Somehow, in a rare juxtaposition, breasts are the foremost expression of female sexuality and of motherhood. But with images of breastfeeding mothers and busty celebrities as ubiquitous as traffic lights, those dueling identities begin to coalesce in our minds from a very young age. So for those stricken with breast cancer, their battle goes beyond fighting for their health—for their lives. In many cases, they also fight to preserve their femininity, their sexual confidence, and their most basic desire to nurture their young.

Breast cancer is the most common cancer among women in the United States, after skin cancer, and the second leading cause of cancer death in women, after lung cancer. And it doesn’t discriminate. Breast cancer doesn’t care if you’ve settled nicely into retirement from public school teaching and are fulfilling a dream to publish a fiction series, like 64-year-old Sylvia Roberts. Or, as with 60-year-old Mariann Ubry, it’s immune to the fact that your husband is about to start a new job as police chief, that your son is entering the Police Academy, or that your twin girls are coming into their own. Breast cancer doesn’t even care if you’re like 41-year-old Lynda Saganowski, who was diagnosed at 39, the same age as her mother who died of the disease 25 years earlier. And it scoffs at 31-year-old Ashley Diaz, who was 10 days from marrying her longtime boyfriend when she got her cancer diagnosis at 29.

These four women stared down breast cancer—they listened to their bodies, found the right doctors, stuck to their treatment plans, and leaned on their loved ones. Here are their stories.

 

Ashley Diaz, 31 years old
Front desk supervisor, Mercer-Bucks Orthopedics

AshleyIt was 6 a.m. on April 18, 2013, and Ashley Diaz was watching her baby godson. He was sitting in her lap and whacked her in the chest. That punch changed her life.

“He punched me right in this spot on my right side, and it was instant pain. I started feeling around, and I felt a lump,” Ashley says. “I don’t do self-breast exams all the time, but I know my body, and I didn’t feel that lump before that punch.”

Although she didn’t think anything was seriously wrong, Ashley scrambled to get her health insurance ironed out, in case it was a cyst or an abscess that she’d need examined or removed. “At that point, I’m thinking, I’m 29 years old. There is no way I have cancer,” she says.

But the clock was ticking. She was about to marry her longtime boyfriend, Jermaine, and she wanted this out of the way. She went to her gynecologist, who tried to aspirate what she thought was an abscess, but nothing came out. She sent Ashley for an ultrasound, during which the tech went to get a radiologist. “He said, ‘I’m sorry to tell you this 2 weeks before your wedding, but you need a mammogram.’ That’s when I knew I had cancer,” she says.

With 10 days to go before her wedding, her fears were confirmed when Lisa Allen, M.D., director of Capital Health’s Center for Comprehensive Breast Care, accompanied by Rona Remstein, Capital Health’s director of Oncology Services, and Breast Health Navigator Trish Tatrai, explained the results to Ashley and her family. They said she had a grade 3 cancer, which is fast growing, but still in stage 1A.

Ashley made it clear to her doctors that she and Jermaine wanted to have children, and they developed a plan of attack that included a double mastectomy and chemotherapy.

She and Jermaine moved ahead with their wedding and honeymoon—a short trip to Las Vegas—but by the time she got back, her tumor had grown from 1.9 cm to 4.5 cm, which moved her from stage 1A to 2A, she says.

Ashley had a double mastectomy on June 25, and there was more bad news. “They removed nine of my lymph nodes and found cancer in three of them,” she says, “which moved me to stage 2B and meant I needed radiation.”

With such an aggressive cancer, Ashley had to start chemo as soon as possible. But since she wanted to have children, she first needed to start daily fertility treatments so her doctors could remove and freeze embryos (fertilized eggs) for them to use down the line. Initially the fertility treatments didn’t work. “At a certain point they said, ‘If we don’t see any growth, we’re done.’ Thank God he gave me more time because I went back in, and there were eggs all over the place. If he had said no right then, I wouldn’t have my four little embryos. I want to have a baby. There is no doubt about that. I would have taken it as far as I could.”

With her four embryos in the bank, Ashley began eight rounds of chemo, which lasted 4 months. In anticipation of losing her long, blond hair, she shaved her head, with support from friends and family. Jermaine shaved off his braids in solidarity. She thought she’d wear wigs, but discovered they irritated her head, so she wore scarves or left her head bare until it grew back.

Twelve days after finishing her radiation, Ashley went back to work. While she still battles the weight gain due in large part to the , a drug that is commonly used to prevent some types of breast cancer from reoccurring, the loss of her breasts and what they represent is still deeply painful for Ashley. “It changes everything. Not only can I never breastfeed my potential child, but in terms of my sexuality, not having nipples is really hard,” Ashley says. “The things that were the hardest have to do with my identity as a woman.”

Ashley recently had a clear bone scan, so her doctors gave the couple a green light to start trying to conceive. While she knows there’s a lot riding on those four little embryos, after everything she’s been through in the last 2 years, she’s not about to lose faith now.

