“I didn’t know anybody who had gone flat after going through this. It was a sense of relief, though. I am so grateful that this path fell into my lap the way that it did.”
“I was diagnosed in October of 2018. I was 28, and within a week I also found out that it was stage 4. It had metastasized to my spine in just one spot that they found,” Sarah began.
Sarah’s diagnosis came as a complete shock. She was young, with two small children and no prior health concerns. In fact, she was training for a half-marathon when she noticed her left breast felt weird. Initially, she thought it was hormonal. Two weeks later, she found a pea-sized lump under her arm and called her doctor, who scheduled her for an ultrasound the next day.
She was swiftly diagnosed with invasive ductal carcinoma. A standard PET scan revealed that it had already metastasized. Chemotherapy successfully reduced Sarah’s spinal metastasis to undetectable. Still, the presence of metastatic disease necessitated swift radiation therapy. As she and her oncologist developed and implemented her treatment plan, she began to think critically about her breast reconstruction options.
“Initially, when I was diagnosed, I had in my head that I would do what anybody else I knew who had breast cancer would do: I would get implants—a new set of breasts—and move on.”
Her oncologist questioned this one-size-fits-all approach. Based on her unique situation and treatment path, her doctor felt that she should consider an aesthetic flat closure. Sarah said that she felt shocked when her doctor challenged the plan that had—until that point—helped her get through treatment emotionally.
“I had this plan in my mind, and that was what was getting me through this whole process, knowing what was coming next. To get this out of the blue was a shock to me. I basically broke down."
Sarah met with a reconstructive surgeon several times. They ultimately agreed with her medical oncologist’s recommendation to stay flat. After she made her decision, Sarah said that the initial shock gave way to a new, unexpected emotion, relief.
“I didn’t know anybody who had gone flat after going through this. It was a sense of relief, though. I am so grateful that this path fell into my lap the way that it did. I’ve also learned over time, no matter what, your body won’t ever look the same. No matter what route you take, it’s still going to be an adjustment.”
Sarah continues to treat her metastatic breast cancer, but she said she focuses on what she can do and on embracing life every day. She grapples with the range of experiences within the metavivor community.
“I take my preventative medications, I still go for infusions, but I’m not in pain. For the most part, it’s manageable. can be lumped with the other stage four thrivers, but even in that group, there’s such a wide range of people. There are people—like me—who almost feel guilt that I can work and keep up with my kids. There are people who are really fighting for the last days of their lives.”
Sarah said that patient education and quality relationships with medical providers were extremely important for anyone managing a breast cancer diagnosis.
“You don’t know what to ask if you don’t know what options are there. I didn’t even know that you could do flap surgeries or anything. Cancer is new. You go with what the doctor says. If you’re not comfortable with who’s doing it or how they’re going about doing it or if they don’t have that type of compassion, you should know to go to somebody else, to talk to other people.”