motivated by his father’s cancer diagnosis and passion for research, he left his role as deputy chief science officer at UnitedHealth Group to launch Astrin in 2021. JP serves on the board at the Hennepin Healthcare Research Institute and holds a Ph.D. in Brain Machine Interfaces from the University of Minnesota. Read More: What Are Dense Breasts Addressing the Unique Challenges of Breast Cancer in People Under 40 Unleashing the Potential of AI in Breast Cancer Screening, Diagnosis, and Treatment Understanding Your Pathology Report: A Comprehensive Step-By-Step Guide On the Podcast: Breast Cancer Conversations Revolutionizing Breast Cancer Detection with JP Parthasarathy, founder and CEO of Astrin Biosciences Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Cara Lockwood After I was diagnosed with HER+ breast cancer in 2023, I knew the journey forward would change me — but I never imagined how much. My therapist told me I’d have a choice between becoming a victim or being a survivor. That road to survivor was hard, involved lots of crying in the shower and pleading with the universe, and also required learning some hard truths about myself. Like nearly every woman I know, I play a loop of negative thoughts that runs in my brain at any given time. I’m an award-winning USA Today bestseller of more than 35 romance novels published by Simon and Schuster, Harlequin, St. Martin’s Press, and Hachette over the last 25 years — and yet I suffer imposter syndrome all the time. Terrible, awful thoughts like: No one is going to read your new book. Sure, your first book was made into a movie, but did anyone even see it? No one wants your stories. You’re not good enough. This playlist ran alongside other ones, like: You aren’t pretty enough. You’re not skinny enough. You’re not sexy enough. You’re not… enough. I let these mean thoughts, fueled by insecurity, run unchecked through my head. They’re constantly in the background, like hold music on a customer service line. But when cancer hit, a new round of negativity began to play: Everyone says you’ve got this, but you 100% do not have this. You’re not strong enough for this. You’re not brave enough. You’re not going to make it. And on, and on, and… on. And I just let it play. Researchers say we can actually talk to ourselves at a speed equivalent to 4,000 words a minute in our heads, and I’ll be honest: Most of those words in my head were negative. Passive aggressive. Critical. Even under the barrage of criticism, I worked hard to get ready for my double mastectomy. I began eating right. Exercising more. I channeled my anxiety about the surgery into being more active. I went to a therapist. I did some hard mental and emotional work on her couch. I did all the hard things to prepare for the scariest thing I’ve ever done in my life. And… you know what? I came out of that surgery with flying colors. I had a complication-free recovery. I made it. And, in the days after that surgery, I gave myself a genuine compliment. I told myself: “You did a good job. You were brave. You did the hard work and it paid off.” I gave myself an honest pat on the back. No caveats, no snide side comments. No buts. No exceptions. Just a good job. Period. And I immediately began crying. Big ol’ shoulder-wracking sobs. Because I realized up until that point in my life, I don’t think I’d ever given myself a genuine compliment. Backhanded ones? Sure. Like, Congrats on making the USA Today bestseller list. It’s not the New York Times, but whatever. Or Oh? You gave birth. Twice? Good for you. Except you have no idea how to soothe this crying baby. You’re useless! There was always a snide side comment to every compliment I ever gave myself. Every. Single. Time. It was then that I realized how mean I’d been to myself my entire life. Cruel, even. Unfair. I’d never say these things in my head out loud to anyone ever. I’d never be that mean to a living soul. But I was regularly that horrible to myself. I’d been living in an emotionally abusive relationship with myself and never even knew it. I read that before a big mission, Navy SEALs train themselves to keep a constant stream of positive-self talk going because they know that when times get tough, the last enemy they want to be fighting on the battlefield is themselves. They put their lives on the line in dangerous missions all the time, where they’re tested mentally and physically, and they know how important positive thinking is. How dangerous negative self-talk can be. And this made me realize that up until my double mastectomy, I’d been fighting cancer all wrong. I’d been a house divided against itself. There’d been a civil war raging in my head about whether or not I’d actually beat cancer. I’d looked for any reason I could to blame myself for the cancer. I’d gained weight. I’d not eaten right. I liked wine too much. I was a little late getting that mammogram. I never gave up Red Dye 40 because I can’t quit Twizzlers or Doritos. The treatments the doctors prescribed probably wouldn’t work on me, I told myself. The odds wouldn’t be in my favor, even when doctors said they