I'm A Breast Cancer Doctor. Here's What I Didn't Know — Until I Was Diagnosed Myself.

When I went to the hospital last year for my annual mammogram, I expected to be in and out in 60 minutes. Being a healthy female in my mid-40s with no symptoms or major risk factors, I knew my chances of breast cancer were low. So I was more annoyed than worried when the radiologist also wanted to perform an ultrasound. 

As a single mom of three boys and a doctor with a busy breast radiation oncology practice, that day was a typical manic workday with every hour booked solid. I was more worried about falling behind in my schedule than what was going on in my breast. But I stayed because the radiologist was able to get me in quickly for the additional procedure. When he returned with the results, I knew something was wrong.  

“You have at least five suspicious masses in the right breast and an abnormal looking lymph node,” he said.

I didn’t hear the rest of what he told me as I was concentrating on trying to stay calm. Having counseled thousands of patients through their breast cancer diagnosis, I was fully aware of how nondiscriminatory this disease could be. But I always thought if I was ever diagnosed, it would be caught early because I underwent routine mammograms. I never expected to have high volume, lymph-node-positive disease.  

Biopsies of the two biggest masses and the lymph node confirmed breast cancer. I proceeded to undergo bilateral mastectomies and implant reconstruction. I elected to have the uninvolved breast removed for prophylactic reasons. When I awoke from surgery, I thought the worst was over.  Preoperative testing showed that I didn’t need chemotherapy or radiation. I would have to take endocrine therapy to block estrogen production for a minimum of five years, but that was just a daily pill and a shot every few months.

When final pathology came back, it revealed more extensive disease than initially anticipated. As a result, my medical oncologist, who was a close friend, added chemotherapy and CDK 4/6 inhibitors to my treatment plan and told me to get my ovaries removed. I knew that radiation would be required after taking a quick glance at my chart. Knowledge is power, but it can also be terrifying. In that one moment, I imagined myself developing every major chemotherapy and radiation complication that my patients have experienced. I was overwhelmed and devastated.

I sought a second opinion at Dana-Farber Cancer Institute. I knew my friend made appropriate recommendations, but I was in such denial that I had to hear it from a neutral third party. As expected, the doctor agreed with the plan. He then informed me that my chances of 10-year disease-free survival was 85%. 

Only 85%? I thought to myself. Four weeks earlier, I was a healthy 46-year-old who never thought twice about whether I’d live long enough to see my children start their own families. Now, I’m learning that, even with all the treatment, I have a 15% chance of developing metastatic disease — meaning I could die. I was in shock.

“Eighty-five percent is a good number,” he reassured me. 

But it isn’t good enough for me as I thought of my three sons. I have too much to live for. I want to be as close to 100% as possible.