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I’m A Doctor Who Had Breast Cancer—Here’s What I Want Every Woman To Know
In the summer of 2022, I went on my annual trip to Colorado. We hiked, biked, and did white-water rafting—things that are a little harder to do in Florida.
One night, after all that activity, I remember having pain on the right side of my ribs, extending into my arm and breast area. Looking back, it was probably musculoskeletal pain from all the activities we had been doing. But that pain led me to notice something else—a very small mass in my right breast. The lump itself didn't hurt. I had a history of breast cysts, so I assumed that's what it was. But as a board-certified internist who had cared for patients with breast cancer for years, I knew I couldn't ignore it.
As soon as we returned to Florida, I made an appointment for the very next day.
I had recently had a mammogram that was normal, and my repeat mammogram was normal, too. But the ultrasound showed something concerning. I asked a friend of mine, the head radiologist, to look at the images. She immediately recognized that the lump was a solid mass and recommended a biopsy.
I had the biopsy the next day.
The following day, I called the pathology department and told them I wanted to know my results as soon as they were available. I still thought it might be a cyst.
Instead, I heard the words I had been dreading: I had breast cancer.
The uncertainty of waiting
The biopsy showed I had invasive lobular carcinoma.
Lobular cancers can be harder to detect on a mammogram because, rather than forming one distinct lump, they can grow in a more scattered pattern. That helped explain why my cancer hadn't been detected earlier.
The next step was an MRI to take a closer look at my right breast and determine whether there were abnormalities in my left breast. It showed that the abnormality was confined to one breast, but it was much worse than the doctors had initially thought. In fact, the final reading was “extensive enhancement involving the entirety of the lateral right breast—suspicious for additional disease.”
After this reading, I was convinced that my cancer staging was going to be much worse than we had originally anticipated, but an MRI only identifies suspicious areas. A biopsy is needed to determine whether those areas are cancerous, so my doctors recommended a second biopsy to investigate the larger area of abnormal tissue.
When that biopsy came back showing precancerous changes rather than invasive cancer, I felt a little relief. But that relief came with a lingering question: What about all the abnormal tissue that hadn't been sampled?
A biopsy only tells you what is happening in the specific area tissue was taken from. The only way to know the true extent of the disease was to examine the entire breast after my mastectomy. Until then, I had to live with the uncertainty of not knowing just how extensive my cancer really was.
Decisions I never thought I'd have to make
As a physician, I knew a lot about breast cancer. But what I didn't fully appreciate was just how many decisions breast cancer patients have to make—and how quickly they have to make them.
Suddenly, I was the patient, facing life-changing decisions about my own body that I had never imagined I would have to make.
Within days of my diagnosis, I met with a multidisciplinary team of doctors, including a medical oncologist, a breast surgeon, a radiologist, a geneticist, and a radiation oncologist. Together, they reviewed my case and helped develop a treatment plan.
Based on my MRI, my team recommended a unilateral mastectomy, meaning removal of the affected breast. But that was a recommendation, not a decision they could make for me.
Ultimately, I had to choose between a lumpectomy, removing just one breast, or having both breasts removed.
I knew myself. If I kept my other breast, I would always worry about what might happen to it. I knew that worry would stay with me for the rest of my life.
For me, the decision was a no-brainer. I chose to have both breasts removed.
Next, I had to choose a breast surgeon to remove the cancer and a plastic surgeon to perform the reconstruction.I consulted with several doctors and quickly realized just how many decisions I had to make in such a short amount of time.
Every surgeon had a different approach. Some recommended placing tissue expanders first, gradually stretching the skin before replacing them with permanent implants. Another surgeon offered to go directly to implants.
Suddenly, I was making decisions not only about how to treat my cancer, but also about what my body would look like afterward.There were so many options, so much information to absorb, and very little time to process it all.
As a physician, I was used to helping patients navigate difficult decisions. But being on the other side of the table was an entirely different experience!
Waiting for my BRCA results
While I was trying to make all these decisions about my surgery and reconstruction, I was also undergoing BRCA genetic testing.
These tests look for inherited gene mutations that increase the risk of breast and ovarian cancer.
Because I am of Ashkenazi Jewish descent, a population with a higher prevalence of BRCA mutations, I was worried that I might carry one. My grandmother had fallopian tube cancer, which added to my concern.
Waiting for those results was frightening.
A positive result could have meant additional discussions about removing my ovaries and fallopian tubes to reduce my cancer risk, as well as genetic testing for my children to determine whether they had inherited the mutation.
Thankfully, my results were negative. It was one more enormous worry lifted from my shoulders during an already overwhelming time.
