Renée’s Stage 2 Breast Cancer Story

Renée F., Stage 2 Metastatic

Symptoms: Breast shaped differently, dimple in breast, flat nipple Treatment: Chemotherapy, mastectomy

  • Post author By Katrina Villareal
  • Post date January 27, 2023
  • No Comments on Renée’s Stage 2 Breast Cancer Story

Renee F. feature profile

Renée first met cancer at 18 when she was diagnosed with acute myeloid leukemia.

In 2019, she was diagnosed with stage 2 breast cancer, which metastasized to her lymph nodes.

In this story, she shares how she developed a second cancer, the challenges she underwent with her treatment plan and how she continues to “thrive” as a survivor.

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.

  • Name:  Renée F.
  • Breast Cancer
  • Breast shaped differently
  • Dimple in breast
  • Flat nipple

Whatever stage you are in and whatever year in your journey you are in, may I remind you: you’re still here. You are still thriving. Even if it was a hard day yesterday, you’re here and that is to be celebrated and enjoyed.

What happened after you got a unilateral mastectomy?

It really took hearing my daughter say, ‘My mommy is a cancer survivor,’ to understand that when we say it, it’s power. We’re getting our power back by saying, ‘I have cancer.’

Life after leukemia

I’m a single mom. I’ve been on my own since she was born and it’s been really tough. But at the same time, I have her looking up at me. It’s like, “How do I explain to my five-year-old (at the time) that I have cancer? How do I reassure her and myself that things are going to be okay?”

I remember being afraid to say the word cancer because it’ll make it real. Then I realized I need to call it by its name because it needs to know my name. If I give it space, then I have some ownership over that, have some control, and it eliminates the scary a little bit.

It really took hearing my daughter say, “My mommy is a cancer survivor,” to understand that when we say it, it’s power. We’re getting our power back by saying, “I have cancer,” and so is saying, “I’m sick.”

Renee F. and daughter Ava

To miraculously get pregnant just blasted all of my doctors’ minds because they’ve always said this is medically impossible. It’s clinically impossible. Total body radiation for two months. There was no fertility at all.

It’s even more incredible because I had my bone marrow transplant [on] September 17, 2002. Eleven years later, I miraculously got pregnant. My due date for my daughter was September 17, 2013. She arrived early [though].

When did you start to notice something?

When I got diagnosed with breast cancer, it was like a sucker punch, but at the same time, I kind of knew what to do this time.

For the last 20 years, we’ve been monitoring my blood work, focusing on my immune system, my anemia, and kind of touch and go on other things. There’s been lumps and bumps throughout the years, but everything has been biopsied and perfectly fine.

I was doing a regular monthly check and didn’t feel anything different or strange. I was about to get in the shower but I dropped something. When I went to pick it up, I saw my reflection in the mirror and noticed that one of my boobs was shaped [differently] when I leaned over. I thought, That’s strange.

I grabbed another mirror and did a couple of little movements then realized if I put my arm up, this whole breast was a totally different shape. I thought, That’s different , so I noted it.

The following day, [as] I’m getting dressed, I notice there’s a weird dimple in my boob that wasn’t there before. Maybe I gained weight. I weighed myself. A couple of days go by and now [I] notice my nipple is flat but I don’t feel anything. It just looks different on the outside.

I had a routine follow-up appointment with my doctor, the one who told me I was pregnant, and [as] we’re finishing things up, she tells me, “Is there anything else before we leave today?” I walk out and said, “Oh, I forgot to tell you! My boob looks kind of weird.” She goes, “What?” She took a look at it and immediately sent me over to get a mammogram.

Renee F. breast self-exam

When we got to the appointment and my doctor walked in, she didn’t have to say anything. She just started crying.

Renee F. in the hospital

In the middle of getting the mammogram, the nurse left the room, came back, and said, “All right, you need to get dressed. We need to go to a different room because we need to do a biopsy.” I was like, “What? Right now?” She’s like, “Yeah, right now.”

She took me to another room, set me up for a biopsy, did this whole biopsy, called the doctor, and then told me, “I’m going to leave you here because I need to go take your results to the lab. Your doctor wants it stat.”

I’m laying with my arm up on this table for what feels like forever. She comes back, does two more biopsies, marks me up, and then says, “You have an appointment tomorrow with your doctor. You should bring somebody with you.”

My mom came with me. When we got to the appointment and my doctor walked in, she didn’t have to say anything. She just started crying. I was crying and said, “What is it?” She goes, “It’s metastatic breast cancer. It’s stage 2.” I said, “How come I didn’t feel anything?” And she says, “It’s behind the breast tissue. It’s along your rib cage and it goes all the way to the back.”

It was a whirlwind [of] scheduling and trying to figure out what we do now.

Cancer genetic testing as a bone marrow transplant recipient

I had to contact all of my bone marrow transplant doctors and let them know what was going on because it meant that we had to do completely different genetic testing. I’ve had a bone marrow transplant so it was a whole different ball game for me.

When you have a bone marrow transplant, it wipes out your immune system [and] also your blood system. When you have an organ transplant, you have a donor organ being transplanted into your body. Bone marrow is an organ so even though I’m me on the outside, technically, I am my sister.

Because of genetic testing, we’re able to determine whether or not this is a line that carries in our family history and if we need to be concerned for other members [of] the family. When you have somebody else’s bone marrow, I’m technically her makeup even though I have my own genetic makeup.

It sent the scientists on a whirlwind trying to figure out what tests to do on somebody like me where if we do a blood test, it’ll show my sister and what her predisposition conditions could possibly be, not mine.

Luckily, we were able to determine that this breast cancer was not genetically inherited. It was in direct relation to, most likely, the chemical burns, doxorubicin, and total body radiation, which is weirdly comforting in the sense that at least I know it’s not genetic.

