By Jessie Woodyard No one tells you That the first place someone looks Someone who hasn't seen you since you were diagnosed is your chest. Eyes straight to your breasts. Are they still there? Which one is gone? Do they look the same to you? How about my eyes? How do they look? Do they look through tears at you stealing your glance? Or are they clear and wide, aware and sad? No one tells you about the drain. How it's the worst part until just before it's the worst part of you. The drain of this illness It is a metaphor and it is real and it sucks, like a vacuum and in every sense of the word. No one tells you That immediate isn't immediately But in fact drawn out Like the word YES written on my chest in ink that takes weeks to remove. No one tells you No one tells you about the return The blood return that you want to see The return of the cancer, malignancy That fear.... No one tells you it's permanent. No one tells you about the fights Miscommunication, misunderstanding Nothing feels right. No one tells you That you may beat it this time but this fear is for life. An uninvited partner for as long as you all shall live. In sickness and even in health No one tells you. I guess no one knows. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

Issue: #276 Tick, tock... did you remember to change your clocks ahead one hour yesterday? Let’s enjoy these later sunsets as we make our way towards a glorious springtime! This weekend, SBC attended the Infinite Strength MBC Conference in New Haven, CT. A huge congratulations and shoutout to Infinite Strength's founder and president, Roberta Lombardi, and her fabulous team, for hosting an educational, powerful, and intimate conference where we were able to connect with experts in the field and forge strong bonds with patient advocates. Among the many key takeaways, I learned the importance of exercise. The question now is, how much exercise does one need to do to receive the benefits and at what point is more not necessarily better? Research is being conducted to explore what the #RightDose of exercise. Dr. Teplinsky gave an exceptional talk normalizing the discussion around sex and intimacy when living with metastatic breast cancer. From providing recommendations on creams and suppositories like Intrarosa and Revaree, she encouraged us to speak with our oncologists and gynecologist about vaginal and pelvic floor health. Oftentimes these questions come up at the end of our already short and usually rushed appointments with our doctors so Dr. Teplinsky recommended making a separate appointment to specifically address these concerns with your team. From laughing about the crazy stuff people say to those diagnosed with breast cancer, to discussions around "you don't look sick", we laughed, cried, hugged, and came together as a community in support of each other's experiences. As the founder of SurvivingBreastCancer.org (SBC), and diagnosed with early-stage breast cancer, I am so grateful to be welcomed into the sacred space of the MBC community! We continue to provide relevant programming to address the pressing topics of those living with MBC. You can check out our MBC Webinar Series and catch our next Webinar this Wednesday hosted by Abigail Johnston and Amy Parliman where we talk about everything you need to know about scans. And a reminder that this Thursday is Write Your Story Day! Perhaps you'd like to attend tonight’s writing workshop with Thomas to write it out. Whether or not you submit your writing for our blog, writing down thoughts can be a really helpful way to process your breast cancer experience. I encourage you to give it a shot! You might be surprised at what you create :) Happy writing! xo, Laura Editorial: Effective Listening At SBC we received a heartfelt, brilliant note from community member and MBC Leadership Team member Kathleen Friel, regarding how to properly listen to and respond when speaking with someone with a speech impairment. See her email below. Kathleen’s memo got me to thinking about how I can personally improve and develop effective listening habits, and after some quick research I came up with the following: Effective listening is a crucial skill that goes beyond simply hearing words; it involves fully comprehending and interpreting the message being conveyed. One key aspect of effective listening is providing the speaker with your undivided attention. This means putting aside distractions, such as phones or other electronic devices, and maintaining eye contact to signal that you are fully engaged. Furthermore, active listening involves non-verbal cues, like nodding or mirroring the speaker’s body language, to convey understanding and encouragement. In addition to non-verbal cues, paraphrasing and summarizing the speaker's message demonstrate that you are not only hearing but also processing the information. This reflective aspect of listening ensures that both parties are on the same page, fostering clarity and preventing misunderstandings. It’s essential to refrain from interrupting and allow the speaker to express themselves fully before responding. This patience and respect contribute to a more open and communicative environment, where individuals feel heard and valued. Ultimately, effective listening is a skill that strengthens relationships, promotes understanding, and facilitates successful communication. From The SBC Blog No Scars to Your Beautiful By Jayita Chatterjee [This one is for me, for my pink cancer friends that went through lumpectomy, mastectomy and/or reconstruction, and really anyone else that needs to hear this.] If you feel horrible, looking like a Frankenstein, with giant stitches all across your body… I am here to tell you it is OK to feel how you feel! It is NOT vain. If your partner or others say that you look beautiful, but you don’t like how you look right now, it’s OK. If you don’t want to look at your body right now, it’s OK. You went through a lot. You went through multiple surgeries, chemo, maybe radiation, immunotherapy. And yes, you are alive. But we are allowed to mourn our old self… not just the body, but the person we were the day before we were told we had cancer. Yes, it’s physical changes, but that’s on TOP of so many other life-altering moments. One day you’re just living your life, and the next you’re talking to oncologists, geneticists, and surgeons. The world will tell you that you’re supposed to be grateful for being alive, and how you look does not matter. But it DOES. From the SBC Poetry Lab Moremi By Goldiin Kelvins In life, I met a girl so strong, brave, and true, Within four walls, she battled, a constant cue. Surviving, not living, she faced a relentless strife, Moremi, a young soul navigating through life. Born in Nigeria's west, in Africa's embrace, Her memory lingers, my heart's sacred space. I try to divert my thoughts, but I can't deny, Her innocent gaze, a plea in each dark eye. Her mind puzzled, imagining the world outside, Yet, hope waned, like a fading tide. She fought against sickness, a brave young soul, Yet, it fought harder, taking its toll. A 12-year-old warrior, courage in her stare, Yet, sickness, a ruthless terror in the air. Determined to live, dreams she'd conceive, But sickness threatened, luring dreams to grieve. Docs and teams fought, her heartbeat's descent, Body systems failing, a despairing lament. Yet, she'd jolt back, gasping for air, Mother's dripping tears, a father's silent prayer. Wishing for release, from the hands that tried, From loved ones' grasp, in pain, she'd hide. Drowning in the pit where life began, Her tears echoed, a heart-wrenching plan. Today, we lay her down in the earth's embrace, Cancer claims victory, a bitter taste. To those fighting, courage to you I send, May your stories not meet this tragic end. Lost a girl, lost a niece, grief in the wind, Adieu, Moremi, where memories begin. Today on the Podcast 11 Years of Survivorship - A Breast Cancer Survivor's Story with Dawn Aegle Dawn shares her journey from diagnosis to traveling the world doing cat sitting after caring for her mother. Their conversation touches on major milestones, personal experiences, and the impact of travel on Dawn's life post-treatment. Tune in for an inspiring story of resilience and adventure. (Click to Listen) Upcoming Events

By Michelle Sandlin In June of 2021, I was in the best shape of my life, or so I thought. I wasn’t overweight. I didn’t drink. I didn’t smoke. I didn’t do drugs. I was working out like a maniac, six days a week. I looked great. I felt great. But guess what? None of that mattered because cancer don’t care. That’s when I found a lump in my right breast. I was in utter shock and disbelief. It didn’t make any sense. As far as I knew, my risk factors for developing breast cancer were very low. My mom didn’t have breast cancer. My grandmothers didn’t have breast cancer. It seemed so random, and completely unexpected. But I was familiar with the statistic: one in eight women. Now I was the one. The day I was diagnosed, I was forced to learn many new words and terms. The first being invasive ductal carcinoma. The second being triple-negative breast cancer (TNBC). And then a few weeks later, a third one was added to the mix. It was BRCA1 gene mutation. Yep, I had that too. Those were the three things that pretty much dictated my treatment strategy. It looked like this: 16 rounds of chemo over the course of 5 ½ months, followed by a double mastectomy and reconstruction surgery, and finally the preemptive removal of my ovaries and fallopian tubes. That was the medical strategy. I also implemented and enforced a personal strategy, which proved to be critical and highly effective for my emotional wellbeing. It looked like this: maintain a positive attitude; keep toxic people and negative thoughts at bay; work out as much as possible; listen to my body; lean on my family, friends, and faith; stay