Life after breast cancer treatment: The hardest chapter

At my annual wellness checkup, I mentioned the lump to my physician. She reassured me that it was likely nothing, but I pushed for more testing. She ordered an ultrasound, which led to a mammogram. The mass wasn’t visible on the images, but my ultrasound raised concern, so I underwent a biopsy.

Nearly two weeks later, I still hadn’t heard anything. On my lunch break at work, I checked my patient portal and saw the words: Invasive ductal carcinoma. My doctor never called me with the results.

I was stunned. But because I worked in health care, I was able to reach out to a trusted provider who helped me get an appointment quickly with a breast oncology team. More scans and tests followed. A few weeks later, I also learned that I carry the BRCA2 genetic mutation, something that runs in my family but that I hadn’t tested for earlier because I wasn’t ready for that kind of worry.

There was no time to let any of it sink in. My care team laid out a treatment plan: eight dose-dense chemotherapy treatments over four months, followed by a double mastectomy with reconstruction, and then 15 sessions of hypofractionated radiation.

Fear and isolation during treatment

Once I understood my diagnosis and set my treatment plan, I shifted to an intentional mindset. I felt mentally prepared to begin treatment and actively engage in my healing. I focused on getting through each appointment, staying present for my daughter, and doing what I could to move forward. That determination carried me through what came next.

Just three days after my mastectomy, the COVID-19 pandemic shut everything down. I had just learned that I had a pathologic complete response (pCR) to chemotherapy — no remaining cancer in the tissue that was removed — and suddenly I couldn’t even bring anyone with me to follow-up appointments. I was immunocompromised, caring for a 1½-year-old, and terrified to leave the house. It was a time of intense fear and deep isolation.

A month after radiation, I began hormone suppression therapy, which I’ll continue for at least 10 years. So far, I’ve had four reconstruction-related surgeries. At age 33, I also made the decision to have a preventive total hysterectomy to reduce my hormone levels and lower my risk of ovarian cancer, a choice made after discussions with my care team and driven by my BRCA2 status.

Throughout it all, my daughter has been my reason to keep going. Even now, she gives me strength during the hard days, especially in survivorship, which, for me, has been the most difficult chapter.

Not the “old Kara”

People often assume that once treatment ends, everything goes back to normal. But the truth is, it doesn’t. Physically and emotionally, you’re forever changed. I’m not the “old Kara” people remember. My thoughts, my feelings, my priorities have all shifted.

And when the appointments slow down, your hair starts to grow back, and people stop checking in, that’s often when the loneliness hits. I’ve never felt as isolated as I did in the months after active treatment ended. Even now, I still carry that sense of being apart from others.

The word “survivor” doesn’t feel quite right to me. It makes it sound like the hardest part is over, but survivorship itself is its own kind of challenge. I still deal with daily medication side effects, early menopause, and lasting physical symptoms: fatigue, neuropathy, memory issues, back pain, trouble sleeping. I often say, “I may look like I’m in my 30s on the outside, but on the inside, I feel 90.”

The fear of recurrence never fully goes away. Every new ache, pain, or vivid dream can spark that worry: What if it’s back? I try to keep those fears in the background and focus on the present, but some days, they surface. Sometimes I’ll be going about my day and suddenly remember: I had cancer.

What’s helped has been therapy, yoga, and connecting with others who’ve been through something similar. I’ve joined several online communities of young women impacted by breast cancer, and it’s been a relief to find people who understand without explanation. I hate that anyone else has gone through this, but I’m grateful we can be there for one another.

Know your body, ask questions, advocate early

What I want others to take away from my story is the importance of self-awareness and self-advocacy. Know your body. Do self-exams. Ask questions. Talk about your family history. My grandmother had breast cancer in her 30s, and I later learned that multiple relatives were BRCA-positive. I put off testing because I didn’t feel ready, but I wish I had taken preventive steps sooner. That’s why I now advocate for my daughter and the people I love.

I’m deeply grateful to be here, and for the treatments that have kept me in remission. But I also know that my quality of life could have been better if I’d taken action earlier and got tested. Perhaps I would have needed fewer treatments or avoided a cancer diagnoses altogether. So, I share my story in hopes that it helps someone else act sooner, ask more questions, or feel a little less alone.

Please, always advocate for yourself and your loved ones. It can save a life.