I was diagnosed with breast cancer in September of 2020 in the mist of the covid-19 pandemic and a month after successfully defending my PhD dissertation. At that time,  I was so happy and excited to finally be done, to finally be able to start living and pursue aspects of my personal life that I had long neglected in my search for academic success. One of those aspects was that of becoming a mother. My 34^th birthday was less than two months away and I was truly feeling the urgency of my ticking biological clock and was mindful of the risks associated with waiting much longer to pursue motherhood. My boyfriend and I were ready to take the next steps.

However,  the Sunday that I found my breast mass, I knew that life had other plans. Being a Nurse Practitioner, I knew that this mass was a concerning one. My period had passed a week prior minimizing the chances that this was just a simple cyst. I tried telling myself that maybe this was just fibrocystic tissue, but the fear in me was palpable. I have often heard it said that “ignorance is bliss” and at times I have rebutted this statement. However, my medical knowledge in some ways has been a bit of a curse that has caused me much anxiety. It has also led me to be proactive in seeking treatment.

I was able to quickly get an appointment with my primary care doctor who ordered a diagnostic mammogram and ultrasound. When the radiologist reviewed my results with me and told me: “I would be highly surprised if this is not cancer,” my whole world briefly stopped and I had a mini breakdown. I quickly pulled it together and called my manager to let her know that I needed time off for a biopsy. Needless to say, the biopsy was positive for hormone positive, HER2 negative invasive ductal carcinoma.

My reaction at the time of diagnosis was one of outrage, exasperation, despair, fear, and disappointment. How could this be happening to me?  Why now? I was mad at myself for being so good at delaying gratification, for not enjoying life, and not being better at living.

What followed was a series of appointments and difficult decisions. Should I have a lumpectomy and radiation, a mastectomy, or a double mastectomy. The lumpectomy gave me the option to one day be able to breastfeed and keep most of my breast nerves intact, but it would mean that I would need radiation, which mortified me. The prospect of  a second breast cancer in the opposite breast also scared me. I couldn’t phantom having to go through this again and didn’t want to leave anything to chance. So a double mastectomy with reconstruction it was, 3 days before my 34^th Birthday. I guess I could’ve been happy as some people tried to encourage me. A free boob job they quipped as if this was really a choice. I mean, other than trying to kill me, my breasts were perfect. To me, this was a necessary mutilation that would give me a chance at life, but at what cost? It would take away a huge chunk of my womanhood and unique way of bonding with a future child. Unfortunately, the surgery was not without complications and I was rushed into the operating room the next day in order to cauterize a small bleed. The days that followed were painful physically, emotionally, and mentally. Seeing my body for the first time in the mirror with new scars and six tubes coming out of my body was shocking. I couldn’t believe that the person looking back at me was really me. I had a panic attack that day. My sister had to help me out of the bathroom so that I could calm down.

I wish I could say that this was the end of this journey, but more appointments still awaited. All of which, due to covid, I had to attend on my own. My boyfriend and/or family waited for me in the car. Next, I found out that due to my oncotype score, I would need chemotherapy. This led to another breakdown, which was interesting for me because prior to knowing that I would need it, I felt guilty about not having it. Did I truly have cancer if my hair didn’t fall out and I didn’t look ill? These were some of the questions that privately ran through my head.

Prior to chemo, I had to advocate for myself in regards to fertility preservation treatment. It did not appear to be a priority for my care team, but it was very important to me. I recall obsessing about finding out how many eggs could be harvested and how to best freeze them. Should it be eggs or embryos? How much would it cost me. I was lucky enough to qualify for a grant that provided me with the needed medications and a discount on the procedure and freezing fees. Thankfully, I also had some savings in my health savings account that covered the $4,000 that were required to be paid prior to the procedure. I hate that this is not a universally covered expense for all women with cancer. I don’t know how I would have coped if I had not been able to afford to even try.

Unfortunately for me there were some setbacks in my egg retrieval process. First, a cyst was found in my ovary that needed to be removed prior to starting the IVF meds. Then, the hardest part of my cancer journey, none of the 15 eggs that were retrieved were mature enough to freeze. For me, this felt like I had just had 15 miscarriages, the dream of ever becoming a mother with my own biological children slipping through my fingers. I could barely speak or interact with others without crying.

When I spoke to my fertility doc, I asked if the eggs could be incubated (I had heard of this being done with other species) or if there was anything else that could be done, but no solution was provided. I did my own research and found out that there is a procedure called invitro maturation that can be done, but it is not yet offered in Rochester, NY.  So my eggs died. I still don’t understand why this happened. My fertility doctor thought that it may have been related to the anesthesia I received during my mastectomy. I wonder why fertility preservation was not offered right at the outset of diagnosis. I certainly wish that there were better ways to determine fertility post chemo specially with drugs like Cytoxan, which are known to cause sterility. For now, I hold on to the hope that Lupron did what it was supposed to in preserving my ovarian reserve and that when I am cleared to take a break from my aromatase Inhibitor (AI) that I am able to conceive.

I came in contact with the Breast Cancer Coalition right before my second reconstruction surgery, while I was trying to figure out how to cope with my cancer diagnosis and all that it meant. For me, the emotional healing did not really start until Active treatment was done. What has helped me through my cancer journey have been my family, friends, and even strangers who have been superbly kind and selfless. Groups like the Breast Cancer Coalition, the Young survivor coalition, and Unite for Her have also been critical in getting the much needed support that I have needed through this process. I am very grateful that these resources exist.

