“Nothing more I can ask for” – Personalized medicine ensures mom will see her kids grow up

For Sarah McRorie, the time after the birth of her daughter Sloane brought hugs, kisses, new challenges and plenty of “firsts.” Eighteen months later, it also brought a diagnosis of stage 3 breast cancer.

It all started with a lump. Shortly after Sloane’s first birthday Sarah started weaning her from breastfeeding.

“About a month and a half after we finished, I noticed what felt like a clogged milk duct in my left breast,” explains Sarah. “I had heard that it can take up to a year for your breasts to return to ‘normal’ after stopping breast feeding, so I didn’t think much of it and figured I would check in with it later.”

However life with a toddler kept Sarah busy and she forgot to check on the “clogged milk duct.” Then three months later she noticed another jellybean-sized lump in her armpit. Sarah still didn’t connect the dots.

“I mentioned the lump to my mom and she said I should get it looked at right away. I brushed her off,” says Sarah. “A few days later, I mentioned it to my husband and he thought it was weird, too, so then I scheduled an appointment with my primary care provider not thinking much more about it until my appointment about ten days later.”

At her appointment Sarah’s primary care physician did a breast exam and immediately ordered a mammogram. “She didn’t mention breast cancer. She said she didn’t know what the lump was,” says Sarah. “I guess she didn’t want to scare me? Or maybe she didn’t believe it could be cancer? Or maybe she really didn’t know about breast cancer in patients as young and healthy as me.”

A few days later Sarah checked in for her mammogram. After the procedure the technician would only say that the doctor would be in contact with results and Sarah found herself leaving with more questions than answers. The next day she got the results – Sarah’s primary care physician told her that she needed an ultrasound and needle-guided biopsy.

“The big C was just starting to enter our thoughts but we still didn’t know and didn’t want to worry unnecessarily, so we tried to be positive and enjoy our beautiful 18 month old baby girl,” says Sarah.

A week later she went in for her biopsy and met with a radiologist immediately after.

“She spoke to me in some form of English, I’m sure, it just wasn’t the dialect I could understand at the time. I understood nothing of what she said except I understood her tone. She was serious and I was frightened,” says Sarah. “I rushed out to the car and sobbed as I told Patrick, my husband, what happened. The next day I was at work, trying to keep busy, when my PCP called and literally said ‘I have bad news. I have 15 minutes to talk to you now or you and Patrick can drive up at six and we can talk for as long as you want.’ I told her we would be there at six.”

YOUNG WOMEN GET BREAST CANCER TOO 

Sarah was diagnosed with stage 3 breast cancer at just 34 years old.

“When I was told I had breast cancer I felt shock, disbelief, scared beyond imagination,” says Sarah. “And then the question flooded in: How far had it spread? Is this curable or only treatable? What about our daughter?”

Being a lawyer, Sarah immediately started researching treatment options, doctors, and places where she could get care.

“I interviewed doctors, oncologists and surgeons. I talked with some nice people but no one who I ‘clicked’ with,” explains Sarah. “Nobody dealt with patients like me regularly. All their breast cancer patients were post-menopausal or entering menopause. We felt helpless. I was the youngest person in the waiting room by about 20 years.”

It wasn’t until Sarah heard from a friend about VirginiaBorges, MD, MMSc, director of the Breast Cancer Research Program and Young Women’s Breast Cancer Translational Program at the University of Colorado Cancer Center that she finally felt a glimmer of hope.

“I remember my husband and I sat in Dr. Borges’ office and said, ‘why should we trust you?’” says Sarah. “It became very clear that she is one of the very few who specializes in young women’s breast cancer. She got me through not only the physical hurdles of cancer but also the mental ones. She is by far the best person I could have ever asked for to handle my care.”

A ROUGH ROAD

Once Sarah connected with Dr. Borges she began a series of tests, scans, MRI’s, blood work, to find out all they could about her cancer. Was it dependent on estrogen or progesterone or the gene HER2? And how far had it progressed?

“Unfortunately post-partum breast cancer is very aggressive for reasons we are still trying to understand,” says Borges. “It drives my team every day to learn more and keep these young women from being diagnosed or even dying from the disease.

Post-partum breast cancer was news to Sarah.

“Dr. Borges was the first one to mention pregnancy-related breast cancer,” says Sarah. “It seems so unusual – cancer that is brought on by pregnancy. Some doctors don’t even know it exists.”

Sarah’s treatment plan included four months of intense chemotherapy, a bilateral mastectomy, and 27 rounds of radiation. This plan would be mentally and physically draining for anyone, but was doubly so for a new mother who was balancing cancer treatment with raising her baby. Luckily for Sarah, she had support.

“My mother immediately retired and moved in with us. With her there we were able to maintain some vestiges of normal life,” explains Sarah. “I continued working through chemo, the best I could, taking days off for treatment and rest, then back in the office during the off week. With my mother’s help, Patrick was able to work full-time.”

For Sarah, Sloane proved to be a shining beacon of light during her darkest days.

“Sloane would rub my head when I couldn’t lift it off the couch. She let me sob on her shoulder as I rocked her to sleep. Her smile, compassion, and the ugly thought she won’t remember me because she is so little, kept me fighting for my life,” says Sarah.

LOOKING TOWARDS THE FUTURE

After finishing treatment Dr. Borges put Sarah on an aromatase inhibitor. In addition to regular checkups, this maintenance therapy would last at least five years. After a year of good health and the okay from Borges, the McRories also decided they wanted to try for another baby.

“We consulted with a fetal medicine specialist, a gynecologic oncologist, my regular oncologist, my regular gynecologist, all in order to determine if it was even safe for me to get pregnant again,” says Sarah. “We had to make sure it was safe for me to be off my aromatase inhibitor. Then came questions like whether I should use my preserved fertility options instead of trying naturally, and whether having a baby was worth these risks.”

Dr. Borges and her team gave Sarah the okay to pause the inhibitor just long enough to try to get pregnant naturally.

“I always joke with my patients that they are allowed to have a baby only if I am on the holiday card list and make them promise to bring those babies in,” says Borges. “I consider myself their surrogate grandmother.”

Unlike her first pregnancy it took time for Sarah to get pregnant. “It did not happen right away like it did with Sloane, and on the last month of trying before we had to go to the preserved fertility options, we got pregnant!”  she says. “We cried tears of joy when we got that positive test result and we could not wait to tell Sloane she was finally going to be a big sister!”

Last summer the McRories welcomed their son Carl into the world. A miracle baby that Sarah was never sure she would be able to have.

“If he would have been a girl her name would have been Ginger,” says Sarah jokingly. “He completes our family.”

Sarah is coming up on four years of being cancer-free – a milestone she was not sure she would see. “Breast cancer was the absolute hardest thing I have ever gone through. I hated not being in control, not being able to enjoy my baby and take care of her myself, not being able to be a normal wife and be a partner in my marriage,” Sarah says. “But now, when I look into the eyes of my children, I know that every horrible day was worth it. I will be able to watch them ride a bike, drive a car, graduate high school, get married. There is nothing more I can ask for.”

About the author: Taylor Abarca

Taylor Abarca (Bakemeyer) is the Social Media Web Specialist at the University of Colorado Cancer Center. Contact her at Taylor.Bakemeyer [at] ucdenver.edu.

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