would be. I challenged everything because I thought this was how I could motivate myself. That if I criticized myself I’d work harder. Be better. But I wasn’t motivating myself at all. I was beating myself down faster than the cancer could. So I decided to challenge that negative playlist in my head anytime it started to play. No longer would I Iet it auto repeat. I decided, genuinely, to show myself the kindness I so often showed others in my life. And I think this helped me kick cancer. I went into remission in 2024. And positive self-talk is still paying dividends in my life as a survivor, too. Studies show that you can reap all kinds of benefits from positive self-talk. Positivity may lead to longer life spans, less stress, and even better cardiovascular health. I give myself genuine compliments all the time now, and it feels amazing. I don’t kick myself when I’m down. I allow myself some grace when I’m a messy human who makes mistakes. I believe it’s made all the difference, both in my fight to end cancer and in the life I live afterward. Because being a survivor doesn’t just mean to live. It means to thrive. And that’s what I plan to do from here on out. Read More: Scheduling Worry Time: A Technique to Control Your Anxious Mind Grit and Grace How Cancer Trauma Can Impact Your Life and Ways to Move Forward On the Podcast: Breast Cancer Conversations How Breast Cancer Changes the Way You See Yourself Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Podcast Weekly Meetup Free Events

New research on Ozempic, Wegovy, and other GLP-1 medications is raising questions about breast cancer risk, treatment outcomes, and survivorship. Here’s what patients need to know. SurvivingBreastCancer.org | By Laura Carfang GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound are best known for helping people lose weight and improve blood sugar control. Now, researchers are asking a bigger question: could these medications also influence breast cancer risk, treatment tolerance, or long-term outcomes? Early studies presented at ASCO in 2026 and research at the San Antonio Breast Cancer Symposium in 2025 suggest the answer may be promising, but the science is still developing. For people living with breast cancer or navigating survivorship, this is an important topic. Weight, metabolism, hormone therapy, and inflammation can all affect health after a breast cancer diagnosis, which is why GLP-1 medications are drawing so much attention. What are GLP-1 medications? GLP-1 receptor agonists are prescription medicines originally developed to treat type 2 diabetes, and several are now also approved for weight management. They mimic a natural gut hormone called GLP-1, which is released after eating and helps coordinate metabolism in several ways: they slow how quickly food leaves the stomach, increase feelings of fullness in the brain, reduce appetite, and help the pancreas release insulin when blood sugar rises while also lowering glucagon, a hormone that tells the liver to release stored sugar. Together, these effects help improve blood sugar control and reduce calorie intake, which can lead to weight loss over time. Common GLP-1 medications include semaglutide, tirzepatide, and liraglutide, sold under brand names such as Ozempic, Wegovy, Mounjaro, Zepbound, Victoza, and Saxenda. Why breast cancer researchers are paying attention Weight and metabolic health matter in breast cancer because excess body fat is linked to higher risk of developing breast cancer after menopause, and it may also affect recurrence, treatment tolerance, and long-term outcomes. That is one reason researchers are watching GLP-1 drugs so closely: if they help people lose weight safely and sustain that loss, they may improve more than just body mass. Scientists are also looking beyond weight loss. GLP-1 medications may influence inflammation, insulin signaling, and other biologic pathways that could matter for cancer development and progression. Because obesity can drive chronic inflammation, raise insulin levels, and alter the metabolic environment around tumors, researchers are now asking whether GLP-1 drugs may help change those conditions in ways that could affect cancer risk or outcomes, not just body weight. GLP-1s and hormone receptors Hormone receptor status is central to breast cancer care because many breast cancers are driven by estrogen or progesterone signals. That is why endocrine therapies such as tamoxifen and aromatase inhibitors are so important for hormone receptor-positive disease. The current research does not show that GLP-1 drugs directly target estrogen receptors, progesterone receptors, or HER2. Instead, the interest is mostly indirect: GLP-1s may help with weight, insulin resistance, and inflammation, which can shape the metabolic environment in which hormone receptor-positive breast cancers develop or recur. In other words, GLP-1 medications are not being studied as hormone therapy; they are being studied as metabolic medications that may affect outcomes in hormone-sensitive disease. This is especially relevant for people with hormone