Introduction
My name is Karleen. I am a 52 year old Jamaican born, 2 time breast cancer survivor.

Mon histoire avec le cancer du sein
My cancer journey began at the age of 30. My husband was the one to discover a small lump, the size of a pea on the outside of my right breast, closer to my armpit. I had removed two fibroid cysts in my early twenties, so I wasn’t concerned. However we decided it was best to follow up with my doctor.

I was very young and had absolutely no history of any breast cancer in my immediate or extended family. Regardless, my doctor decided to send me for an ultrasound and the results came back “inconclusive.”

He then sent me for a CT, which also returned “inconclusive.” At that point he still wasn’t extremely worried but, with my request, agreed to refer me to an Oncologist at Sunnybrook Hospital in Toronto. After seeing the doctor, he suggested we wait and continue to watch it based on my age and no family history. But I felt it was necessary to simply get rid of it. He agreed and booked me for day surgery.

Upon my 10 day post surgery follow-up, he confirmed the pathology report and to his surprise and definitely to mine, I was diagnosed with stage 2 breast cancer.

At the time, I was raising a very young family. We had a teenage daughter and 3 young boys ages 3,6 and 7. My world was immediately turned upside down. But we dealt with it head-on.
I initially had a lumpectomy, then a second surgery to clear a larger perimeter, then completed 6 weeks of radiation therapy. In the end, I was declared cancer free and happily continued living my life.

Then 21 years later, my life was again flipped on its head.

What led to my second diagnosis is extremely important, so because of this I would like to share the details.

With my second diagnosis, there was no lump felt or seen.

A little history… In 2019, I decided it was time to give myself a little self care. Since the first breast cancer surgeries at 30, I was left with my right breast being half the size of my left. I was always self conscious of it, but wore clothing that would camouflage the misfit. But In 2019, I decided to have breast cancer reconstructive surgery. In this surgery, a silicone implant was used to build volume in the RIGHT previous cancer breast, while the other breast had a reduction and balancing to match. All was well.

In April 2020, I cancelled my scheduled mammogram because of Covid and did not reschedule.

However in May 2021, again I was scheduled for my routine mammogram, which I had been doing yearly since my previous diagnosis.

After completing the mammogram, I was contacted the following week and asked to come back for a follow-up imaging of my LEFT breast, as they saw something they needed to revisit. I wasn’t nervous because this had happened several times before where nothing was found. I scheduled the follow up appointment for the end of the week. In the meantime, I decided to take a personal moment and conduct a proper self assessment, as I hadn’t been doing as often as I should.

When I really stopped to look, feel and pay attention, I could see there was a physical change in my RIGHT breast. The skin texture had changed somewhat and had little dimples, almost like an orange peel. As well, my nipple appeared to be very slightly indented. I also noticed there seemed to be a pooling of fluid in my lower breast, closer to my chest. I was convinced my implant was leaking!

Both my husband and best friend strongly suggested I go to the Emergency at our local hospital. I felt they were being dramatic and instead decided to call my plastic surgeon. But her office would be closed for the next 2 weeks.

Upon the constant nagging over the next two days to go to Emergency, my girlfriend dropped me off early one morning at the hospital.

When I explained the reason I was there, along with having a physical exam, the doctor wasn’t fully convinced there was much to be overly concerned about.

He was having a hard time seeing the drastic changes that I was seeing based on my skin colour. So I pulled out my phone and showed him the pictures I had taken instead. Upon seeing my pictures, he called on the advice of another doctor to discuss. He then requested I leave and come back to Emergency the following day for an ultrasound, where they would also give me the results within 2 hours.

I was fine with that, but a little worried.

The following day, I reported to the ER, completed the ultrasound, waited about 4 hours and was called into a room for the results. A different ER doctor advised they had seen a “few masses” in my RIGHT breast but could not be diagnosed conclusively and needed to refer me to the Regional Cancer Centre in Barrie. At that moment, I definitely felt panicked.
Everything moved exceptionally fast after that. I had scheduling after scheduling for all kinds of imaging and was assigned a team of doctors specializing in different things. As overwhelming as it was, they were incredibly efficient. If nothing else, I felt very well taken care of.

