My husband, Matt, and I were happily expecting our first child, thinking about nursery patterns and what life would be like as parents, when our world was turned upside down.
At 27, I had no family history of breast cancer and was healthy and busy climbing the corporate ladder. I found a lump during a self exam and showed it to my obstetrician. Thankfully, my doctor took it seriously and had it checked out. Surprisingly, some doctors dismiss young woman thinking they are too young for it to be breast cancer.
November 22, 1999, just three days before Thanksgiving, is a day I will never forget. I was 27, 22 weeks (5 ½ months) pregnant when the surgeon told me those four words, “You have breast cancer.” My head spun and all I could think was, “Am I going to die? Is my baby going to make it?” It was hard to understand how a baby could be thriving in my body, while cancer was trying to kill me. What should have been one of the happiest times in our lives was spent researching everything we could on being treated for breast cancer while pregnant. At the time there were just 40 cases in the national registry. All of the babies had been born healthy but, in many cases, prematurely. Today, we know that breast cancer is the most common form of cancer in pregnant and post-partum women, occurring once in every 3,000 pregnancies. In addition, nearly 4% of pregnancies are complicated by breast cancer, and 10% of breast cancer patients under 40 develop the disease while they are pregnant.
We visited with several doctors before making a final decision on treatment as the pregnancy complicated things just a bit. I am an overly organized, Type A person, so I needed a plan:
• First – Surgery. I opted for a single mastectomy since I couldn’t have the radiation that is required with a lumpectomy during the pregnancy. I couldn’t have reconstruction at the time of surgery since my other breast was enlarged due to pregnancy. I also didn’t want to be under anesthesia any longer than necessary. (I had reconstruction four years later.)
• Second – Chemo. My cancer was very aggressive (ER-/slightly PR+ and HER2+++), as it is in most young women and growing rapidly. Because of the aggressiveness of the tumor, I had to start chemotherapy during my pregnancy. There was a new drug, Herceptin® (trastuzumab), in clinical trials for Her2+ breast cancer, but I did not qualify with the pregnancy. The baby and I tolerated the red devil Adriamycin (Doxorubicin) and Cytoxan (cyclophosphamide).
Because I didn’t want to use my leave time before I delivered and needed to work as a distraction and for the income, I continued working, with reduced hours. The day after my last treatment, I unexpectedly went into labor five weeks early. I wore my wig in the delivery room to try to feel normal. It kept popping off, so I finally flung it across the room and let them deal with a bald pregnant woman. The doctor on call joked that we had matching bald heads. The room was full of neonatal doctors and nurses who anticipated that our son would need assistance. Matt and I both cried when Parker was born. He was perfectly healthy with a head of hair, which was our sign that he hadn’t been harmed by all of the treatments.
I didn’t want cancer to take away the experience of nursing, so the lactation experts worked dutifully with me, forgetting every time that I only had one breast to pump. Since I’d just finished chemo, they wanted me to “pump and dump” for at least three weeks. As much as I tried, my milk never came. It was just as well. I was tired and loved having Matt help feed Parker.
The precious baby we worried so much about is now a healthy 12-year-old that just started 7th grade. I know how fortunate I am to be here for his many milestones. I don’t take them for granted.
I am grateful for the profound impact YSC has made during the last 14 years. I was desperate to talk to another young woman who had gone through cancer treatments while pregnant when I was diagnosed, but it was hard to find someone in 1999. YSC and Hope for Two now connect young women facing this dreaded disease. My friends give my contact information to other young women, especially those who are pregnant with breast cancer. I am happy to help them and provide hope that they can get through this difficult journey.
We now know so much more about pregnancy during breast cancer and new targeted therapies are available. Progress is being made, but it’s still not good enough. I won’t stop advocating until we can prevent this disease from starting and spreading. Until then, I will be here to offer support to other women who, as one survivor so eloquently put it, have to, “wear my bra.”
Jennifer co-authored the award-winning book Nordie’s at Noon: The Personal Stories of Four Women “Too Young” for Breast Cancer (www.nordiesatnoon.com) with three other women who were diagnosed when they were 30 or younger.