It’s a little frustrating to know that this is from what I had to have. If I would have known then what I know now, would I change anything? No, not at all. If I would have known then that I would end up at 35 years old with stage 2 breast cancer, I still would do everything the same.

Renee F. in the hospital

What was the treatment plan?

The plan was to go with chemotherapy and radiation to wipe out the immune system and bone marrow to do a full bone marrow transplant and cross our fingers. The long-term routine was to continually check the blood levels and make sure that everybody is where they’re supposed to be.

Then just managing the chronic issues from the treatments — fibromyalgia, migraines, and things like that — and regular cancer awareness routines, self-checks, and making sure to get my first mammogram at 40, and just stick to that.

When I got diagnosed with breast cancer, it changed everything because I had so much chemotherapy given to me in 2002. There’s only so much your body can have maximum. I’m on eight doses out of ten.

What was really frustrating was that once we found out that it was metastatic breast cancer, I already had a lot of the typical chemotherapy that’s used to treat this type of cancer.

It would be in my best interest to do a different chemotherapy routine, hope that that works, and shelf the remaining doses of doxorubicin, just in case, and just try our luck.

If I would have known then that I would end up at 35 years old with stage 2 breast cancer, I still would do everything the same.

How did you process this diagnosis compared to your first?

I think I processed this one better because I was awake. When I was going through leukemia, I was so sick, medicated, and comatose so I really don’t remember a lot.

I’m thankful because we kept daily logs of what was going on and I can look back. Thank goodness I don’t remember because I don’t want to.

Walking into treatment brought back flashbacks that I was not expecting to have and moments that I was not prepared to cope with. I think it made it hard for my family to embrace the situation because I did keep a lot of things internally.

You have these emotional breaks where you’re just a wreck and people don’t know how to cope with that. They don’t know how to comfort somebody. “Oh, you’re going to get better. You’re going to be fine.” Not really helping.

Tell me I can be angry. Tell me it’s okay to be upset. Then tell me I’m strong. I got through yesterday. Remind me of another time when it was really tough and I got through that. Because no matter how hard this might be, even if I’m on the floor in the fetal position, feeling desperate and clinging to life, I’m still clinging to life and that is to be celebrated, that is to be focused on.

Renee F. stronger than you think

Tell me I can be angry. Tell me it’s okay to be upset. Then tell me I’m strong… No matter how hard this might be, even if I’m on the floor in the fetal position, feeling desperate and clinging to life, I’m still clinging to life and that is to be celebrated.

Renee F. and daughter Ava

Breaking the news to my daughter

Having my five-year-old and facing the biggest fear that I had being a parent — what do I do if this comes back? — I had to embrace it as best as I could and explain it to my kid without terrifying her.

I was teaching preschool and told her, “When you make artwork and you add glue, paint, and glitter to things, sometimes it gets really messy. You can’t go over and erase glue and glitter. Sometimes, you have to just start over. If you look at people, we’re made of glue and glitter. Sometimes things get a little messy and that’s why there [are] doctors. They come in, erase the board, and clean it up so that you have a new space to create something new. And that’s basically what mom’s going through.”

I had a unilateral mastectomy so it means that I had just one breast removed, mostly because we needed to hurry up and get started on treatment.

Renee F. and daughter Ava

Side effects from treatment

Hugging my daughter was different. It changed. Those were things that I wasn’t really expecting to deal with.

Hair loss? I knew that was coming so I wasn’t going to sit around and wait for my hair to fall out. I started cutting it and then we shaved my head.

Renee F. and daughter Ava

My daughter and I got henna tattoos. I got one on my head and continued to get henna tattoos because, from my previous experience, wigs were not comfortable for me. I didn’t like the feeling and it was hard to wear my masks.

Renee F. head henna tattoo

What did you learn from going through leukemia that helped you?

As far as being prepared and using some of what I have learned from leukemia to help me with breast cancer, it was the hair, the food train, and financial resources. But the emotional stuff, I was not prepared for.

It took me a long time to realize that a lot of the things that I was doing in [the] clinic were from [my experience with] leukemia, like instantly asking for a warm blanket. That solidifies that I’m really here. This is really happening. I know my way around. This warm blanket brings me some comfort because I know what to ask for. In the cafeteria, I also know to ask for vanilla ice cream instead of applesauce.

Sometimes you need to have a moment with nature to remember [that] you’re just this small little stardust in this great, huge world. There’s surviving and thriving all around you.

What helped you process your breast cancer diagnosis?

Mindfulness practice is huge. I didn’t realize how. I’m an Aquarius so I love water and anything related to water, but I didn’t realize how much that impacts your emotional wellness and stabilizes some of these things.

When I was going through leukemia, I would listen to [the] sounds of the ocean. I’m locked in this room. I can’t leave. I’m bedridden.

My mom would fill the basin with ice-cold water, rocks, and shells that I had from my collection, and she’d swoosh it back and forth for me. I just closed my eyes, put my hands in the basin, feel the waves, trance out, and go where it doesn’t matter.

It’s still something I practice. It’s still something that I hold on to. I have a fountain in my yard. I love the rain because it’s just so beautiful.

Renee F. near the beach

I went surfing for the first time and in an instant of wiping out and bleeding in the ocean, I realized my cancer doesn’t matter. Cancer doesn’t matter [at] this moment. If a shark really wanted to eat me, he’d eat me. He doesn’t care if I have cancer.

The moment that I realized that there is peace [in] being in nature was the moment that I realized that I see hearts in clouds. I see hearts in leaves. I see hearts in rocks. I see hearts constantly in nature. I feel like it’s some type of validation or affirmation. You’re part of this, too. Keep growing. Keep being in this moment.

When you’re submersed in nature and captivated [by] the mystical beauty of it, you start to forget your problems and then you start to breathe. It feels so invigorating, [like] that feeling after a good workout.

