Nancy McCauley

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On May 25, 2017, at age 40, I was diagnosed with breast cancer, after finding a lump in my armpit. This was after a clear exam from my ob/gyn in January. Upon further testing, and a very uncomfortable liver biopsy, we discovered that it had also progressed to my liver, with “innumerable” lesions (more than 14), placing my cancer into stage 4, metastatic breast cancer.  Metastatic breast cancer (MBC) has no cure, and is terminal, but it can be treated with different therapies, depending on the subtype. Some people have good luck with how long these therapies last, some don’t at all. The average life expectancy is 3 years, but thankfully this is getting better. Still, it’s a crapshoot. With MBC, you stay on a therapy until the tumors become resistant (which always happens), and then move onto another, until there are no more that will work for you.  


My subtype is mixed intraductal and lobular, ER/PR+, Her2-, grade 2. This means that the tumors are fueled by estrogen and progesterone, negative for a certain protein (Her2), and the grade is right in the middle of 1-3 as far as aggressiveness goes. The tumors had qualities of originating in both the milk ducts and the lobules. With lobular tumors, you may not feel a lump, because they form in more of a weblike pattern, making it much harder to feel with exams.  I also discovered I am BRCA1 positive, which was not surprising, with my strong family history of both breast and ovarian cancer on my dad’s side of the family. 


I had a complete hysterectomy to stop the hormone production, plus having a great risk of ovarian cancer. I did not have a mastectomy because once it has spread, there’s no real point in removing the breasts. I was diagnosed “denovo” which means stage 4 from the beginning. Thankfully, I am still on my first line of treatment of Ibrance (chemo) and Letrozole (hormone blocker). With these meds, I have many side effects, but I am able to pretty much go about my day, with rest periods. I don’t look sick, which many people say, but unfortunately I am on the inside. At this stage, the tumors in my liver are what we have to watch, and look for any new ones; the ones in breast don’t really matter too much, those aren’t the ones that kill you. 


My family and friends have been my rock; I am so thankful for them. I couldn’t do it without them! I also cherish my time outdoors, this is my mental and physical therapy. Every day is a gift.