I'm proof that early detection is key—and that even COVID-19 shouldn't deter you from getting your annual screenings.

By Jackie Miller, as told to Mallory Creveling
October 16, 2020
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I don't think there's any way to articulate the feeling you get when you hear you have cancer. Those words specifically—"you have cancer"—are at the top of the list of things no one ever wants to hear. Unfortunately, my journey to hearing those three words began over the summer, during the COVID-19 pandemic.

On July 14, I went in for my annual ob-gyn exam—one that, in all honesty, I nearly cancelled because of coronavirus concerns. I had just turned 35 in February, and since my doctor, Elena-Maria Buruiana, MD, FACOG, an ob-gyn in private practice in New York City, and I had been talking about getting an early mammogram for years, I knew that that would be a topic of conversation that day. My mom actually had breast cancer—DCIS, or stage 0 breast cancer—when she was 46. So, it was especially important that I started paying attention to my breast health at an earlier age than most.

Dr. Buruiana also made it very clear that in her office, her practice was to start annual mammograms at the age of 35 instead of 40, the commonly recommended age. “Most patients diagnosed with breast cancer have no family history or identifiable risk factors,” Dr. Buruiana says. “I care about patients’ health, so I set up protocol to start screening earlier.” The benefits just outweigh the risks, she says.

When Dr. Buruiana performed my manual breast exam, she found a small lump deep in the side of my left breast. Initially, she didn’t think it was a tumor because it was a little soft (for the most part, she told me, tumors are hard). But given her stance on being proactive about breast health, and because I was going to get a mammogram this year anyway, we immediately booked a mammogram and sonogram. I went in for the appointment two days later.

The diagnosis

My imaging tests seemed to go off without a hitch—at least at first. The doctor I saw wasn't initially concerned about the lump, which he also figured was just a benign mass. But then something changed. As I walked out of the doctor's office, a nurse called me back in and the doctor said something I'll never forget: "Jaclyn, I don't like what I'm seeing," he said. Upon a closer inspection of my breast images, he saw a few things that concerned him. The abrupt change in his medical opinion worried me, and I could tell by his urgency that he thought I had cancer. "We need to get a biopsy on this ASAP," he told me.

I had two biopsies just a few days later—one on the mass I knew about, and the other on a smaller, unknown mass I found out about after the mammogram and sonogram. A new doctor had to perform the biopsy, due to COVID-19 restrictions and staffing limitations at the imaging office. To make matters worse, my husband wasn't allowed to accompany me during these appointments, again due to COVID-19 precautions. He was, however, waiting for me outside the office on a bench where we held each other and cried, a moment I’ll never forget.

The next day, I received my biopsy results: I had stage 2, ER-positive breast cancer. (This diagnosis was preliminary and once they removed the tumor, they determined it was smaller than originally thought and classified it as stage 1 cancer.) The entire process, from finding a lump in my breast to being diagnosed with cancer, took just one week. I feel extremely fortunate for that, considering all of it happened during a pandemic.

It’s also worth noting that due to the tumor’s size and its location deep in my breast, several other doctors couldn’t believe that Dr. Buruiana was able to feel the tumor. I was lucky she found it, but also lucky that even if she hadn’t, it would have been caught in a matter of months as I was due for a mammogram that year. It’s not lost on me that in different circumstances and with a different doctor who didn’t find the lump and who doesn’t do early mammograms, my outcome could have been different.

The treatment

There really is no one-size-fits-all approach to treatment, especially with breast cancer. For my own personal journey, I had two top priorities for treatment: The first was gaining an understanding of the biology of my disease and what was going on in my own body. The second was that I would pursue the options that would lower my risk of recurrence as much as possible.

Based on those priorities, a very good treatment option for me personally included surgery—either a lumpectomy (simply removing the cancerous mass) or a mastectomy (removing the affected breast or both breasts). Because my chances for a cancer recurrence are slightly higher than the average woman, due to my family history and the young age at which I got my diagnosis, I chose to do a double mastectomy.

This was definitely a hard decision, mostly because the act of surgically removing my breasts means I'll never be able to breastfeed my future children. But with those sad thoughts came another realization: To have those future children at all, and to be able to play with them when they're older, I have to be as healthy as possible. The double mastectomy would give the opportunity to live a full life, which is why it became an easy choice.

The author, saying goodbye to Memorial Sloan Kettering Cancer Center after being discharged after her surgery.
Jackie Miller

Another thing happened when I made that decision: It empowered me and allowed me to take back control. For the first few weeks of this process, I felt helpless. I was scared. But in choosing to remove my breasts, I played an active role in my health, which I felt had been taken away from me.

Of course, COVID-19 added a layer of complications to the double mastectomy surgery process. I had to get tested for the virus a couple times before surgery, and if I was infected, I would have to prolong treatment, which I didn’t want to do. This definitely added a layer of stress, but thankfully, I was cleared.

Another thing that was really hard was the change in visitation rules—I wasn’t able to have guests afterward. The anticipation of waking up and being alone and not being able to hold my husband’s hand was really scary for me. But I will say, the anticipation was actually worse than the experience itself. I had an amazing team at the hospital, I was able to FaceTime my husband, and I only had to stay one night. Ultimately, I made it through, and the surgery went well.

As I write this, I'm recovering from that double mastectomy. (I can even lift my arms above my head now—a huge win in my surgery recovery process.) Later this month, I’ll also start chemotherapy. I don't necessarily know what's in store for me during that part of my journey, but looking back at what I've already been through, it's nothing I can't handle.

Jackie Miller

The lesson

Getting diagnosed with breast cancer—and then undergoing treatment for it—during a pandemic has certainly been an experience. It's taught me to appreciate my body and its strengths, it's reinforced my love and gratitude for those around me (especially my mom, who had also previously undergone a mastectomy, so I had someone to talk to who had been through this). It also taught me to stop taking the little things for granted.

If I can pass along one thing to other women that I've learned from this experience, especially right now, it's that under no circumstances—not even a pandemic—should you cancel your necessary cancer screenings and routine checkups. I think my physician, Dr. Buruiana, said it best: "Nobody should be scared of doctor visits and imaging at this time. It's tremendously important."

Finding a proactive doctor like my own Dr. Buruiana is important, too. I truly feel like she saved my life. It may take some research and trial-and-error, but you want to find an ob-gyn who will give you the time you need; initiate open, honest communication about breast health (and encourage you to do the same); and treat you like an individual—not just a diagnosis. Dr. Buruiana would actually call me after hours and on the weekends just to check in on me. Finding a doctor who is not only smart and knowledgeable is key, but also someone who’s compassionate and who’s going put in the time is just as important.

I've felt many things in the weeks since my diagnosis and surgery: anger, sadness, discomfort, pain, joy, relief. But the one thing I've never felt, not even once, was regret. All of the decisions I've made recently—from keeping that checkup scheduled for July to deciding to remove both of my breasts—I’ve made because I felt confident that they were the right thing to do for my health. Cancer doesn’t discriminate so being an active participant in your own health journey, and being a bold advocate for yourself, is the most important thing a woman can do.

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