Renee F. with family

Due to the timing, with my history and everything, we had to do surgery right away to eliminate the problem as much as we could physically and then attack it with medicine. We rushed in and did a unilateral mastectomy and removed the entire left breast and my lymph nodes on the left arm.

As soon as I recovered from that, I started chemotherapy again. I was on Taxotere and Cytoxan. I had to do home injections as well so it was paired with chemotherapy. That was for about six months.

I had six rounds total of chemo then I had targeted radiation to the chest and parts of my arm. I had about 25 sessions of radiation and then started the process of healing.

In 2020, we did a scan to check everything. There [were] markers in the right breast, but the findings weren’t as aggressive as what we discovered in the left breast. When we did that scan, it revealed that I actually now would also need my thyroid removed. There [were] tumors there as well. It was just safer to remove the entire thyroid and not leave parts of it.

I had chemo and radiation again, a ton of surgery, only to find out that we were going to go take something else. And that was in the middle of the pandemic, too, so it was terrifying.

They removed the thyroid. I’ve had no problem since then and I’ve been on this long-term hormone, anti-cancer regimen for the last couple of years and I’m on it for a few more years. I think I get off in 2024.

Renee F. in hospital bed

[In] April [2022], I was finally stable enough, health-wise, to have a finalized mastectomy and DIEP flap reconstructive surgery. Because of all my radiation and how much they had to remove from the chest wall, implants were not an option for me.

DIEP flap surgery is grafting different parts of either your back or your abdomen to make boobies. They were able to graft my abdomen, move it all up, and do a full reconstructive surgery.

The right side gave me a ton of problems and I’ve had a bunch of complications since then — necrosis and staph infections. I’m still bandaged [after eight months], but I’m getting there. I’m almost done healing and I have a normal-ish-looking body again. I don’t have to wear a prosthetic breast anymore, which was a whole lane to walk down, too.

At this point, things are stagnant and that’s a good thing. My health is stable. The treatments are working. My blood looks great. Still anemic like usual, but everybody’s acting right.

I don’t consider myself cancer-free. I consider myself a survivor but more than anything, I consider myself a thriver.

Renee F. cancer-free written on sand

How do you feel knowing that everything is good and stable?

To be honest, mixed feelings because it’s this basket of hope, like, “Yehey! I get to get on with my life again, move on, figure out what life is like with my stomach is my boobs now, and rebuild [and] re-plan my goals.”

But on the other side, it’s, “All right. Is this the calm before the storm? What’s next? If we’ve removed parts that I can function life without, what do you come for next?”

I don’t consider myself cancer-free. I consider myself a survivor but more than anything, I consider myself a thriver and that’s where I associate myself with my health and [the] long term.

Renee F. and daughter Ava

Words of advice

Don’t stop dreaming. I know it sounds so cliché. Make that vision board. If you focus on living in all ways, then you remove the stress, fear, and worry.

I have plenty of days where [I’m] down and mopey and all I can do is sit on the couch. But I know that there will be a day [when] I have energy and I’m out there, living, touching, tasting different things, and feeling the world. It’s okay to have both days.

Just because you’ve been diagnosed with cancer doesn’t mean it’s over. It’s not over yet. You’re not dead yet. When it gets too much and nature doesn’t work or listening to music doesn’t work or talking to somebody doesn’t work, my best advice is [to] go clean something.

Organize something. Accomplish a small, achievable task. You can polish it up. You can reorganize it. You will take pride in that. Then all of a sudden, dopamine and serotonin and all these things start running through you because you achieved.

I have never been good with body image and loving myself the way that I look and who I am in my skin until I got breast cancer. Then I started really, really loving the fact that I heal really [well] from things that try to destroy me.

When I get caught up and it really takes a toll on my emotions or my finances, I have to remember how much I heal. I have to touch my scars and remind myself: we rebuilt. Sometimes you need to touch your scars to remind yourself that you’re still here and you’re a freaking badass.

Renee F. Project Athena

If you focus on living in all ways, then you remove the stress, fear, and worry.

Renée was 18 when she started noticing bruises but she was on the cheerleading and dance teams so she just associated the bruising with those. After she had her wisdom teeth removed, her health rapidly declined, prompting her mom to bring her to the hospital. She shares her story of how her cancer journey began.

Read Renée’s acute myeloid leukemia story here »

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Metastatic Breast Cancer Stories

Sherrie shares her stage 4 metastatic breast cancer story

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Stage 2 Breast Cancer Diagnosis, Treatment, and Survival Rate

Survival rate for women with stage 2 breast cancer is around 93% with treatment

  • Survival Rates

Follow-Up Care

Stage 2 breast cancer survival rates are high and with the right treatment, the outlook is very good. Stage 2 breast cancer means your tumor is at least 1 centimeter (cm) in size and has spread to lymph nodes.

Treatment of stage 2 breast cancer usually includes surgery (either a lumpectomy or mastectomy), and adjuvant chemotherapy (therapy after the initial treatment) is often recommended. Radiation therapy is needed after a lumpectomy, but may or may not be needed after a mastectomy.

This article discusses the diagnosis and treatment of stage 2 breast cancer. It also looks at survival rates for people who are diagnosed at this stage.

Stage 2 breast cancer is considered invasive, meaning that cancer cells have broken out of the ducts or lobules of the breast. This is not the same as metastatic (stage 4) breast cancer. It means that abnormal cells have passed through a thin layer of tissue called the basement membrane and have the potential to spread.

Breast Cancer Treatment Options

Cancers are scored and divided into stages by the TNM system . Stage 2 cancer can be either 2A or 2B.

In this system:

  • T stands for tumor size:  In stage 2, the T score can range from 0 to 3. T0 means that a tumor cannot be detected in the breast. T1 includes tumors that have a diameter of 2 cm or less (an inch or less). T2 includes tumors that are between 2 and 5 cm in diameter. T3 includes tumors larger than 5 cm in diameter.
  • N stands for lymph node involvement:  Stage 2 can be either 0 or 1. N0 (N-zero) would mean that cancer has not spread to any lymph nodes. N1mi describes cancers that have spread to lymph nodes but the spread can only be detected microscopically ( micrometastases ). N1 is used to describe tumors that have spread to at least one lymph node near the tumor.
  • M stands for metastasis:  All stage 2 cancer is M0, meaning no metastases are present.