I was diagnosed with breast cancer in September of 2020 in the mist of the covid-19 pandemic and a month after successfully defending my PhD dissertation. At that time,  I was so happy and excited to finally be done, to finally be able to start living and pursue aspects of my personal life that I had long neglected in my search for academic success. One of those aspects was that of becoming a mother. My 34^th birthday was less than two months away and I was truly feeling the urgency of my ticking biological clock and was mindful of the risks associated with waiting much longer to pursue motherhood. My boyfriend and I were ready to take the next steps.

However,  the Sunday that I found my breast mass, I knew that life had other plans. Being a Nurse Practitioner, I knew that this mass was a concerning one. My period had passed a week prior minimizing the chances that this was just a simple cyst. I tried telling myself that maybe this was just fibrocystic tissue, but the fear in me was palpable. I have often heard it said that “ignorance is bliss” and at times I have rebutted this statement. However, my medical knowledge in some ways has been a bit of a curse that has caused me much anxiety. It has also led me to be proactive in seeking treatment.

I was able to quickly get an appointment with my primary care doctor who ordered a diagnostic mammogram and ultrasound. When the radiologist reviewed my results with me and told me: “I would be highly surprised if this is not cancer,” my whole world briefly stopped and I had a mini breakdown. I quickly pulled it together and called my manager to let her know that I needed time off for a biopsy. Needless to say, the biopsy was positive for hormone positive, HER2 negative invasive ductal carcinoma.

My reaction at the time of diagnosis was one of outrage, exasperation, despair, fear, and disappointment. How could this be happening to me?  Why now? I was mad at myself for being so good at delaying gratification, for not enjoying life, and not being better at living.

What followed was a series of appointments and difficult decisions. Should I have a lumpectomy and radiation, a mastectomy, or a double mastectomy. The lumpectomy gave me the option to one day be able to breastfeed and keep most of my breast nerves intact, but it would mean that I would need radiation, which mortified me. The prospect of  a second breast cancer in the opposite breast also scared me. I couldn’t phantom having to go through this again and didn’t want to leave anything to chance. So a double mastectomy with reconstruction it was, 3 days before my 34^th Birthday. I guess I could’ve been happy as some people tried to encourage me. A free boob job they quipped as if this was really a choice. I mean, other than trying to kill me, my breasts were perfect. To me, this was a necessary mutilation that would give me a chance at life, but at what cost? It would take away a huge chunk of my womanhood and unique way of bonding with a future child. Unfortunately, the surgery was not without complications and I was rushed into the operating room the next day in order to cauterize a small bleed. The days that followed were painful physically, emotionally, and mentally. Seeing my body for the first time in the mirror with new scars and six tubes coming out of my body was shocking. I couldn’t believe that the person looking back at me was really me. I had a panic attack that day. My sister had to help me out of the bathroom so that I could calm down.

I wish I could say that this was the end of this journey, but more appointments still awaited. All of which, due to covid, I had to attend on my own. My boyfriend and/or family waited for me in the car. Next, I found out that due to my oncotype score, I would need chemotherapy. This led to another breakdown, which was interesting for me because prior to knowing that I would need it, I felt guilty about not having it. Did I truly have cancer if my hair didn’t fall out and I didn’t look ill? These were some of the questions that privately ran through my head.

Prior to chemo, I had to advocate for myself in regards to fertility preservation treatment. It did not appear to be a priority for my care team, but it was very important to me. I recall obsessing about finding out how many eggs could be harvested and how to best freeze them. Should it be eggs or embryos? How much would it cost me. I was lucky enough to qualify for a grant that provided me with the needed medications and a discount on the procedure and freezing fees. Thankfully, I also had some savings in my health savings account that covered the $4,000 that were required to be paid prior to the procedure. I hate that this is not a universally covered expense for all women with cancer. I don’t know how I would have coped if I had not been able to afford to even try.

Unfortunately for me there were some setbacks in my egg retrieval process. First, a cyst was found in my ovary that needed to be removed prior to starting the IVF meds. Then, the hardest part of my cancer journey, none of the 15 eggs that were retrieved were mature enough to freeze. For me, this felt like I had just had 15 miscarriages, the dream of ever becoming a mother with my own biological children slipping through my fingers. I could barely speak or interact with others without crying.

When I spoke to my fertility doc, I asked if the eggs could be incubated (I had heard of this being done with other species) or if there was anything else that could be done, but no solution was provided. I did my own research and found out that there is a procedure called invitro maturation that can be done, but it is not yet offered in Rochester, NY.  So my eggs died. I still don’t understand why this happened. My fertility doctor thought that it may have been related to the anesthesia I received during my mastectomy. I wonder why fertility preservation was not offered right at the outset of diagnosis. I certainly wish that there were better ways to determine fertility post chemo specially with drugs like Cytoxan, which are known to cause sterility. For now, I hold on to the hope that Lupron did what it was supposed to in preserving my ovarian reserve and that when I am cleared to take a break from my aromatase Inhibitor (AI) that I am able to conceive.

I came in contact with the Breast Cancer Coalition right before my second reconstruction surgery, while I was trying to figure out how to cope with my cancer diagnosis and all that it meant. For me, the emotional healing did not really start until Active treatment was done. What has helped me through my cancer journey have been my family, friends, and even strangers who have been superbly kind and selfless. Groups like the Breast Cancer Coalition, the Young survivor coalition, and Unite for Her have also been critical in getting the much needed support that I have needed through this process. I am very grateful that these resources exist.