in the moment, then let it go; use meditation to combat anxiety; no tears; no Google; no downward spiral. The idea was to develop a philosophy around controlling what I could control during this out-of-control time. And I documented every moment along the way, sharing personal messages, photos, and videos on social media. This helped tremendously with the crippling feelings of isolation that I experienced throughout my treatment. It also let people keep up with me and my progress and be able to see for themselves how I was doing. I wanted to be able to share the raw, emotional, candid moments. I wanted to share my message of love, hope, encouragement, motivation, inspiration, and the importance of community. I hoped others would be able to benefit from my experience. Then on Valentine’s Day 2022, I received the best news possible. That’s when my breast surgeon told me I was cancer-free! CANCER-FREE! This was just a few days after my double mastectomy. She introduced me to yet another new term: pathological complete response, meaning that there was no residual invasive cancer in the tissue that was removed during surgery. My prayers had been answered. In the months that followed, I realized I needed to process everything that had happened. There was no time to do that when I was first diagnosed, and certainly no time to do that when I was in the throes of treatment, surgery, healing, and recovery. So now that I was on the other side, it was time to process. That’s when I decided to write a book. To share my thoughts, feelings, and insights about my breast cancer experience. Everything I had been through—physically, emotionally, and spiritually—and what it’s like to be on the other side. To lift the veil and share the most intimate, personal details. To share the many life lessons that were woven into my journey. To share my perspective about life after cancer. And ultimately, to help and inspire others, and give them hope, regardless of the battle they may be fighting or the struggles they may be facing. To shine the light on the road to healing and inner peace. My hope is that others will benefit from my story. About the Author: Michelle Sandlin is an award-winning writer and bestselling author. She spent the better part of the past decade as a freelance writer and columnist. During that time, she wrote a weekly column for the Houston Chronicle, which ran from 2013 through 2020. Originally from Shreveport, Louisiana, Michelle currently lives in Houston with her husband, Kenny, and their English Bulldogs, Max and Stella. She published a book about her breast cancer experience, Cancer Don’t Care, in January 2024. For more information about Michelle, please visit her website: www.MichelleSandlin.com. Read More: A New and Unexpected Life Understanding Genetic Testing for BRCA1 and BRCA2 Mutations Remember You Are Not Alone On the Podcast: Breast Cancer Conversations Good News for Triple Negative Breast Cancer: A Vaccine and Hope for the Future Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

At SBC we received a heartfelt, brilliant note from community member and MBC Leadership team participant Kathleen Friel, regarding how to properly listen to and respond when speaking with someone with a speech impairment. (See her email below). Kathleen’s memo got me to thinking about how I can personally improve and develop effective listening habits, and after some quick research I came up with the following: Effective listening is a crucial skill that goes beyond simply hearing words; it involves fully comprehending and interpreting the message being conveyed. One key aspect of effective listening is providing the speaker with your undivided attention. This means putting aside distractions, such as phones or other electronic devices, and maintaining eye contact to signal that you are fully engaged. Furthermore, active listening involves non-verbal cues, like nodding or mirroring the speaker's body language, to convey understanding and encouragement. In addition to non-verbal cues, paraphrasing and summarizing the speaker's message demonstrates that you are not only hearing but also processing the information. This reflective aspect of listening ensures that both parties are on the same page, fostering clarity and preventing misunderstandings. It's essential to refrain from interrupting and allow the speaker to express themselves fully before responding. This patience and respect contribute to a more open and communicative environment, where individuals feel heard and valued. Ultimately, effective listening is a skill that strengthens relationships, promotes understanding, and facilitates successful communication. …the message from Kathleen Hi Friends, I am writing to share a tip sheet that may help you feel better prepared to interact with people who have a speech impairment. Some people, like me, have a lifelong speech impairment. Others may be experiencing extreme fatigue, dry mouth, or mouth sores. I’d love to make SBC groups more inclusive of people with speech impairments. This TNT training is a great start! In essence, it’s simple: we all want to be heard. Think of your own experiences in SBC groups – don’t you love it when we all have time and space to be heard! Everyone should be able to speak. Interruptions and repeating are generally seen as demeaning. I answered a question on Sunday saying if you want to repeat what someone said, ask. I want to step back a tad. Perhaps first, ask if they want to use the chat to share. During such chat-writing time, it would be ideal for the group to quietly wait. (Like, 2 min or less, not forever! Most people will type small bits of info, hit enter, then type more, which is more like the beat of a conversation.) Common things I’ve encountered •           Assumption that I’m mentally impaired. Someone’s speech does not correlate with intellect. •           People finishing my sentences or interrupting, often with something wildly different from what I was trying to say. Give people the chance to speak for themselves. •           People not recognizing that those with disabilities have lives just as complex as everyone else. People often seem shocked when I talk about dating, work, the fact that I live alone and drive… most people don’t have to hear, ”Oh WOW you’re so inspiring,” when they drive to the store. •           Folks unaware how carefully I plan when I’m going to talk, and unaware of the unease I feel when the plans don’t go smoothly. It’s not that different from the planning that other people with disabilities do. Imagine arranging ahead to have a ramp at the restaurant you’re meeting friends at. You may feel proud of your master plan. Then of course, no ramp at the restaurant. The planning and organizing that people with speech impairments do are not as visible, but just as important. Examples: resting before gathering, typing out things in a Word doc that I think I might want to put in the chat.  If you call on someone with a speech impairment and we need a second to take a drink or sit up straight, be patient. We’ve got a LOT going on behind the scenes! 😊 •           I know this shouldn’t need to be said, but no teasing! I grew up being teased, as most people with disabilities do. I’m over it. Teasing is painful, not funny, and not cool. I hope this all helps!! Kathleen

By Goldiin Kelvins In life, I met a girl so strong, brave, and true, Within four walls, she battled, a constant cue. Surviving, not living, she faced a relentless strife, Moremi, a young soul navigating through life. Born in Nigeria's west, in Africa's embrace, Her memory lingers, my heart's sacred space. I try to divert my thoughts, but I can't deny, Her innocent gaze, a plea in each dark eye. Her mind puzzled, imagining the world outside, Yet, hope waned, like a fading tide. She fought against sickness, a brave young soul, Yet, it fought harder, taking its toll. A 12-year-old warrior, courage in her stare, Yet, sickness, a ruthless terror in the air. Determined to live, dreams she'd conceive, But sickness threatened, luring dreams to grieve. Docs and teams fought, her heartbeat's descent, Body systems failing, a despairing lament. Yet, she'd jolt back, gasping for air, Mother's dripping tears, a father's silent prayer. Wishing for release, from the hands that tried, From loved ones' grasp, in pain, she'd hide. Drowning in the pit where life began, Her tears echoed, a heart-wrenching plan. Today, we lay her down in the earth's embrace, Cancer claims victory, a bitter taste. To those fighting, courage to you I send, May your stories not meet this tragic end. Lost a girl, lost a niece, grief in the wind, Adieu, Moremi, where memories begin. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Robin Castle-Hine I will never forget the day I went in for my routine mammogram in October 2022. Not a care in the world, I was expecting to walk out and go back to work, where I would call my mom and let her know I got my yearly mammogram. You see, I wasn’t the best about having it done yearly, and my mom had been diagnosed four years prior. After my mammogram, I immediately had an ultrasound completed by Natalie, the technician. I was then asked to sit in a different room—the one I had been sent to years before when they found something suspicious. I didn’t think too much about it at the time. I was more concerned about them saying, “You are all set,” so I could go back to work. Natalie came back and asked me to follow her to another room. Once inside the ultrasound room, I saw a doctor waiting to talk to me. She had me lay down and she did another ultrasound before telling me they needed to do a biopsy. I immediately said “No, thank you.” I explained that I’d had a biopsy on my other breast several years ago, and I had no desire to ever have it done again. The doctor was extremely kind and tried explaining why it was so important. She basically said, “It looks like cancer, and we must get it out of you.” Natalie was amazing and stayed positive with me the entire time. The doctor strongly encouraged me to schedule the biopsy, but I had time to think about it as they were booked solid that day. I again told them I did not wish to have a biopsy, and they let me go stating they really hoped I would reconsider. I refused to think much about it and went on to work. I got calls every single day asking me if I was ready to schedule. I got so frustrated; I told them on the phone not to call me again for at least a few days. I needed time to process this. I think it was at that point I realized this could be cancer. It was at this moment that it all began for me… If it was cancer, what would I do about it? How bad would it be? What treatments would they offer and what would I accept or deny? There were so many things running through my head. I knew I had to make my decision before they gave me options. This was my way of staying in control of everything. A few days later they called me and said, “I hope now is a good time.” I laughed a little and said, “It is never a good time, but thank you for being patient with me. I am ready to schedule the biopsy.” It was scheduled for the next week and everyone that assisted with it was just amazing! The doctor did say to me when she was done that no matter what the results showed, I had to see a surgeon and get it removed. She told me that more than once. I was certain it was cancer at this point. While having dinner with my husband two days later, my phone beeped. MyChart had a message for me. My husband was talking away, but I didn’t hear anything he was saying. I sat there thinking, should I open it? I knew once I opened it, there was no going back. I am not sure how long I sat there wondering if I should open it or wait until we finished dinner. After what seemed like forever, and while my husband was still talking, I opened the phone to read the message. Invasive ductal carcinoma (IDC). I must have been holding my breath while I read, because I let out a big sigh and my husband asked, “What is wrong?” I slid the phone over to him and placed my head in my hands for a moment. He read it, looked at me and said, “It’s okay, we will get through this.” It was at that moment my life changed forever. The next day, I was at work when a nurse navigator called me. Her name was Kelsey, and she was so kind and patient. I let her talk, and then told her it was okay; I knew all about breast cancer as I walked this path with my mom who had the same cancer in the same breast four years prior. That didn’t matter to her, she was there to take care of me. The problem was I didn’t want anyone to take care of me. I was angry. Kelsey got me scheduled with the surgeon for a lumpectomy, which was two months out. I didn’t mind the wait, because I was trying to figure out how I would take care of everything. I had to deal with cancer, still work every day, take care of my family like I always do and see my youngest graduate from college. I really didn’t have time for cancer in my life. You are probably thinking I am crazy, but that is how I felt. The pressure I felt at this moment was so incredibly hard. My cancer was found early, and was very treatable. I was diagnosed with IDC stage 1. Lumpectomy and radiation were recommended, and that is what I did. I had the lumpectomy in January and my radiation started in March. I had several problems after my surgery. I had to have a seroma (fluid build-up) drained three different times after surgery before they could start radiation. I was frustrated with this until I realized there was nothing I could do about it. Once it was radiation time, I had 20 rounds with the last four being “boosts.” By the third week, I was tired. Not sleepy, but very tired. I went to radiation before work every day. By the time the workday was over, I felt exhausted. When I would get home, I would try to do a load of laundry or vacuum the house, then it was straight to bed. I didn’t want to sleep; I just had NO energy to do anything, and I believe that is when I fell into depression. On the weekends, I would lay in bed. Other than a trip to the grocery store on Saturday to make sure there was food in the house for everyone, I didn’t do much of anything except work and lay in bed. I gained 25 pounds during this time. About seven months later, my doctor realized that my vitamin D was extremely low. I have been on the weekly 50,000 IU pill once a week since. I am going into month six of taking it. My levels have gone up, and my fatigue has gotten better. I wish my doctor had tested me sooner. I was touched that a few people reached out to me with cards, texts, gifts, prayers, etc. What completely blew me away was many “friends” and some family never thought twice about me. I felt lonely. The longer this went on, the angrier I became at everyone and everything in this world. I withdrew from almost everything. I guess I needed to prove to myself that I didn’t need anyone, and wanting others to be there was not being fair to them or me. You should never have to wonder if you have the support of your family or friends. It should just be assumed you do. Well, I didn’t. My husband even disengaged in wanting to hold conversations with me. To be fair, he had a lot going on in his life that I continued to support him with, but he couldn’t see past what he had going on to help me with what I had going on. It really hurt my heart, if I am being honest. My kids just knew I was the “strong” mom who was okay. I was always the strong mom that helped everyone and asked for nothing in return. Though they are grown, I cannot blame my kids as they honestly have never seen me need anything. As the summer went on, my work hours increased (which is normal). I am so tired and not sure where I am getting the energy to make it through the days, but I am doing it without having to ask for help. This makes me happy but, on the inside, I am no longer that fun energetic caring person I once was. I am just empty. This is what my life has become. I am an angry person who doesn’t have anything to look forward to. I look the same on the outside, but I am empty on the inside. This is my new normal. If you are frustrated reading this, then imagine being me. I am not complaining, I am just telling my story. I am angry, I am frustrated, I no longer care, I am hurt, I am empty. I had cancer and it changed me. For now, I will work on caring again. I still love my family, even the ones that hurt me the most. I have learned that your friends are not really your friends, your job doesn’t care if you are sick, your doctors follow a written plan for everyone, never considering you as an individual and the emptiness I have may never go away. On the positive side of things, I no longer worry about everything, I have learned how to rest when I need to, I let most things go even when irritated, and I have learned I really do not need anyone. I can do most things on my own. I have cancer? No, I had cancer. What is the difference? So many things went right and so many things went wrong. I say with great confidence that I am no longer the same person. I am different in so many ways that sometimes I don’t even recognize myself. I don’t worry about cancer or if it is coming back, yet I do worry about what it has done to my relationships and my mental health. I was told that until I cry and have some fear, I would never heal. I guess I am also waiting for that moment and wondering why it hasn’t hit me yet. I never accepted that I mattered in the cancer world until I found SurvivingBreastCancer.org’s Thursday Night Thrivers group. I always felt because my diagnosis wasn’t worse, I didn’t have the right to feel the way I felt. Once I joined the group and listened to others, I realized I do matter. We all have different battles with cancer, and mentally I think it is hard on all of us. The way the ladies support one another no matter what is going on is simply amazing. This group allowed me to get rid of some of my anger and to advocate for myself even when I didn’t think I was worth it. I owe a bunch of “strangers” so much for helping me to “feel” again. I am not healed, but I am trying to be the best version of myself I can be. Read More: Navigating Relationships After a Breast Cancer Diagnosis The Psychological Impact of Breast Cancer: Strategies for Coping Unlocking the Power of Emotional Intelligence: Taking Control of Your Cancer Experience How Do I Find ME Again? On the Podcast: Breast Cancer Conversations Discovering Your Divine Purpose with Dr. Sophia Edwards-Bennett Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Linda Dugan The Start On January 6, 2021, the day of the insurrection on the US Capitol, I learned that cells in my right breast were staging an insurrection. A door slammed shut on my life that day and I consciously choose to not look back. A little history… I have dense breasts and have been resolute in keeping yearly mammogram appointments since my 30s (I’m 65). Into my 40s, my yearly appointments included sonograms and in my 50s, frequent 3D imaging. I never missed a yearly appointment. Then the pandemic hit. My annual exam was delayed by two months due to the facility’s Covid scheduling. I wasn’t concerned, but asked for the earliest possible appointment, which was January 6th, 2021. It was the first time in 30 years that my annual exam was after 14 months rather than 12. When I walked out of the appointment, the tech handed me a paper and told me someone would call me. I read the paper in the changing room and realized I had cancer. The tech notes indicated signs of tumors in my right breast and right lymph nodes. My phone rang while I was standing in a waiting room filled with patients and a disembodied voice confirmed what I already knew. No one met with me or tried to help me understand my