Your treatment can include a combination of approaches. Treatment options include:

Local Treatments

Surgical choices will include a lumpectomy or a mastectomy. If you opt for a mastectomy, it will also be important to consider the pros and cons of having a single vs. a double mastectomy .

Radiation therapy may be used after a lumpectomy to mitigate the risk of cancer cells recurring in the same breast or nearby lymph nodes. If radiation is recommended, that will affect the timing of any breast reconstruction that you may have.

After a mastectomy, an oncologist may determine that radiation is necessary if the tumor was larger than 5 cm, if there was lymph node involvement, or if cancer was found outside of surgical margins.

Systemic Treatments (Adjuvant)

These therapies will affect your whole body and will help prevent a recurrence. Depending on your age, general health, hormone receptor status, lymph node involvement, and HER2 testing results, you may be given:

  • Chemotherapy
  • Hormonal therapy including either tamoxifen or an aromatase inhibitor
  • A HER2-targeted therapy such as Herceptin

With triple-negative breast cancer, immunotherapy can sometimes be part of systemic therapy. The drug Lynparza (olaparib), a PARP inhibitor, is now being used as part of systemic therapy to treat early-stage and metastatic HER2-negative breast cancer with a BRCA1 or BRCA2 mutation that has previously been treated with chemotherapy—either before or after surgery.

Neoadjuvant Treatment

Your oncologist may suggest systemic treatments before surgery to shrink the tumor. When this approach is successful, the smaller tumor can be removed and local treatment may be given if needed.

Some tumors don't respond well to pre-treatment; when that happens, a mastectomy will be necessary. You may then consider breast reconstruction .

You may spend three to 18 months or longer in the active treatment of stage 2 breast cancer. It may range from surgery and six weeks of radiation to a full array of chemo, radiation, and biologic therapies.

If the tumor is estrogen receptor-positive, hormone therapy is usually prescribed for five to 10 years. For those who are postmenopausal, bisphosphonate therapy may be recommended as well to reduce the risk of recurrence. If the cancer is HER2-positive, targeted therapy is often used prior to surgery.

Survival Rates for Stage 2 Breast Cancer

Stage 2 breast cancer survival rates are high, but it is important to understand that the rates are not a direct indication of how long you will live following the diagnosis and treatment of breast cancer. Rather, rates reflect how many people on average will be expected to survive for a given period of time.

The five-year survival rate for stage 2 breast cancer is 93% for women who have completed treatment. Women with stage 3 cancer have a five-year survival rate of 75%.

Treatments continue to improve over time, so you may have a longer-term estimated survival if you are newly diagnosed.

Is Stage 2 Breast Cancer Curable?

Stage 2 breast cancer is curable with the right treatment. Although recurrence is possible, the chances can be reduced with radiation treatment and appropriate follow-up care.

After your treatment is completed, you will have a five-year minimum follow-up period with your oncologist; check-ups will take place every three then every six months.

During this time, you may need to take hormone therapy if your tumor was hormone-sensitive. Sometimes hormone therapy is recommended beyond five years for those with estrogen receptor-positive tumors.

If your tumor is estrogen-receptor positive, your oncologist may also recommend that you use bisphosphonate therapy if you are postmenopausal. Bisphosphonates are medications that are used for the treatment of osteoporosis, and they also may help reduce the chance that breast cancer will spread to bones (the most common site of metastases).

What are the chances of breast cancer recurrence after treatment for stage 2 breast cancer?

For women diagnosed with stage 2 breast cancer, the 15-year rate of local recurrence is about 16%.

Distant recurrence in those who had a mastectomy is most influenced by axillary lymph node involvement. When axillary lymph nodes are not cancerous, the recurrence rate is 6% in five years. When axillary lymph nodes are cancerous, the recurrence rate is 23% in five years with mastectomy but no radiation.

Unlike some cancers, routine scans are not usually done after primary treatment for stage 2 breast cancer has been completed. The reason for this, even though recurrence is a possibility, is that finding a recurrence early (before symptoms appear) does not improve survival. For those who have finished treatment, it's important to be familiar with the potential signs and symptoms of a recurrence and to contact your healthcare provider with any concerns.

After five years, you may only need to see your oncologist annually, but these visits most often continue throughout your life. Check-ups are important to make sure that recovery is going smoothly and that treatment for recurrence won't be needed. 

Breast Cancer Healthcare Provider Discussion Guide

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If you've been recently diagnosed with stage 2 breast cancer, you may feel overwhelmed.

There is a multitude of resources for receiving support and learning more about your diagnosis. Ask for help and reach out to your loved ones. Consider becoming involved in one of the active breast cancer support groups or support communities available.

Most importantly, learn how to be your own advocate in your cancer care . Cancer treatments are changing rapidly, and it's important to understand the options available so you can be an active member of your cancer treatment team.

If you've been diagnosed with stage 2 breast cancer, the outlook is very good. You are more likely to have chemotherapy and/or radiation therapy than if your tumor was stage 1, but these tumors are still very treatable.

If your cancer is successfully treated, you will need follow-up care, which includes treatment that decreases the chances of a cancer recurrence. 

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Hagan TL, Medberry E. Patient Education vs. Patient Experiences of Self-advocacy: Changing the Discourse to Support Cancer Survivors .  J Cancer Educ . 2016;31(2):375–381. doi:10.1007/s13187-015-0828-x

Scharl A, Kühn T, Papathemelis T, Salterberg A. The right treatment for the right patient - Personalised treatment of breast cancer .  Geburtshilfe Frauenheilkd . 2015;75(7):683–691. doi:10.1055/s-0035-1546270

National Cancer Institute (US). Breast Cancer Treatment (Adult) (PDQ®) . PDQ Cancer Information Summaries [Internet].