Within 3 weeks of testing, I was formally diagnosed with stage 3b-Triple Negative Invasive Ductal Carcinoma.

I share these details with you to stress the importance of doing self screening, not being passively dismissive about changes in your body and to be your biggest advocate. Doctors are trained to assess each patient’s concern, but they don’t know your body the way you do.
Go with your gut instinct and be vocal about what you need done. In this case, had I not taken photos to show, I could have been dismissed from the ER and told it was nothing to worry about, or to follow up with my family doctor which could have delayed me any action being taken for weeks, possibly months if not taken seriously.

Aside from that, when I completed the requested second mammogram, (the same week I had gone to the ER), the results confirmed only that there was a potential fibroid in the LEFT breast but showed NOTHING in my RIGHT breast.

After discussing with my oncologist and plastic surgeon, it was concluded that the tumours located in my RIGHT breast may not have been detected based on the angles screened by the technician, as well, possibly the positioning of the implant! Wow… That really shook me. Because if I did not have pictures to show, I would not have been booked for an ultrasound at the ER. AND my routine mammogram would not have detected the tumours in my RIGHT breast. Where would I be today?

The cancer I was diagnosed with is a very difficult and aggressive breast cancer to treat. It spreads quickly and can only be tackled with aggressive chemotherapy.
At the time of diagnosis, I had 4 tumours in my RIGHT breast. No cancer was ever found in the left.

Triple negative is not the same type of cancer I previously had at 30.
It is completely different.

Upon diagnosis, it had already spread outside of my breast to my chest wall and a spot in my upper neck.

Since June 2021, I have been fighting for my life. To date, It’s now been over a year of treatment.

I’ve completed 6 months of aggressive chemotherapy, a double bilateral mastectomy with Diep reconstruction surgery, as well as radiation therapy 5 days per week for 5 weeks.

Since cancer was still present after completing surgery, I was approached to take part in a 6 month trial specifically for triple negative breast cancer (TNBC). 9 cycles using 2 new chemotherapy drugs which are being given once every 3 weeks.

This is my current treatment.

As I write this, I am now half way through the 9 cycles.
Being diagnosed a second time has really been difficult, not only for myself but for my family. My kids are now all adults and are much more aware of what cancer is and the potential outcome.

It’s been physically, mentally and emotionally exhausting. But each day, I count my blessings to still be alive and living my life the best way I can based on how I’m feeling. My support system is incredible. My husband, children, best friend, and small but mighty friendship circle have been instrumental in my continued battle. The love and support from my girlfriends,co-workers, and bosses have been truly more than I could ever ask for. I am so incredibly blessed. But more than anything, my faith in God has been the centre of my strength.

On my good days and bad days, my conversations with Him rejuvenate my will to push through. I believe I am on this earth for a reason and still have a lot to do. Through Him, all things are possible.

I will continue to fight everyday. Cancer has stolen too many lives, destroyed hope, faith and have crushed families, friendships and relationships. It cannot continue to win. My battle is not over and is far from being lost.

Ce que j’aimerais vous dire
“Triple-negative breast cancer (TNBC) accounts for about 10-15% of all breast cancers. These cancers tend to be more common in women younger than 40, who are Black, or who have a BRCA1 mutation. TNBC differs from other types of invasive breast cancer in that it tends to grow and spread faster, has fewer treatment options and tends to have a worse prognosis (Breast Cancer Research Foundation).”

Breast cancer is not a death sentence.
But we must be vigilant with doing our own self-checks and showing up for mammograms. Even though my mammogram did not detect the existing tumours, I feel this was an isolated case. I believe in screening and strongly urge women to see your doctor to discuss ANY concerns you have. I also encourage both women (and men, though a very small percent can also be diagnosed with breast cancer) to be your own and loudest advocate. Early detection is key.

Karleen
Diagnosed at 30 and 52