Surgery, pathology, & more waiting
In August 2022, I underwent a bilateral mastectomy with temporary tissue expanders.
After surgery, I faced another period of waiting—this time for the final pathology results that would determine my cancer stage and whether I would need chemotherapy.
All I could think about was, What if I need chemo?
When the results finally came back, I learned that my tumor size was T1b, my lymph nodes were negative, and based on my other test results, I would not need chemotherapy. I was overjoyed. I felt incredibly lucky.
In fact, I was so relieved that I posted on Facebook that I was “out of the woods” before I had even completed all my testing. I wanted so badly to believe that the worst was behind me.
There was one more important piece of information in my pathology report: my cancer was estrogen- and progesterone-receptor positive. That meant hormones could stimulate the growth of any remaining cancer cells. So even though I didn't need chemotherapy, my treatment wasn't over. I would need to take medication to suppress estrogen's effects and reduce my risk of recurrence for at least five years. At that point, my doctors would reassess whether I should continue treatment for another five years.
I had been so relieved to hear that I didn't need chemotherapy, but I was beginning to understand that surviving breast cancer wasn't just about surgery. It was also about the years of treatment, follow-up, and uncertainty that could come afterward.
My reconstruction happened in stages. About three months after my mastectomy, my tissue expanders were removed and replaced with permanent implants. About a year later, I needed a third surgery to correct an implant that had shifted out of position and to tighten both sides.
The reconstruction process reminded me that breast cancer treatment doesn't always end with the initial surgery. The road to recovery can involve additional procedures and more time than you ever expected.
How cancer redefined how I practice medicine
I'm now four years out from my diagnosis, and sometimes it feels like yesterday.
I continue to take medication to help prevent the cancer from coming back, but otherwise, I haven't changed much about my routine. I was already extremely active, and as a physician, I understood the importance of healthy eating and regular exercise.
But through all of this, something unexpected happened. Being a patient changed the way I practice medicine.
I understand the fear that comes with knowing something is wrong but not knowing exactly what it is. I understand what it's like to wait for test results, imagine the worst, and feel as though your entire life is on hold until you get answers.
I've always cared about my patients, but experiencing that fear firsthand has given me a deeper level of empathy.
More importantly, I understand that what might seem like a small thing to a doctor can feel enormous to the person sitting in front of us.
I may not be able to take away my patients' fear, but I can listen, acknowledge it, and make sure they know they're not facing it alone.
What I want every woman to know
Immediately after my diagnosis, I reached out to Sharsheret, an organization that supports Jewish women and families facing breast and ovarian cancer. I told them I wanted to speak for their organization once my treatment was finished.
It was so important to me, especially as a physician, to spread awareness about breast cancer and help other women navigate their own journeys.
I always think: If my talk helps even one person, I've done my job.
After speaking with the organization for nearly four years, I'm being honored this December for my work. That means a great deal to me because something positive has come out of an experience I never would have chosen.
There are several things I tell every audience I speak to and every patient I see.
- Know your own body: Even though routine breast self-exams are no longer universally recommended as a screening method, it's important to be familiar with your breasts and notice changes. You know your body better than anyone else.
- Speak up when something doesn't feel right: Don't dismiss a lump or a change just because your last mammogram was normal. My own mammogram was normal, yet I had breast cancer. I was fortunate to have access to care quickly, but the most important first step is to call your doctor and explain your concerns.
- Know whether you have dense breasts: Dense breast tissue can make cancer harder to detect on a mammogram. Ask your doctor how breast density affects your screening plan and whether additional imaging might be appropriate.
- Don't skip your mammogram: It's easy to postpone a screening appointment, especially when you're busy or worried about discomfort. But the screening you are tempted to skip could be the one that detects something important.
- Ask about genetic testing: This is particularly important for people of Ashkenazi Jewish descent and those with a family history of breast, ovarian, or related cancers. Men can carry and pass on BRCA mutations, too, so family history matters on both sides of the family. Knowledge gives you power. Ask questions, understand your risks, and advocate for yourself.
The takeaway
From the day I felt that lump, I wanted to find out what it was and get moving.
I recognize that being a physician helped me navigate the medical system and access care quickly. Not everyone has the same advantages. But everyone can take that first step of calling a doctor, asking questions, and speaking up when something doesn't feel right.
My journey taught me that you have to be your own advocate. You have to ask questions, gather information, and make the decisions that are right for you.
And I've learned one more thing. You don't get to pick cancer. Cancer picks you.
Everyone is going to deal with it differently. There's no single right way to feel, no one-size-fits-all approach to treatment, and no need to compare your journey with someone else's. You have to find your own strength, accept help when you need it, and remember that you don't have to go through this alone.