By Lynne Eldridge, MD  Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."

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Stage 2 (II) And Stage 2A (IIA) Breast Cancer Overview

stage 2 breast cancer journey

Last updated on Jan 17, 2024

What Does It Mean To Have Stage 2 Breast Cancer?

Stage 2 means the breast cancer is growing, but it is still contained in the breast or growth has only extended to the nearby lymph nodes.

This stage is divided into groups: Stage 2A and Stage 2B. The difference is determined by the size of the  tumor  and whether the breast cancer has spread to the lymph nodes.

For Stage 2 breast cancer, chemotherapy is usually done first, followed by surgery and radiation therapy.

stage 2 breast cancer journey

Stage IIA Breast Cancer Means One Of The Following Descriptions Applies.

stage 2 breast cancer journey

No actual tumor is associated with the cancerous cells and less than four axillary lymph nodes have cancer cells present.

The tumor is less than 2 centimeters and less than four axillary lymph nodes have cancer cells present.

The tumor is between 2 and 5 centimeters and has not yet spread to the lymph nodes.

Stage IIB Breast Cancer Means One Of The Following Descriptions Applies.

The tumor is between the 2 and 5 centimeters and has spread to less than four axillary lymph nodes.

The tumor is larger than five centimeters, but has not spread to any axillary lymph nodes.

stage 2 breast cancer journey

Related reading:

  • Stage 0 Breast Cancer Overview
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  • Stage 3 (III) A, B, And C Breast Cancer Overview

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Breast cancer patient experiences through a journey map: A qualitative study

Laura ciria-suarez.

1 Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain

Paula Jiménez-Fonseca

2 Medical Oncology Department Hospital Universitario Central of Asturias, Oviedo, Spain

María Palacín-Lois

3 Social Psychology and Quantitative Psychology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain

Mónica Antoñanzas-Basa

4 Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain

Ana Fernández-Montes

5 Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain

Aranzazu Manzano-Fernández

Beatriz castelo.

6 Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain

Elena Asensio-Martínez

7 Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain

Susana Hernando-Polo

8 Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain

Caterina Calderon

Associated data.

Relevant anonymized data excerpts from the transcripts are in the main body of the manuscript. They are supported by the supplementary documentation at 10.1371/journal.pone.0244355 .

Breast cancer is one of the most prevalent diseases in women. Prevention and treatments have lowered mortality; nevertheless, the impact of the diagnosis and treatment continue to impact all aspects of patients’ lives (physical, emotional, cognitive, social, and spiritual).

This study seeks to explore the experiences of the different stages women with breast cancer go through by means of a patient journey.

This is a qualitative study in which 21 women with breast cancer or survivors were interviewed. Participants were recruited at 9 large hospitals in Spain and intentional sampling methods were applied. Data were collected using a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data were processed by adopting a thematic analysis approach.

The diagnosis and treatment of breast cancer entails a radical change in patients’ day-to-day that linger in the mid-term. Seven stages have been defined that correspond to the different medical processes: diagnosis/unmasking stage, surgery/cleaning out, chemotherapy/loss of identity, radiotherapy/transition to normality, follow-up care/the “new” day-to-day, relapse/starting over, and metastatic/time-limited chronic breast cancer. The most relevant aspects of each are highlighted, as are the various cross-sectional aspects that manifest throughout the entire patient journey.


Comprehending patients’ experiences in depth facilitates the detection of situations of risk and helps to identify key moments when more precise information should be offered. Similarly, preparing the women for the process they must confront and for the sequelae of medical treatments would contribute to decreasing their uncertainty and concern, and to improving their quality-of-life.


Breast cancer is the most common cancer and the one that associates the highest mortality rates among Spanish women, with 32,953 new cases estimated to be diagnosed in Spain in 2020 [ 1 ]. Thanks to early diagnosis and therapeutic advances, survival has increased in recent years [ 2 ]. The 5-year survival rate is currently around 85% [ 3 , 4 ].

Though high, this survival rate is achieved at the expense of multiple treatment modalities, such as surgery, chemotherapy, radiotherapy, and hormone therapy, the side effects and sequelae of which can interfere with quality-of-life [ 5 ]. Added to this is the uncertainty surrounding prognosis; likewise, life or existential crises are not uncommon, requiring great effort to adjust and adapt [ 6 ]. This will not only affect the patient psychologically, but will also impact their ability to tolerate treatment and their socio-affective relations [ 7 ].

Several medical tests are performed (ultrasound, mammography, biopsy, CT, etc.) to determine tumor characteristics and extension, and establish prognosis [ 8 ]. Once diagnosed, numerous treatment options exist. Surgery is the treatment of choice for non-advanced breast cancer; chemotherapy, radiotherapy, and hormone therapy are adjuvant treatments with consolidated benefit in diminishing the risk of relapse and improving long-term survival [ 9 ]. Breast cancer treatments prompt changes in a person’s physical appearance, sexuality, and fertility that interfere with their identity, attractiveness, self-esteem, social relationships, and sexual functioning [ 10 ]. Patients also report more fatigue and sleep disturbances [ 11 ]. Treatment side effects, together with prognostic uncertainty cause the woman to suffer negative experiences, such as stress in significant relationships, and emotions, like anxiety, sadness, guilt, and/or fear of death with negative consequences on breast cancer patients’ quality-of-life [ 10 , 12 ]. Once treatment is completed, patients need time to recover their activity, as they report decreased bodily and mental function [ 13 ], fear of relapse [ 14 ], and changes in employment status [ 15 ]. After a time, there is a risk of recurrence influenced by prognostic factors, such as nodal involvement, size, histological grade, hormone receptor status, and treatment of the primary tumor [ 16 ]. Thirty percent (30%) of patients with early breast cancer eventually go on to develop metastases [ 17 ]. There is currently no curative treatment for patients with metastatic breast cancer; consequently, the main objectives are to prolong survival, enhance or maintain quality-of-life, and control symptoms [ 17 , 18 ]. In metastatic stages, women and their families are not only living with uncertainty about the future, the threat of death, and burden of treatment, but also dealing with the existential, social, emotional, and psychological difficulties their situation entails [ 18 , 19 ].