 

Lynda Saganowski, 41 years old
Secretary, Robbins Elementary School

LyndaWhen you lose your mom to breast cancer before your 14th birthday, there’s a sense of foreboding that can creep in and leave an ominous shadow over your life. Lynda Saganowski’s mom was 39 when she was diagnosed, and for 25 years she had an overwhelming sense that she would eventually get it too. So, starting at 30, Lynda began getting routine annual mammograms.

She had nine clear scans before a mammogram and a biopsy in 2013 revealed ductal carcinoma in situ (DCIS), non-invasive cancer, in her left breast. She got the difficult news on the day before Christmas Eve. While her prognosis was positive, Lynda was 39, the same age as her mother, so it was a huge blow.

“I always felt getting breast cancer was inevitable for me. That’s why I was so cautious about always getting checked,” Lynda says. “I have a little sister, and she gets checked religiously. Her 39th birthday is approaching, which is so scary.”

While she wasn’t shocked by the results, she was overcome with concern for herself, her two daughters—Tori, 17, and Sophia, 12—and her younger sister. She was tested for the BRCA1 and BRCA2 breast cancer genes but was surprised to learn she was negative, despite the seemingly genetic connection between her mother’s cancer and her own.

Lynda was presented with treatment options, which included the combination of a lumpectomy to eliminate the cancerous tissue and radiation, a unilateral mastectomy, which removes the affected breast, or a double mastectomy. While a mastectomy meant the removal of one or both breasts, reconstructive surgery, and a lengthy and painful recovery, Lynda had no doubt about her choice. “I made the decision to have a double mastectomy, especially because of my mom,” Lynda recalls. “I just didn’t want to worry about it anymore. I’d been worrying about it for so long.”

After deciding on a nipple-sparing double mastectomy, they scheduled the surgery for February 6, 2014, 6 weeks after she was diagnosed. But the wait felt like much longer, Lynda says. “My cancer wasn’t aggressive, but I’m thinking, if this doesn’t get out of me soon, what will happen?”

Before the surgery, her daughter Tori showed Lynda a drawing she made in art class, which depicted Lynda looking on with a quiet smile, one breast marred with an ugly criss-crossed scar. More than the worry over her appearance, the picture expressed the fear they were all experiencing.

Recovering from surgery—physically and emotionally—was the hardest part, but Lynda had tremendous support. “My family and friends were incredible. When I came out, there were about 20 people in the waiting room.” The help was crucial after the surgery because she couldn’t use her upper body much, and the drains were uncomfortable.

Beyond the physical constraints, finding the courage to look at her new body was an uphill battle, but with help from her reconstructive surgeon, Matthew Lynch, M.D., she got there. “After you get over the initial fear that you’re going to die, you’re worry about being deformed,” she says. “But Rosemary Fox, RN, Dr. Lynch’s right hand, was always there to reassure me. She’d say, ‘You’re going to be beautiful,’ and eventually I was.”

Dr. Lynch filled in her breasts over the next 6 months, until they felt right to Lynda. While she doesn’t have complete sensation, she says the nipple-sparing surgery did help her keep some feeling.

On the whole, Lynda is feeling healthy and focused on enjoying her life. She can even laugh about it a little, occasionally throwing on the T-shirt her sister got her that says, “Yes, they are fake. My real ones tried to kill me.”

But after losing her mom to the same disease, Lynda knows how lucky she is, and all she can feel is grateful for her life. “I just thank God I was getting checked regularly. If I had maybe skipped that year, everything could have been different.”

 

 

Mariann Ubry, 60 years old
Secretary, Rider University

mariannMariann Ubry was busy during the summer of 2014. She went on vacation to Mexico, her husband of 23 years was about to start as chief of police in Lawrence, N.J., and her son Matthew was entering the Police Academy. Her twin daughters, Madison and Mackenzie, were a whirlwind of activity. And, having retired from her 27-year career working in IT for the State of New Jersey, she was working as a secretary at Rider.

But she’d been feeling pain under her arm since her trip to Mexico, so during her gynecologist appointment at the end of August, she mentioned it. Her doctor wasn’t terribly worried about breast cancer because it’s not usually associated with pain, but she sent her for an ultrasound to be sure.

The radiologist told her to schedule an appointment with a breast surgeon as soon as possible, and a subsequent biopsy came back positive. Before she knew it, she and her husband were facing a stage 2B breast cancer diagnosis. “The doctor said someone must have been looking out for me because you wouldn’t have seen it on a regular mammogram,” she says. “He explained that the cancer is lobular, which means it grows where breast milk is made, so it can be hard to pick up. I’m very lucky the doctor listened to me in the first place.”

The diagnosis was a shock. Despite her family history of breast cancer—her mother had it and her sister died from it—Mariann tested negative for multiple genetic mutations, and she had been vigilant about her health, getting regular mammograms since she was 35. “I had never had any health issues. I never had any surgeries,” she says. “So I was totally beside myself.”

Mariann steeled herself to face what she says was the hardest part—telling her kids. She and her husband agreed to be open and honest, talking to each of them individually and giving them the chance to ask any questions about what she was facing. “I told them, ‘You have a job to do. I don’t want you to sit here and stare at me. I want you to go to school and  have friends. I want you to do things with your life,’” she says. “‘We are going to work through this as a family.’”