situation. I was told that ordinarily I would have a biopsy the same day but, again due to Covid, I would have to wait a week. No one directed me where to go next so I had to find my own way to the scheduling office. Cancer and Covid I called both my gynecologist and GP on January 6. My GP set up an immediate after-hours appointment with me. Before the biopsy results were completed, he strongly suspected triple negative breast cancer (TNBC), given the tumor size and the cancer’s swift progression. My GP had access to prior mammography and sonogram records (with no prior indications of cancer) and surmised that the size and spread were highly suggestive of TNBC. He was right. I was diagnosed with TNBC, stage 3C. Thanks to my GP’s diligence and community connections, within days my husband and I had our first appointment with a breast oncologist through Roswell Park Comprehensive Cancer Center in Buffalo, NY. This is a story for another day, but if I had listened to the follow-up suggestions from my gynecologist and/or the facility that discovered the initial cancer, it would have been to my great detriment. Both recommended a breast surgeon, who I would not have been able to see for at least a month. My GP said, “You need an oncologist right now, not a surgeon.” And he made a personal call to a noted breast oncologist that same night. My GP and oncologist have repeatedly assured me that the delayed mammogram may have actually been to my benefit (so to speak), as it was likely the cancer began after what would have been my annual exam. I’ll never know whether the delay meant the difference in staging—for better or worse. Both doctors also agreed that the initial tumor could not be felt by self-exam. By the time treatment started, I could feel the breast tumor. Nonetheless, “what ifs” occasionally creep in and I work to keep them at bay. January 2021 was a blur of MRIs, scans, genetic testing, biopsies, port placement, and various doctor appointments, but in just over three weeks I went from the initial mammogram appointment to sitting in an infusion chair as the “red devil” (Adriamycin chemotherapy) was pumped into my body. I’m certain the tumor grew significantly in those weeks before starting chemotherapy. I give great credit to my oncologist and GP who facilitated the speed of these pre-infusion appointments. Cancer anytime is traumatic, but cancer during a pandemic is its own special kind of hell. My husband was not allowed into any of the facilities where the pre-treatment exams occurred. He was only allowed into the first oncology, first surgeon and first infusion appointments. Only our sons and daughter-in-law were allowed in our home. Otherwise I was always alone, but beyond grateful for my amazing medical team and the incredibly supportive oncology nurses. My close friends and family were there for me “virtually” and found unbelievably lovely and creative ways to support me when we could not be together. (“Ghosting” by other friends and family was a sad surprise, but I have since learned that it’s quite a common experience for cancer patients.) In the long run, I had to develop internal coping strategies knowing that, as much as my family and friends wanted to support me, the challenging treatment journey (I actually call it a forced march) would mostly be solo. My Treatment For chemotherapy, I first received four rounds of Adriamycin/Cytoxan (AC). After AC was completed, I then received 12 rounds of Taxol, followed by surgery (lumpectomy and axillary lymph node removal). The surgery results indicated I did not have a pathological complete response (pCR), as cancer cells were still present in my lymph nodes. It was disappointing as I had an amazing response to chemotherapy (the five-centimeter tumor shrunk to “pea” size), and my surgeon was optimistic. I then received 30 rounds of radiation, followed immediately with 6 months of oral chemo (Capecitabine). Mental Health Support and Physical Recovery My career was in mental health and, early on, I recognized the need for mental health support as a subset of my oncology treatment. Despite Covid restrictions, I was able to meet with a psychologist at Roswell. Within three sessions, she helped me develop coping strategies that I still use to this day. The strategies that work best for me include cognitive behavioral therapy (CBT) with an emphasis on cognitive defusion, which involves detaching from thoughts to observe them. This helps to break the cycle of intrusive thoughts. I also work on “flow state” strategies, where I am completely immersed in a high interest activity (in my case photography), where time and distractions can fall away. I find these strategies helpful in breaking patterns of intrusive thinking, fueled by anxiety. I also found amazing support (via phone calls) from a cancer coach that I connected with through Roswell. She has been there with me through the ups and downs, and I consider her a dear friend. We have never met in person, and have never needed to. When Covid restrictions lifted a bit, I tried an in-person support group, but personally found it to be counter productive. I have also made it a point to write thank you notes, with explicit reasons for my gratitude, to literally everyone who has lifted me up and cared for me during my treatment. Expressing gratitude is shown to reduce anxiety and stress. I participated in a six-week session of the LiveSTRONG fitness program for cancer survivors through my YMCA, which was a first step in trying to regain strength and mobility. In addition, I completed twenty sessions of physical therapy to improve strength, mobility and balance. Additionally, with a dear friend, I completed two winter hiking challenges (through infusion and oral chemotherapy) through a local organization. Some hikes were successful, and others I cried and practically crawled, but enough can’t be said about the physical and mental health benefits of being outside and walking during chemotherapy. The neuropathy side effects from chemotherapy remain a significant issue; however, I have a successful fitness routine developed through LiveSTRONG. Fast Forward I have now reached 2.5 years with no evidence of disease (NED)—but with my TNBC diagnosis, or any cancer diagnosis, the future is unsure. In the fall, I hosted a fundraiser and raised over $4,300 which went directly to research and TNBC foundations. I recently went through training at Roswell and have been confirmed as a cancer coach. My own cancer coach is as excited as I am. I knew from the very start that I was in a new and unexpected life, and looking forward was the only direction I should take. I’m grateful to be here, grateful for an amazing health care team, grateful for all those that supported me along the way, and grateful to have opportunities to give my support to others who are just beginning this grueling journey. Read More: The Importance of Physical Therapy During and After Cancer Treatment Navigating Relationships After a Breast Cancer Diagnosis Exercise and Breast Cancer The Psychological Impact of Breast Cancer: Strategies for Coping On the Podcast: Breast Cancer Conversations The Benefits of Pilates for Breast Cancer Recovery Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Dania Francis Although most people know that October is Breast Cancer Awareness Month, many do not realize what a tough month it is. For someone newly diagnosed, in active treatment, someone who has lost someone to this awful beast, and even survivors and thrivers, it is difficult. It is in our face every day, and there is so much pink everywhere. October has always been my favorite month. It is the first month that starts to really feel like fall… the crisp air, sweatshirts, pumpkin spice coffees (man I miss being basic), wineries, football, and fun outings. October is also the month I brought my daughter into this world—a daughter we fought pretty hard to have—so yes, October holds a special place in my heart. I started hating the month this past October because it was just too much to handle. All the stories and research and clinical trials flooding my feed… all the 5Ks and “Fun Runs” and all the pink... need I say more? But I’ve also read some posts about “Reclaim October,” and I know that has more to do with stopping corporations and companies from “pink washing,” which is just cruel and ridiculous. Slapping pink ribbons and catchphrases on their sites to attract sales that may not even be going anywhere important for the breast cancer research we still need. So, I decided after 2/8 rounds of chemotherapy done, and some October still left, I was also going to reclaim October—for myself, and for my daughter. I dressed up for the first time in a while and attended a beautiful wedding. To my surprise, I also felt beautiful. People told me I was glowing and looked so beautiful, in the pictures and at the wedding. And I decided, you know what? My husband’s 92-year-old nanny was right. When I was first diagnosed, she told me to get mad at it. The cancer. I didn’t understand at the time, because all I could do was cry. But this is how I will reclaim my October. The brighter I can shine and the more I can glow, that is me showing this cancer who’s boss. Cancer, you may have taken my boobs and some other things from me… but I will not let you take my shine. I will not let you win. Every time someone tells me I’m glowing, I will be sure to let you know I am still winning. Breast Cancer Awareness Month, thanks for getting in everyone’s faces. Because if it’s not actually in your face every day, you may not pay attention as much. I know I didn’t pay as much attention until now… and I’m hoping all those I reach are more aware now, too. I am so lucky to have such amazing support from family and friends (that act like family) all around me, and all others I have known through the years that have supported me in so many ways. I cherish every single one of you and hold so much space for all of you. Sending you so much love and light always. Thank you for giving me hope and strength during this heavy time. And to my husband, who makes me feel beautiful and tells me I’m glowing every single day since being diagnosed, while taking care of me and our two children every day. Here’s to many more Octobers to shine and sparkle, even in pink. About the author: Dania is 41 and lives in NY with her husband and two small children. She is a Family Nurse Practitioner, Yoga teacher, and certified Reiki healer. She is a stage 2 Triple Negative Breast Cancer Thriver. Read More: Hearing the words “You have cancer” is heavy The Cost of Breast Cancer Cancer Etiquette: How to Talk With Loved Ones About Their Breast Cancer On the Podcast: Breast Cancer Conversations The Dollars Behind the Cure: Where Does it Actually End Up? Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Jayita Chatterjee [This one is for me, for my pink cancer friends that went through lumpectomy, mastectomy and/or reconstruction, and really anyone else that needs to hear this.] If you feel horrible, looking like a Frankenstein, with giant stitches all across your body… I am here to tell you it is OK to feel how you feel! It is NOT vain. If your partner or others say that you look beautiful, but you don’t like how you look right now, it’s OK. If you don’t want to look at your body right now, it’s OK. You went through a lot. You went through multiple surgeries, chemo, maybe radiation, immunotherapy. And yes, you are alive. But we are allowed to mourn our old self… not just the body, but the person we were the day before we were told we had cancer. Yes, it’s physical changes, but that’s on TOP of so many other life-altering moments. One day you’re just living your life, and the next you’re talking to oncologists, geneticists, and surgeons. The world will tell you that you’re supposed to be grateful for being alive, and how you look does not matter. But it DOES. Even when we get a haircut or get our nails done, we are anxious. Breast cancer surgery is not the same as a haircut or manicure, as hair and nails typically grow out. Chopping off a body part that you will never get back is huge! And having to make that decision is huge! You lose your hair from chemo, and you might want to wear wigs to feel a bit more normal. You have incisions all over from surgery or you have no breasts anymore, and you cannot wear your old clothes. Or you need prosthetics to fit into clothes to look and to feel good, and you want tattoos to cover your multiple scars, and you cry when you look at yourself in the mirror and you research makeup to draw on eyebrows, which you lost to chemo. So disregard when people say “Just be thankful you are alive"… we ARE allowed to mourn, and we do not have to dismiss our emotions. I always tell people that cancer is a journey that is not just physical, but mental and psychological as well. You normally wouldn’t have looked and felt like this. So is that our new normal? Yes, it is. Unfortunately, our new normal is now forever different. Having said that, equally true is that these battle scars will fade in time, and the hair will likely grow back eventually. So, yes, mourn. Mourning is healthy, mourning cleanses the soul, mourning ushers acceptance into our hearts. Mourn… but then keep living on. And wear the scars proudly! I’ll sign off here with an excerpt from Alessia Cara’s song, “Scars to Your Beautiful”: But there’s a hope that’s waiting for you in the dark You should know you’re beautiful just the way you are And you don’t have to change a thing The world could change its heart No scars to your beautiful We’re stars and we’re beautiful No better you than the you that you are (No better you than the you that you are) No better life than the life we’re living (No better life than the life we’re living) No better time for your shine, you’re a star (No better time for your shine, you’re a star) Oh, you’re beautiful, oh, you’re beautiful. Read More: Life anticipated her collapse, but she arrowed ahead and stood strong. Remember You Are Not Alone Cancer Sucks, and That’s Okay Moving forward but not moving on… On the Podcast: Breast Cancer Conversations Discovering Your Divine Purpose with Dr. Sophia Edwards-Bennett Connect with Jayita: Tumblr Facebook YouTube Instagram

By Dawn Oswald – In Loving Memory Sunshine You get it I get it We all need a little sunshine What we need And what we get can be different Go outside and get some sunshine And some free vitamin D We all need vitamin D I’m happy to wake up Sit up and put my feet on the ground I tell myself I’m going to tackle today Today, as in the present We all like presents Worry about today Not tomorrow Not yesterday But today Enjoy the present Open it and keep it Go outside for 10 minutes What more can you ask for Today is the day Worry about today only Get your sunshine on Embrace the sun Let it hit your face Breathe the air Enjoy that sunshine Enjoy the air We don’t know what tomorrow brings So breathe Take some deep breaths Look around Soak it all in That vitamin D Have a sunny D Don’t stay too long You don’t want to get burnt Just 10 minutes We all like free My daughter told me I was her sunshine You can be someone’s sunshine too Shine on Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Taylor McKnight Physical therapy is often the last thing on people’s minds when they receive a cancer diagnosis. However, it is an essential part of your treatment plan that enhances your quality of life and allows you to return to regular activities more quickly. Most hospitals have specially trained physical therapists for cancer patients who can help you throughout your journey. Continue reading to learn about the treatment-related challenges physical therapy can address, what kinds of rehabilitation are available, and other long-term considerations for those who have received cancer treatment. Why Is Physical Therapy Important During and After Cancer Treatment? Cancer treatment such as chemotherapy, surgery, and radiation can impact your well-being in ways you may not have considered. Many cancer treatments can cause muscle weakness, increased difficulty in balancing, and a smaller range of motion. Physical therapy is essential to your recovery process and can help you restore your strength and physical function. Your physical therapist can work with you to create a plan of care that aligns with your healing process and individual goals. Cancer treatment affects not only your physical health but your mental well-being, too. Many cancer survivors experience depression and anxiety even after they have completed treatment. Exercise is a powerful way to combat the side effects of treatment and positively affect your mental health. In addition, some research has shown that regular physical activity and exercise may even lower your risk of cancer returning. What Kind of Rehabilitations Are Available Alongside Cancer Care? There are several types of rehabilitation you can receive alongside cancer care. Most plans will incorporate some physical rehabilitation as well as occupational therapy, language pathology, and vocational rehabilitation services. Each component is essential to help improve your quality of life so you can return to the activities you enjoy most. Physical therapy: Your physical therapist can help you recover your strength, endurance, flexibility, and mobility once you complete treatment. Many also offer treatment for pain management, while some specialize in managing conditions like lymphedema. Occupational therapy: Occupational therapists play an essential role by helping you resume your usual daily activities. These activities may include bathing, dressing, and returning to work. They devote considerable time and effort toward improving arm strength and function as well as range of motion. Speech and language pathology: Some cancer survivors struggle with language comprehension and expression. Others may have difficulty swallowing food or drinks. A speech and language pathologist can assist with communication, cognitive skills, and swallowing disorders. Vocational rehabilitation specialist: Many cancer survivors eventually return to work. Vocational rehabilitation specialists evaluate when the time is right to work again and how to accomplish this. They may recommend special equipment or guide those who must find a new line of work. While this is not an exhaustive list of rehabilitation services, they are the ones that most cancer survivors utilize. Each service is pivotal in helping you improve your quality of life and physical well-being. Adhering to their guidance and attending each appointment can make a huge difference in how you feel after receiving cancer treatment. Other Things To Consider After Cancer Treatment Many survivors feel unsettled and worry about an uncertain future after cancer. Some feel anxious that the cancer may return and stress they are not doing enough to remain vigilant about warning signs. In addition, many still experience negative symptoms associated with their treatment even after it ends. Commonly, many survivors continue to experience insomnia, fatigue, memory loss, pain, neuropathy, and emotional distress. It's essential to recognize that these fears and worries are all valid. Sharing these concerns with a loved one or joining a support group can also bring relief. Support is invaluable at this stage of recovery, and you may even seek professional help to address your concerns. In addition, if you are struggling with your diet, a registered dietician can help you meet the nutritional goals necessary for your best outcome. Remember, everyone’s cancer experience is unique, but leaning on other survivors and loved ones for help is instrumental in maintaining your mental health after treatment. Take it one day at a time, and be