Supporting and accompanying breast cancer patients throughout this process requires a deep understanding of their experiences. To describe the patient’s experiences, including thoughts, emotions, feelings, worries, and concerns, the phrase “patient voice” has been used, which is becoming increasingly common in healthcare [ 20 ]. Insight into this “voice” allows us to delve deeper into the physical, emotional, cognitive, social, and spiritual effects of the patient’s life. This narrative can be portrayed as a “cancer journey", an experiential map of patients’ passage through the different stages of the disease [ 21 ] that captures the path from prevention to early diagnosis, acute care, remission, rehabilitation, possible recurrence, and terminal stages when the disease is incurable and progresses [ 22 ]. The term ‘patient journey’ has been used extensively in the literature [ 23 – 25 ] and is often synonymous with ‘patient pathway’ [ 26 ]. Richter et al. [ 26 ] state that there is no common definition, albeit in some instances the ‘patient journey’ comprises the core concept of the care pathway with greater focus on the individual and their perspective (needs and preferences) and including mechanisms of engagement and empowerment.

While the patient’s role in the course of the disease and in medical decision making is gaining interest, little research has focused on patient experiences [ 27 , 28 ]. Patient-centered care is an essential component of quality care that seeks to improve responsiveness to patients’ needs, values, and predilections and to enhance psychosocial outcomes, such as anxiety, depression, unmet support needs, and quality of life [ 29 ]. Qualitative studies are becoming more and more germane to grasp specific aspects of breast cancer, such as communication [ 27 , 30 ], body image and sexuality [ 31 , 32 ], motherhood [ 33 ], social support [ 34 ], survivors’ reintegration into daily life [ 13 , 15 ], or care for women with incurable, progressive cancer [ 17 ]. Nevertheless, few published studies address the experience of women with breast cancer from diagnosis to follow-up. These include a clinical pathway approach in the United Kingdom in the early 21st century [ 35 ], a breast cancer patient journey in Singapore [ 25 ], a netnography of breast cancer patients in a French specialized forum [ 28 ], a meta-synthesis of Australian women living with breast cancer [ 36 ], and a systematic review blending qualitative studies of the narratives of breast cancer patients from 30 countries [ 37 ]. Sanson-Fisher et al. [ 29 ] concluded that previously published studies had examined limited segments of patients’ experiences of cancer care and emphasized the importance of focusing more on their experiences across multiple components and throughout the continuum of care. Therefore, the aim of this study is to depict the experiences of Spanish breast cancer patients in their journey through all stages of the disease. To the best of our knowledge, there are no studies that examine the experience of women with breast cancer in Spain from diagnosis through treatment to follow-up of survivors and those who suffer a relapse or incurable disease presented as a journey map.

A map of the breast cancer patient’s journey will enable healthcare professionals to learn first-hand about their patients’ personal experiences and needs at each stage of the disease, improve communication and doctor-patient rapport, thereby creating a better, more person-centered environment. Importantly, understanding the transitional phases and having a holistic perspective will allow for a more holistic view of the person. Furthermore, information about the journey can aid in shifting the focus of health care toward those activities most valued by the patient [ 38 ]. This is a valuable and efficient contribution to the relationship between the system, medical team, and patients, as well as to providing resources dedicated to the patient’s needs at any given time, thus improving their quality of life and involving them in all decisions.

Study design and data collection

We conducted a qualitative study to explore the pathway of standard care for women with breast cancer and to develop a schematic map of their journey based on their experiences. A detailed description of the methodology is reported in the published protocol “Ascertaining breast cancer patient experiences through a journey map: A qualitative study protocol” [ 39 ].

An interview guide was created based on breast cancer literature and adapted with the collaboration of two medical oncologists, three nurses (an oncology nurse from the day hospital, a case manager nurse who liaises with the different services and is the ‘named’ point of contact for breast cancer patients for their journey throughout their treatment, and a nurse in charge of explaining postoperative care and treatment), and two psycho-oncologists. The interview covered four main areas. First, sociodemographic and medical information. Second, daily activities, family, and support network. Third, participants were asked about their overall perception of breast cancer and their coping mechanisms. Finally, physical, emotional, cognitive, spiritual, and medical aspects related to diagnosis, treatment, and side effects were probed. Additionally, patients were encouraged to express their thoughts should they want to expand on the subject.

The study was carried out at nine large hospitals located in six geographical areas of Spain. To evaluate the interview process, a pilot test was performed. Interviews were conducted using the interview guide by the principal investigator who had previous experience in qualitative research. Due to the Covid-19 pandemic, all interviews were completed online and video recorded with the consent of the study participants for subsequent transcription. Relevant notes were taken during the interview to document key issues and observations.

Participant selection and recruitment

Inclusion criteria were being female, over 18 years of age, having a diagnosis of histologically-confirmed adenocarcinoma of the breast, and good mental status. To ascertain the reality of women with breast cancer, most of the patients recruited (80%) had been diagnosed in the past 5 years. Patients (20%) were added who had been diagnosed more than 5 years earlier, with the aim of improving the perspective and ascertaining their experience after 5 years.

Medical oncologists and nurses working at the centers helped identify patients who met the inclusion criteria. Participants went to the sites for follow-up between December 2019 and January 2021. Eligible women were informed of the study and invited to participate during an in-person visit by these healthcare professionals. Those who showed interest gave permission to share their contact information (e-mail or telephone number) with the principal investigator, who was the person who conducted all interviews. The principal investigator contacted these women, giving them a more detailed explanation of the study and clarifying any doubts they may have. If the woman agreed to participate, an appointment was made for a videoconference.

