Sarah Dean learned she had breast cancer on her son Luke’s second birthday. “My husband Andrew and I just couldn’t believe it,” she says. At just 32 years old, Sarah’s oldest child Lilley was only 4, and the couple was hoping to have a third baby.
Although their lives took this unexpected and challenging detour, a cancer-free Sarah now has her health back and eight-month old son Anderson “completes” her family.
A Less Common Breast Cancer
A few months before Luke’s birthday, Sarah felt a lump in her breast that initially didn’t concern her doctor because of her age. However, it grew and a biopsy revealed triple-negative invasive ductal carcinoma, a fast-growing breast cancer that tends to occur in younger women.
Triple-negative breast cancer lacks the estrogen, progesterone and HER2 receptors, according to Antoinette Tan, MD, Sarah’s medical oncologist at Atrium Health Levine Cancer Institute (LCI).
A Unique Patient Population
“Only about 4 to 7% of women diagnosed with breast cancer are under 40,” says Dr. Tan. A small portion of them are genetically predisposed to the disease, so both younger and older women need to understand their family history. But for many breast cancer patients, including Sarah, genetics isn’t to blame. This makes breast awareness and age-appropriate screening critical.
For patients like Sarah, a breast cancer diagnosis in the springtime of her career, marriage and motherhood presents unique challenges. For example, chemotherapy can affect a woman’s ability to conceive, which is why Dr. Tan referred Sarah to Atrium Health Women’s Institute to discuss her fertility risks and options before starting her cancer treatment.
In 2017, Levine Cancer Institute established the Sandra Levine Young Women’s Breast Cancer Program to treat patients under 40 like Sarah. Funded by The Leon Levine Foundation, the program provides young women with specific resources geared to their particular stage in life, such as fertility guidance, relationship support and work/family balance. They also get to connect with other women in the same situation.
Most triple-negative breast cancer patients are treated with a combination of chemotherapy, surgery and radiation. Sarah underwent all of that while continuing to work as a school psychologist.
When she began losing her hair from chemotherapy, Sarah decided to take Lilley with her to get her head shaved so that her daughter would see that it wasn’t so scary. But there were exhausting and trying days. “I’d put on my wig, go to work and pretend like everything was fine even though it wasn’t,” Sarah says.
Her endurance paid off as did the fact that she underwent chemotherapy prior to surgery, according to Richard L. White, Jr., MD, Sarah’s surgical oncologist at Levine Cancer Institute.
Dr. White notes several benefits to the chemotherapy-first approach used at LCI for triple-negative breast cancers, which is based on a 2015 study. By initially shrinking the tumor with chemotherapy, the subsequent surgery is less substantial, the patient can keep her breast and she has much less risk of a swollen arm due to lymph node removal.
A Bright Future
“Sarah is such a positive person, and she had a great support system,” says Dr. Tan, speaking of things that help patients deal with cancer. “The time after treatment can be particularly challenging as they try to get back to how things were before their diagnosis.”
Sarah credits her LCI medical team, especially her nurse navigator Megan Hagler, for helping her through her treatment. And then there was her extended family and friends who stepped in to help her with her kids. “It was beautiful that so many people were there for me,” she says. ” But I also had to grieve that time I missed with my kids – they were still so little.”
Recharging herself has included participating in some extraordinary things, including the Wind River Retreat and Go Jen Go Foundation, all the while reveling in the wonderfully ordinary, like coaching Lilley’s Girls on the Run team, watching Luke thrive and caring for baby Anderson.
Because of her fighting spirit, Sarah was honored as the Carolina Panthers Keep Pounding Drummer at their October 29 home game. Andrew, Lilley, Luke and Anderson were all proudly by her side.
“Sarah’s story is one of hope, promise and research,” says Dr. White. And according to Dr. Tan, further research keeps that promise coming with recently developed chemotherapy and immunotherapy treatments for triple-negative breast cancer patients, including those with the BRCA1 mutation or with more advanced disease.
Learn more about breast cancer care and the Sandra Levine Young Women’s Breast Program at Levine Cancer Institute.