And they did. While Mariann carved out a treatment plan with Dr. Allen, her kids went to school, worked, got good grades, and supported their mom. But as assured as she was with her kids, internally Mariann was still trying to get a grip on what was happening. “I kept crying every time I saw her. The last time I met with her, she said, ‘You’re not going to die. You’re going to have a rough year, but you will not die,’” she says. “When she said that to me, I knew she was right. I’m not going to die. No matter what I have to do, I’m going to get through this. Up to that point, I think I felt like, this can’t be me. Are you sure? That’s where I was stuck.”

But from that moment on, Mariann was determined, dogged, and often academic in her approach to her cancer treatment, starting a high-protein diet recommended by a specialist, journaling about her experience, and learning everything she could to make informed decisions.

Mariann divided her treatment plan into parts—the double mastectomy, chemo, breast reconstruction, and radiation. After each milestone, she would treat herself—get her nails done or go out to lunch so she could regroup and get mentally prepared to take on the next challenge.

While the double mastectomy was an emotional battle, she had very little pain and was pleased with the reconstruction. “Dr. Gary Tuma, my reconstructive surgeon, is a total perfectionist.” The chemo was the most challenging part, she says. She had four treatments of Adriamycin and Cytoxan and 12 of Taxol, which began in November 2014 and ended March 2015. She lost her hair within 2 weeks. “That was hard, but my son was in the Police Academy, so we were bald together.”

After her breast reconstruction, Mariann had 26 radiation treatments, ending in July. While she still feels tired, she is proud of the way her body bounced back. If she could offer advice to other women, she says it’s critical to accept help. “We all try to be mother of the year, but if people want to run your kids to a game or do a load of laundry, accept it,” she says.

She knows going through breast cancer has made her stronger and more appreciative of her life. “Look, cancer changes a lot about you—your acceptance of things and your patience for things,” Mariann says. “I was glad those things came out of this, but I don’t want to do it again.”

 

Sylvia Roberts, 64 years old
Author, retired grade school teacher

sylviaThe year 2013 started out just fine. She’d been happily retired for 6 years, married to her husband Tony for 13, and the second fiction novel in her series Beyond Church Doors was published. Her stepdaughter, who calls her Moo, was close to graduating from Rider University. Sylvia felt at home in her church, happy in her faith. Life, on the whole, was good.

But after a routine annual mammogram, the radiologist recommended a second look. She wasn’t alarmed because dense breasts sometimes make it tricky to get a clear picture, but then the doctor ordered a biopsy. “When I was sitting in Capital Health’s Center for Comprehensive Breast Care waiting for the results of the biopsy, I thought, something’s wrong, because I’m sitting out here too long.”

Radiologist Brad Hoppenfeld, M.D. performed the procedure and explained the results. “Dr. Hop showed me the film. I saw these little white dots on my left breast—I called them my constellations. My gynecologist later explained that I had DCIS.”

But the good news was that they discovered the cancer at stage 0, so after discussing her options with Dr. Allen, Sylvia opted for a lumpectomy to remove the tissue from the mammary duct followed by 33 radiation treatments. Dr. Allen explained the steps to her, even drawing them out on a piece of paper so she could have a clear picture. “I still have that little sketch she drew,” Sylvia says. “She made me feel like I was a part of the process, not like this was something that was just happening to me.”

She was scared, but between Tony’s quiet calm and her own faith in God, Sylvia continued to put one foot in front of the other, taking a measured approach to her cancer. “I tried to allow the Lord to guide me, and even if He decided it’s time for me to transition to another place, I felt I’d be OK. Don’t get me wrong, I was fighting to stay here,” she says. “I think you should fight for your life. I’m not from the school of, ‘Woe is me. Let me just sit here and die.’ No. I’m going to fight.”

After she healed from her lumpectomy, Sylvia began getting her 33 radiation treatments 5 days a week. The doctors prepared her for what she’d face as a result of the radiation, and that alone helped her cope with the side effects. “Everybody told me what to expect. They said, ‘Your skin’s going to get dark, but it’s going to come back,’ and it did.”

While she tried to stay positive, the treatments were tough on Sylvia. So Tony would do his part to relax and reassure her. “After my treatments, when I came in the house, he’d have classical music playing, because he knows that’s soothing to me. I would go into the sun room, get in the recliner, and just relax,” she recalls. “Still to this day, in the morning when I get up, there’s classical music playing softly on the radio. I think about my radiation treatments when I hear that music. It was his quiet way of saying, ‘Everything’s going to be okay.’”

Sylvia says having cancer strengthened her faith and helped her focus on what she wants out of life. She tries to say yes to more things and enjoy the little moments as much as possible. Her third book in the series is at the publisher right now, and she feels ready to branch out into a completely new story.

“Everything is more vivid now. Cancer reminds you that you’ve got to find those things that are good for you, like reading and good food and music and friends,” Sylvia says. “I believe God kept me around for a reason, so I try to do everything I can.”

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