A total of 21 women agreed to participate voluntarily in this research. With the objective of accessing several experiences and bolstering the transferability of the findings, selection was controlled with respect to subjects’ stage of cancer, guaranteeing that there would be a proportional number of women with cancer in all stages, as well as with relapses.

Data analysis

The data underwent qualitative content analysis. To assure trustworthiness, analyses were based on the system put forth by Graneheim, and Lundman [ 40 ]. Interviews were transcribed and divided into different content areas; units of meaning were obtained and introduced into each content area; meaning codes were extracted and added; codes were categorized in terms of differences and similarities, and themes were created to link underlying meanings in the categories. All members of the research team (core team, two medical oncologists, three nurses and two psycho-oncologists) reviewed the data and triangulated the outcomes between two sources of data: qualitative data from the interview and non-modifiable information, such as sociodemographic (i.e., age, marital status, having children) and clinical (i.e., cancer stage and surgery type) data. Following this process, we reached saturation of the interview data by the time we had completed 21 interviews.

Ethical considerations

This study was performed in accordance with the ethical standards of the Declaration of Helsinki, and its subsequent amendments. The study was approved by the Research Ethics Committee of University of Barcelona (Institutional Review Board: IRB00003099) and supported by the Bioethics Group of the Spanish Society of Medical Oncology (SEOM) 2018 grant. All participants received a written informed consent form that they signed prior to commencing with the interviews and after receiving information about the study.

Patient baseline characteristics

In total, 21 women with a mean age of 47 years (range, 34 to 61) were interviewed. Most of the study population was married (66.7%), had a college education (66.7%), and had 2 or more children (42.9%). All cancer stages were represented, up to 23.8% tumor recurrence, and most of the primary cancers had been resected (95.2%) (see Table 1 ).

Description of the breast cancer patient journey

The women diagnosed with breast cancer describe the journey as a process tremendously affected by the different medical stages. Each stage has its own characteristics that condition the experiences, unleashing specific physical, emotional, cognitive, and social processes. Additionally, the patients perceive this entire process as pre-established journey they must undertake to save their life, with its protocols based on the type and stage of cancer.

“ People said to me , ‘What do you think ? ’ and I answered that there was nothing for me to think about because everything is done , I have to go on the journey and follow it and wait to see how it goes” (Patient 6)

Fig 1 displays the various phases of the journey that patients with breast cancer go through; nevertheless, each woman will go through some or others, depending on their type of cancer.

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Throughout the entire patient journey

Processes of loss and reinterpretation of the new circumstance . What stands out the most in the process these women go through during the diagnosis and treatment of breast cancer is loss; specifically, the loss of health and a reinterpretation of the new circumstance and the new bodily reality. In the most extreme cases, the loss of health emerges with the fear of death that many women report at the time of diagnosis or during treatment, due to the distress generated. The loss of identity seems to be related to the evolutionary (existential) moment in which the woman is; there are patients who report feelings of disability or loss of attractiveness, or fear of not being able to get pregnant in the future, especially the youngest.

I felt a terrifying fear and thought , “You have cancer you tell yourself , you’re going to die tomorrow .” (Patient 6) I feel like after the hysterectomy , as a woman , I no longer have anything , only the physical . Sure , I look great , but I tell myself that it’s just a shell , the shell I inhabit , because as a woman , I only have one breast left . (Patient 6) At that moment , I had to make the decision that I was no longer going to be a mother . (Patient 14)

Personal change . Most of the women report that with the diagnosis of breast cancer, their life stands still and from that point forward, a different journey begins. The sole focus on this journey is the disease and its implications. During all those months, the patients stop working; they focus on their medical treatments, and reflect a lot on their current situation and on life. Most of the participants state, especially those who have already been discharged, that they know themselves better now; they take better care of themselves, and they enjoy their day-to-day and the small moments more, making the most of their time, with more initiatives and fewer trivial complaints.

Clearly , you’re not the same person you were before; I don’t think she’ll ever come back; your mindset changes completely and I have sequelae from all the treatments . (Patient 1) I re-think wasting energy on lost causes; what’s more , I’ve also learnt to say no . If I’m not in the mood to go somewhere , I just say no . (Patient 7) I take much more advantage of the present now , because you realize that things can change on any given day . (Patient 3)

Trust and appreciation for their physician . Most of the interviewees stated that they fully trusted the doctors who care for them, without question or objection to the treatments proposed. They reported that, as they go forward, they discuss the tests and treatments that are going to be performed, as well as possible side effects. Several stated that they are unaware of the stage of their cancer; similarly, most also do not know the benefits expressed in X% of the treatments. A few of the participants claimed that they did talk in detail about the different types of treatments with their oncologists, that they had sought another opinion, and one of them even reported having decided to stop chemotherapy, which was very hard for her, given her physician’s insistence that she continue.

The truth is that the oncologist didn’t say much about percentages; what she told me were the steps that I had to take; I thoroughly trusted her and she gave me a lot of peace of mind . (Patient 5) I told him , “I’m going to do whatever you tell me to . ” It never occurred to me to dispute whatever the oncologist might tell me . I was willing to do whatever was needed . (Patient 8)

Most of the women, at some point during the interview, state that they are grateful for the care they received and that, within the seriousness of their situation, there is a treatment for their condition.

I am super grateful for the treatment I’ve received and with the doctors assigned to me . (Patient 2) I’m very lucky; I’m only on my second line of treatment for metastasis and I’ve got a lot more ahead of me , but I consider myself lucky and I believe things are going very well . (Patient 20)

Role of the woman . We can see that the women adopt a role of care-givers and managers of their surroundings. They worry about the disease negatively affecting the people around them, which is why they make an effort to manage the family’s activity for when they can’t do it and they try to avoid being a physical burden or cause emotional distress to the people around them.