kind to yourself throughout the process. Keep up with your regular screening exams, and always speak up if something feels wrong. No one knows your body better than you, and finding the right doctor to listen to your health concerns may save your life. Written by Taylor McKnight, Author for FYZICAL Therapy & Balance Center Note: This article is designed to provide general information and not replace professional medical advice. Always discuss your options with your healthcare provider. Learn More: Exercise and Breast Cancer The Healing Power of Pilates: Benefits for Breast Cancer Patients 9 Essential Tips for Breast Cancer Survivors Moving Through Treatment and Survivorship On the Podcast: Breast Cancer Conversations The Importance of Physical Therapy in Breast Cancer Recovery SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Maria Montanile I could have done without 2017. From beginning to end. My wonderful best friend, Teresa, succumbed to lymphoma in February. Her mother texted me, “Your best friend went to Heaven this morning.” This was around 7:25 am. I wanted to go be with the family, but knew they needed time to grieve, so I did not visit them that day. I am a teacher and I had an observation from an administrator that morning at 9:30 am. I considered rescheduling. How could I teach while crying? I did not cry for long though because this feeling of peace infiltrated my heart suddenly. I could still do this. I did not cancel. I was not nervous or insecure this time and that was very unusual for me. My administrator said I did a fantastic job teaching my small reading group. I have to thank Teresa for this one. Still helping me out. Fast forward to June. I found out that I had DCIS breast cancer, stage 0. I was hysterical. I’m not supposed to get cancer. What made me so special? I got local radiation and a lumpectomy. That was it. I was extremely fortunate. In 2021, I ended up needing a mastectomy. Still stage 0, but it was all over the breast this time. I was still extremely fortunate. Fast forward again to early November. My 93-year-old father died from lung cancer. He told me two months before he died that he had lived a good life. I told him about all of the things he had taught me, such as working hard for your family and being on time to work. In turn, he expressed the reasons he was proud of me. He took my hand and told me not to cry. He said that he would be okay. That was the year 2017. Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Lourdes D. Heras After a breast cancer diagnosis… My life, your life, our life changes and the lives of those around us are impacted. I’m not going to lie. During this diagnosis, on several occasions I have felt defeated, but I know that I have to get up, and boy is it hard sometimes. One medicine results in certain side effects that require other medicines, and it’s a never-ending cycle. Beyond this, the fear of cancer recurrence is on our minds, some days more than others. This creates a significant impact, both mentally and physically. AND, when it happens, not only is the person experiencing the recurrence crushed, but so are loved ones. Remember you are not alone – focus on that light of hope and in the present of each day. Not long ago, while on my way to see my oncologist, a person in the elevator rushed in a little agitated, turned to me and said, “Today has been such a bad day.” I turned to her, smiled, and said, “The day is not over, it can’t go on this bad.” As the elevator door opened, she turned and thanked me: “That is what I needed.” Of course it may not be that easy, remember that each person is different, and what works for one person may not work for another. But it is up to us to demonstrate empathy, to be understanding toward ourselves – practicing self-love, taking it one day at a time, even on those difficult ones, there is always something to be grateful for. Encourage a gradual process toward a self-loving mindset. Putting ourselves first is not selfish. By doing this, we will be better for our loved ones. If you have not been able to join one of SBC’s weekly support groups, I recommend that you do it. You will really feel better, especially on those days when you didn’t think that a meeting would help you at all. Learn More: Cancer Sucks, and That’s Okay Moving forward but not moving on… The Psychological Impact of Breast Cancer: Strategies for Coping Share your story: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Kate Wunsch My name is Kate. I was diagnosed with stage 3B inflammatory breast cancer in April of 2022. This is a self portrait showing what some days of survivorship feel like. Connect with Kate: @keiightt Submit your story, poetry, or art for our blog: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Kiara Ford A breast cancer diagnosis is devastating for many reasons. The questions of how this will disrupt your life, what will treatment be like, and how will this affect your family are common and understandable responses. And for many, these emotional questions are followed by one major financial one: how will I be able to afford cancer costs? Continue reading to learn more about insurance coverage for cancer, Medicaid and Medicare options, what medical expenses to expect, other treatments that may not be covered by insurance, and additional financial considerations for those with breast cancer. What Insurance Covers Cancer Care? In the United States, healthcare and cancer treatment are not guaranteed. Private health insurance will typically cover some, but not all cancer costs. In addition, depending on the private insurance someone has, their plan may only pay for them to see certain doctors or undergo certain treatments. Out-of-network doctors, specialists, and specific treatment options may not be covered. People without private insurance often rely on Medicaid, a government program that provides coverage to low income people, older people, people with disabilities, and those with dependent children. Medicaid is funded on both a state and federal level, so the exact parameters of eligibility and coverage vary state by state. This is not to be mistaken with Medicare, which is a federal health insurance program for people 65 and older and some younger people with disabilities. Even with these options, it is unlikely for them to cover all cancer costs. Even for those who are fortunate enough to have primary costs covered by insurance, they will still have to pay for their own co-pays and coinsurance, deductibles, premiums, and other out-of-pocket expenses. What Medical Expenses Can I Expect During and After Cancer Treatment? The exact cost of direct medical expenses varies depending on treatment plans. Treatments such as surgery, chemotherapy, radiation, hormone therapy, and immunotherapy all come with their own individualized prices, and you will typically have to pay for some combination of these options. This partially explains why studies have shown the cost of cancer treatment to be lower the earlier it is diagnosed, as they may not require as many treatments. One study found that for stage I and II breast cancer the price range was $61,621-$97,066, whereas for stage IV the average cost was between $89,463-$182,655. These numbers continue to grow with follow-up care. Cancer care does not necessarily end after active treatment is finished. You may be monitored throughout your lifetime in order to manage recurrence. This means there are added costs of check-ups with oncologists, mammograms (with the exception of those who have had a double mastectomy), medications to reduce risk of recurrence, and various other tests and exams. What Other Treatments Should I Consider? In addition to all of these necessary costs, there are many treatments which may not be considered essential for your active treatment, but can still greatly help you. Physical therapy and acupuncture can be beneficial for the discomfort caused by surgery, chemotherapy, and radiation, but are not always covered by insurance. There is also the mental challenge of experiencing cancer, which may be aided by the work of a therapist, psychiatrist, or counselor, but once again, are not always covered by insurance and often come with a hefty co-pay. Other Financial Considerations Medical costs are only one piece of the puzzle. There is also the toll cancer can take on your lifestyle, and the costs that come with it. Many people with cancer are unable to work while undergoing treatment. Some employers have health leave policies, and some people may qualify for social security disability income, but even with these assistance programs, many people will experience a loss of income. With the inability to work may also come the inability to perform essential daily tasks, including looking after children. Parents with breast cancer may have to navigate the added cost of childcare. Finally, there is the issue of transportation. During treatment, you will likely need to spend a great deal of time commuting back and forth to appointments. Whether you’re spending money on public transportation fares or gas, this travel comes at a price that can quickly add up and create more complications to an already difficult situation. The Bottom Line The cost of cancer can have life-altering impacts. Research has found that patients with cancer are 2.5 times more likely to declare bankruptcy than other adults with health care debt, and 30% of cancer survivors report experiencing financial hardship. A cancer diagnosis alone is already a massive amount of stress. The compounding factor of financial toxicity is quickly creating a crisis that is devastating patients, families, and communities. Learn More: Navigating Relationships After a Breast Cancer Diagnosis The Psychological Impact of Breast Cancer: Strategies for Coping 9 Essential Tips for Breast Cancer Survivors Navigating Cancer Treatment: Top Tips from an Oncology Pharmacist On the Podcast: Breast Cancer Conversations Breast Cancer and the Law: Resources for Patients and Caregivers About the Author: Kiara Ford is a recent graduate of Emerson College, where she majored in communication studies and minored in health and society. She is currently a community health worker trainee with the non-profit organization Asian Women for Health. She is passionate about patient advocacy and health equity, and hopes to raise awareness and increase understanding of patients’ rights through her work. From the Same Author: Overlaps Between Breast Cancer and Domestic Violence Datopotamab Deruxtecan Shows Promise in Clinical Trials Metastatic Breast Cancer: Understanding the Significance of Stage IV Breast Cancer and Healthcare Access Within the Hispanic Community Inflammatory Breast Cancer: Breaking Down the Basics Getting through the Holidays with Breast Cancer