receptor-positive breast cancer who are taking endocrine therapy. BreastCancer.org highlighted research suggesting GLP-1 use may help some patients on hormonal therapy lose weight, even though that weight loss may be slower or less dramatic than in the general population. At the same time, the available studies are still early, so GLP-1s should not be viewed as a breast cancer treatment outside a clinical trial. What the newest studies suggest At the 2026 ASCO Annual Meeting, Penn researchers reported that women ages 45 to 80 who used GLP-1 medications were about 30% less likely to develop breast cancer than women who did not use them. That result is encouraging, but it was observational, so it shows an association rather than proof of prevention. Other ASCO-presented research found that people with stage I, II, or III lung, breast, colorectal, or liver cancer who took a GLP-1 drug were less likely to progress to stage IV disease than those who did not take one. It is important to note that some cancer treatments, including certain chemotherapy drugs and targeted therapies, may not be a good match with GLP-1 medications. Because these drugs can affect how treatment is tolerated and how well it works, your care team will weigh the potential risks and benefits before deciding whether to pause or continue a GLP-1 during cancer treatment. What we know about weight loss One of the most familiar effects of GLP-1 medications is weight loss, and that may matter for some people with breast cancer. For patients who are gaining weight during treatment, or who are struggling with weight after treatment, these medications may offer another option to support overall health and wellbeing. Researchers are still studying how this may affect breast cancer outcomes, but for many patients, the most immediate benefits may be feeling more in control of weight, energy, and day-to-day health during and after treatment. What this does not mean These findings do not mean that GLP-1 drugs should be used outside of a clinical trial to treat or prevent breast cancer. The current evidence is mostly observational, and people with prior cancer were often excluded from the large trials that led to GLP-1 approvals. It also does not mean that GLP-1 medications are right for everyone with breast cancer. The best choice depends on cancer subtype, current treatment, medical history, weight goals, diabetes status, side effects, and insurance coverage. Questions to ask your care team If you are considering a GLP-1 medication, these questions can help guide a conversation with your care team: Is a GLP-1 medication appropriate for my situation? Could it help me if I am struggling with weight gain during or after treatment? Are there any concerns with my cancer subtype or current therapy? What side effects should I watch for? How will we know whether the benefits outweigh the risks for me? Why this story matters now Even though evidence is still early and more research is needed, GLP-1 medications are now part of a broader conversation about cancer prevention, survivorship, treatment tolerance, and long-term health after breast cancer. For those navigating a breast cancer diagnosis, there is hope but also caution—especially until larger studies can confirm which patients may benefit most and when these medications are safest to use. 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: SABCS 2025: What the Science Is Saying Breast Cancer Risk Factors Exercise and Breast Cancer Recovery On the Podcast: Breast Cancer Conversations The Prehab Plan Surgeons Wish You’d Start

By Jill Rackham “You have oestrogen-positive breast cancer,” the sympathetically eyed consultant said. “Your three tumours have been fuelled by oestrogen so we need to do all we can to stop any spread.” I was aged forty-three so needed a monthly injection to send my ovaries to sleep. It was a huge needle and painful but this was the plan I had to keep. Then came medication to reduce the oestrogen in my body even more. This was all new to me, I was in a clinical menopause, something I hadn’t ever considered before. In time my ovaries were removed, so the monthly injection was not needed. Now I was in a surgical menopause, in abolishing you oestrogen - I’ve succeeded! But throughout all this my body was suffering so much more. The cancer had been taken but now it was time for menopausal symptoms galore. Hot flushes, joint pain, brain fog, dry skin to name but a few. Followed by itchy skin, hair thinning, fatigue, brittle nails and a feeling of not knowing what to do. For me the menopause happened all of a sudden instead of taking several years. It took time to get used to and accept my new normal, it did make me shed a few tears. Cancer treatments leading to an early menopause I never knew that would be. But here I am living and owning it and all that it entails for me. So well done ladies if a cancer diagnosis brought a medically induced menopause to your door. You are doing amazing - let’s all support each other to lessen the intensity a little more. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events