By Conny Reichardt I wanted to share my story of being a previvor. A previvor is someone who has taken preventative measures to decrease their chances of getting a cancer they may be predisposed to. I have been lucky enough to know I have a BRCA1 genetic mutation so that I can make choices that will be a win not only for me but my family and generations to come. I do not have a strong family history of breast cancer; the only person is my paternal grandmother, so it was not as much of a concern as if it had been on my maternal side. So, I did as I should and went to the doctor for my annual visit every year. At 39, I did my first baseline mammogram. From there I went yearly. I did get called back in once and had to have an ultrasound. I just had dense tissue, nothing to be concerned about. I’ll share a little more background on my health history, which has also made me proactive in my health. I got married at 26 and of course was ready to start a family as soon as my husband was. Unfortunately, it was not that easy. After many tests and being referred by my great OBGYN to an amazing fertility specialist, I was diagnosed with polycystic ovary syndrome (PCOS). After trying many different options to get pregnant, we knew the best option for me was in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Did I get lucky; I got pregnant with twins on my first try! I did manage to get pregnant without fertility treatments about three years later, only to lose that baby around 12 weeks. After that, I had to have precancerous cervical cells removed that were found during a routine Pap smear. We were told that in order to have another viable pregnancy, I would need to go through the whole IVF process again. We decided life was good as a family of four, however that is not what was in the cards for us; we were meant to be a family of five! I managed to get pregnant again without fertility treatments. After putting extra hormones in my body during the IVF process, I knew that I would always be at a higher risk for some cancers. Little did I know, that is not what was putting me at a higher risk for breast cancer and ovarian cancer. A few years ago for Christmas, we were given an ancestry DNA test which included a health option that gives you some insight into your genetic data. I got my results back and learned a lot of interesting things about my ancestry that I was not previously aware of. I have no Native American in me, I am 25% Ashkenazi Jewish, I have an aversion to cilantro (YES, I hate it!) and my husband and kids are more Polish than me! I also learned I carry the BRCA1 gene mutation. I had heard of it, I knew it put me at a higher risk of breast cancer, but I had no idea how it would impact my life! I already had an appointment scheduled with my OBGYN, so I decided I would bring my test results and share them with him. Well, he had a different reaction than I ever expected. The first thing out of his mouth was, “Let’s get you scheduled for a hysterectomy with oophorectomy.” This is the removal of tubes and ovaries—or, as we like to say in layman’s terms, a total hysterectomy. I was 50, and I was not having any more kids, so I agreed. Because the BRCA1 mutation puts you at a high risk of ovarian cancer (which is very hard to monitor), and after knowing people that have had reproductive organ cancers, I was okay going ahead with the procedure. My OBGYN also had me see a breast specialist right away. The breast center I went to wanted to confirm with a genetic counselor that I indeed had the BRCA1 gene mutation, as the home genetic testing kits may not always be accurate. And it was my lucky day, I still came back positive on the tests ordered by my genetic counselor. The counselor went over all of my risks and gave me a lot of information. I then met with the breast specialist, who was an advocate for a double mastectomy for me. I had just scheduled my hysterectomy; can we deal with one thing at a time!? My doctor was very honest and helpful. Together we decided to alternate between breast MRIs and 3D mammograms every six months. Thankfully, each test that followed came back clear, which was a relief knowing I am considered high risk. I got my initial BRCA results back in February 2023, went to my OBGYN in March, scheduled my hysterectomy for June, and was set on a plan for monitoring for breast cancer. After my second MRI, it was time for my annual visit with the breast specialist. After meeting with her and talking with my husband, we decided that a double mastectomy with a DIEP flap reconstruction was the best choice for me and our family. In late August after sending two kids to college out of state and the youngest starting high school, I was scheduled for another surgery. As I write this, I am still recovering from my double mastectomy with DIEP flap reconstruction. I do not know where I inherited the gene mutation, although there is a much higher percentage of those that have it in the Ashkenazi heritage than others, it really doesn’t matter. I know I have it, and I have to be proactive to prevent cancers.  There are other cancers that can be at a higher risk with the BRCA1 gene mutation, but I now have much lower risk for the two that are most pronounced (breast and ovarian cancers). I will still meet with my OBGYN and breast specialist once a year for checkups. If my story does nothing more for you other than make sure you have annual checkups, then I have done what I have set out to do. I could look at all of this and think, “I got dealt a bad hand of cards,” but I would rather look at it like this is the path I was given. We don’t always like the path chosen for us, but hopefully we learn from it and can teach others. Learn More: Understanding Genetic Testing for BRCA1 and BRCA2 Mutations The Power of Knowledge (My BRCA Story) Breast Cancer & Genetics Exploring Breast Reconstruction Surgery On the Podcast, Breast Cancer Conversations: Prophylactic Mastectomy and BRCA Mutation Share your story: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Dawn Oswald – In Loving Memory Nurses Some are good Some are bad Some are on top of everything Some don’t give a damn But the nurse I got, does You do care You do love You do want to do everything You want your patient to leave with a smile on their face A caring nurse is blessing nurse, bursting with love No one wants to curse you out When someone is at their worst You are there to save the day with your contagious smile You thirst for more to help You’re the best at what you do You are that great nurse That nurse that carries a purse Full of tricks to make you smile and laugh You are loved back by so many Continue to be the best that you are Don’t change anything The best nurse ever Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

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

In today's episode, part of our MBC webinar series, we delve into the San Antonio Breast Cancer Symposium (SABCS). We aim to break down the overwhelming amount of information into digestible insights with new snippets coming out each day this week! Today we discuss key findings, particularly on inflammatory breast cancer (IBC) and invasive lobular carcinoma (ILC), with insights from Amy Parliman, a member of our MBC leadership team. Amy highlights the advancements in technology that outpace current treatment options and the importance of recognizing the unique challenges of diagnosing IBC and ILC due to their imaging difficulties. She shares that the symposium acknowledged these challenges and that there's growing research focusing on the genomic mutations specific to these types of breast cancer. We also touch on the significance of patient-centric care, reminding listeners that they have the ultimate say in their treatment decisions. Amy shares her personal experience with her treatment regimen and the importance of sticking with what works unless there's a compelling reason to change. The episode also covers the potential of contrasted mammograms and the need for different types of CT scans for accurate diagnosis. We stress the importance of being informed and advocating for oneself, as treatments can vary based on individual cancer properties. As always, we remind our listeners that the information shared is from personal experiences and not a substitute for professional medical advice. We encourage reaching out to your medical care team with any questions or concerns. Topics Covered: 00:02:46 - Dr. Mankoff's Research on Imaging Technology 00:04:02 - Genomic Mutations in Different Breast Cancer Types 00:04:34 - Clinical Trials and Research Timelines 00:04:56 - Genes Implicated in Inflammatory Breast Cancer 00:06:02 - Imaging Challenges with Lobular Breast Cancer 00:07:07 - Amino Acid Studies and PET-CT Imaging 00:09:19 - Personalized Treatment and Informed Questions Listen Now

By Molly Gaynor I’m 35 years old. I’m two years post active treatment for breast cancer. I have eight more years of pills. People tell me, “I can’t wait for you to be able to put this behind you.” I’ve heard a lot of responses to my cancer that I did not appreciate, but it’s always been from someone who hasn’t been through cancer, so I tell myself that they just don’t understand, and they don’t know what to say. It’s an uncomfortable topic. When I hear this from someone who has also been through this journey, I wonder how you can say that. Is cancer something that you can just put behind you? Maybe it is for some people. Maybe that’s healthy. I think we all cope differently, and that’s okay. I think we should normalize talking about life after cancer, though. I expected chemo, a double mastectomy, and radiation to be miserable, so I didn’t complain much except to those closest to me. Once it was all over, after a few months I listed some complaints to my oncologist and he said, “This is the first time I’ve heard you complain.” I explained that I expected everything to be miserable up until this point. I viewed it as a small portion of my life in the grand scheme of things. I did not expect, however, that I would still feel miserable, and in some ways even worse after it was all over. I didn’t expect to not recognize myself. I didn’t expect to feel foreign in my body. I didn’t expect that movement would continue to be difficult. I didn’t expect the weight gain. I didn’t expect the joint pain. I didn’t expect the hot flashes. I didn’t expect the worry. Now, when I think about retirement, I sometimes wonder what the point is. Am I going to make it that long? How do I get ahead with medical bills coming at me all the time? Cancer sucks. I think we need to normalize acknowledging that. That it’s okay to be miserable sometimes. Just don’t stay there. Your feelings are valid, and it’s healthy to feel them and work through them. You move through the negative emotions more quickly when you allow them and move on from them. Find a support system online or in person. Feed the love more than you feed the fear. You’ve got this. Connect with Molly: @mindsetmolly Learn More: Moving forward but not moving on… Breast Cancer in Young Women: Common Questions Answered The Psychological Impact of Breast Cancer: Strategies for Coping Unlocking the Power of Emotional Intelligence On the Podcast, Breast Cancer Conversations: Finding Your Voice With Brenda Denzler & Elaine Schattner Share your story: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Carol Collins 770 days since that call 602 days since I finished poisoning my body. 573 days since my breasts changed for forever. The days have passed, and I am moving forward but not moving on somehow. My amazing coworker comments almost weekly on how much she loves my hair, “it’s so beautiful” she says.  I take the well-intended compliment because she has only known me for 5 months.  She doesn’t know the version of me I wish I could still see in the mirror some days.  My after-chemo curls and gray hair are not BEAUTIFUL to me.  They are a reminder that I will never be the same.  I can move forward but not on. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Trudy Trybulski Playful colours and funky shapes, Sharp edges with smooth centres. Dots and lines expressing the journey. Swirls, splashes with wiggly lines, Universe. Greens of the garden, purple and pink. Blue waves of sparkling sea, cool and free. Marks make up family, friends and grandsons. Life’s lines that then fade to peace. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

Breast cancer is a complex disease influenced by various factors, including genetics. Understanding the role of hereditary factors and genetic mutations is crucial in comprehending the predisposition, risk assessment, and management of breast cancer. Introduction: Unraveling the Genetic Puzzle Genetics play a significant role in approximately 5-10% of breast cancer cases. Hereditary breast cancer stems from inherited gene mutations passed down through generations, increasing the risk of developing breast cancer. Hereditary Breast Cancer Genes BRCA1 and BRCA2: BRCA1 and BRCA2 genes are the most extensively studied and commonly known breast cancer susceptibility genes. Carrying mutations in these genes significantly increases the risk of breast and ovarian cancers, among others. Other Genes: Besides BRCA1/2, mutations in genes like TP53 (Li-Fraumeni syndrome), PTEN (Cowden syndrome), and PALB2 (partner and localizer of BRCA2) are associated with increased breast cancer risk. Inheritance Patterns Autosomal Dominant Inheritance: Inheriting one mutated copy of the gene from either parent increases the risk of breast cancer. Offspring have a 50% chance of inheriting the mutated gene. Penetrance and Variability: Penetrance refers to the likelihood of developing cancer with a specific gene mutation. Variable expressivity leads to varying cancer types and ages of onset among carriers. Hereditary Breast and Ovarian Cancer Syndrome (HBOC) Characteristics and Impact: HBOC syndrome encompasses a significant portion of hereditary breast cancer cases. Carriers have a higher risk of developing breast, ovarian, pancreatic, and prostate cancers. Genetic Testing and Counseling Importance and Process: Genetic testing identifies specific gene mutations linked to hereditary breast cancer. Genetic counseling guides individuals on the implications of test results, discussing risk management and family planning. Criteria and Eligibility: Criteria for genetic testing include personal or family history suggestive of hereditary cancer. Updated guidelines and criteria evolve as research advances. Risk Assessment and Management Risk Reduction Strategies: Risk-reducing surgeries (prophylactic mastectomy or oophorectomy) for high-risk individuals. Enhanced surveillance with earlier and more frequent screenings. Impact on Treatment Decisions: Genetic testing results may influence treatment choices, such as targeted therapies. Community and Support Support for Carriers: Support groups, online communities, and counseling services offer emotional and informational support. Empowering individuals to make informed decisions about their health. Conclusion: Empowering Knowledge for Informed Decisions Understanding the role of genetics in breast cancer empowers individuals to assess their risk, make informed decisions, and adopt proactive health measures. Genetic testing and counseling facilitate personalized risk management strategies, emphasizing the importance of awareness, early detection, and support in the fight against hereditary breast cancer.

Breast cancer remains a significant health concern affecting millions of women worldwide. Timely detection is crucial for effective treatment and improved outcomes. Recognizing the early signs and symptoms of breast cancer empowers individuals to seek prompt medical attention, potentially saving lives. Breast cancer is a malignant condition characterized by the abnormal growth of cells in the breast tissue. It can manifest in various forms and stages, impacting both women and, in rarer cases, men. Understanding the signs is crucial in the early identification and treatment of this disease. Early Signs and Symptoms Lump or Thickening: The most common sign is a noticeable lump or thickening in the breast or underarm area. While not all lumps are cancerous, any new lump or change warrants immediate medical evaluation. Changes in Breast Appearance: Changes in breast size, shape, or contour could signal breast cancer. Dimpling, puckering, or redness of the skin should also be noted. Nipple Changes: Changes in nipple appearance, such as inversion, retraction, or discharge (especially if bloody), may indicate underlying issues. Skin Changes: Changes in the skin texture, like scaliness, ridges, or pitting resembling an orange peel, could signify a problem. Pain or Discomfort: Unexplained pain or tenderness in the breast or nipple area can sometimes indicate breast cancer, although it's less common. Risk Factors for Breast Cancer Several risk factors contribute to the development of breast cancer, including genetics, family history, age, hormonal factors, lifestyle, and environmental factors. Understanding these risk factors can help individuals assess their susceptibility and take necessary precautions. Importance of Regular Self-Exams and Screenings Performing regular breast self-exams (BSE) helps individuals become familiar with their breasts' normal appearance and detect any changes promptly. Mammograms, clinical breast exams, and other screenings are vital diagnostic tools for detecting breast cancer at an early stage, often before symptoms appear. When to See a Doctor If any of the aforementioned signs or changes are noticed, it's crucial to consult a healthcare professional promptly. Prompt evaluation can lead to early diagnosis and appropriate management. Steps After Diagnosis Upon suspicion or confirmation of breast cancer, further tests and evaluations, including imaging tests, biopsies, and staging procedures, are performed to determine the extent and nature of the disease. Treatment options, such as surgery, chemotherapy, radiation, hormone therapy, or targeted therapies, will be discussed based on the diagnosis. Emotional Impact and Support A breast cancer diagnosis can be emotionally challenging. Seeking support from healthcare providers, support groups, counselors, or online communities can provide immense emotional and psychological support during the treatment journey. Conclusion Understanding the early signs and symptoms of breast cancer is pivotal in facilitating timely diagnosis and intervention. By staying vigilant, practicing self-exams, undergoing regular screenings, and promptly consulting healthcare professionals upon noticing any changes, individuals can take proactive steps toward early detection and better treatment outcomes in the fight against breast cancer.

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.