I was very strong ; I made everything easy for people , but making it very easy , doesn’t mean that it was easy for me , but that I made it easy for everyone . (Patient 8) I didn’t want to worry anyone because that’s just the way I am , I push forward and that’s that . (Patient 5)

Support network . In all cases, the family appears to be one of the elements that is most involved in the disease process. Within the family, the partner deserves special mention. The testimonies in this regard reveal a wide spectrum of possibilities that range from the feeling of having had great support to a lack of attention and understanding that, in many situations, causes the relationship to be strained or to end. Friends tend to appear more occasionally.

I can’t complain about my husband; he was up to the challenge , very attentive toward me and he fully understood how I was feeling ; I felt very supported . (Patient 14) We’ve had a period of a lot of arguing; I’ve had to sit down with him and tell him that life had changed for me . (Patient 18) I had a partner I had lived with for five and a half years and he told me , literally , that he looked at me like a little sister , no longer as a woman , and he left me , and that hurt me tremendously . (Patient 6)

On the other hand, many patients commented on the importance of social media, where they have met people in the same situation as them. They report feeling understood and in good company; likewise, they commented on the importance of being able to share their doubts and get to know about other experiences.

It’s a situation that only someone who has gone through can understand; you can have all the good intentions in the world , but if you haven’t gone through it , you can’t even begin to understand . (Patient 8)

Use of complementary treatments . Most patients follow conventional medical treatment. However, many resort to other disciplines that help them improve their quality-of-life, like dietary changes, getting more exercise than usual, visits to a psychologist or physical therapist, or using other integrative therapies, such as acupuncture, yoga, reiki, flowers of Bach, homeopathy, cannabis, or meditation.

I started to read a whole bunch of books to see what I could do to take care of myself in terms of nutrition and exercise ; you consider everything you can do . (Patient 5)


This phase encompasses the time from when the woman detects some symptom or goes to a check-up until the medical diagnosis is made. For the woman, this is a time of a series of tests and results. We have observed that the procedures, especially the healthcare professionals that deal with the patients, and the timing vary, depending on the medical center where they are being cared for. Emotionally, this is one of the most complicated stages.

Emotional whirlwind . The wait to obtain test results has a huge emotional impact for the women, given that it is a time of great uncertainty and fear.

An entire month with all the anguish of finding out if you have something . (Patient 3) The worst part is waiting 15 days to find out the magnitude of the tragedy , if it’s throughout your entire body or only in your breast; you go through a brutal emotional whirlwind; the wait is horrible because there’s nothing else you can do , so that anguish that you carry inside is dreadful; it was hell for me . (Patient 10)

Additionally, the interviewees described many other emotions that included fear of death, fear of having no time, feeling of unreality, rage, anger, sadness, avoidance, denial…

The first thing I thought was that I was going to die and that I wouldn’t finish watching my children [grow up]; my father had died of lung cancer 25 years ago . (Patient 9) My only aim was to get back to normal , as if there were nothing wrong . (Patient 4) You have a lot of conflicting feelings; you wish this weren’t happening; you want to run away , but you say , “Where am I going to run to ? ” . (Patient 14)

Impact of medical communication . Several women comment that, when given the diagnosis, they dissociate because of the emotional impact and that they don’t listen to all the information that the medical professional is giving them.

I remember that she talked and talked , but I didn’t know what she was saying until she said , “Isabel , you’re going to be cured , okay ?”. (Patient 9)

During the diagnostic testing, the women are highly sensitive to the healthcare professionals’ words and gestures.

I looked at the face of the person who was doing the mammogram and that’s when I started to imagine the worst . (Patient 20) I say to them , “ But , is there a solution to this ? ” , and they say to me , “Don’t worry , I’m sure there is a solution . ” That “sure” is etched in my mind . (Patient 10)

Communication and managing their surroundings . After the diagnosis, the patients feel that they have to tell the people around them about their situation, especially those closest to them, the family. They all agree on how hard it is to share. Normally, the people it’s hardest to tell are their mother and their children. When they do, they try to put the most positive spin on it possible, in an attempt to keep them from worrying.

You no longer think only about yourself , you think , “Good grief , now I’ve got to tell my mother .” It’s hard . (Patient 16) I wanted to tell my kids the way I say things , always trying to look for the upside , and positive , although it was hard , but , anyway , in the end , it went well . When I finished , my husband told me , “You’ve convinced me that it’s no big deal .” (Patient 9) I told my son , “Son , don’t cry , your mom’s going to get over this , this is nothing .” (Patient 1)

During this period, the women contemplate how their situation will affect their surroundings and they try to organize it as much as possible.

I devoted myself to planning everything , to organizing what to do with my daughter , and to thinking about work , too , how I had left things at work . (Patient 4)

Surgery/cleaning out the cancer

Uncertainty and fear . The participants express that before going into surgery, they are told about the kind of procedure that will be done, but that, depending on what they find and the analysis, it may change. In light of this, they exhibit an enormous feeling of uncertainty and fear. In addition, many voice concern about how the surgery will go.

They tell you conservative surgery , but if we open up and see something we didn’t see on the tests , then everything could change . (Patient 10) Aside from the anesthesia , that I’m terrified of , you spend several hours in surgery and you don’t really know how things will go; when they clean it out , they analyze it , and you go into the operating room and you don’t know what can happen . (Patient 9)

Feeling of loss . Considering that the breast is associated with an intimate, feminine part [of their body], many women experience the operation as a loss. This loss is more acute if the operation is a mastectomy and there is no reconstruction at the same time. The loss also involves a loss of identity, compounded by the side effects of chemotherapy, such as hair loss. The interviewees who had undergone mastectomy say that following surgery, when the bandaging is removed and the scar is revealed, is one of the most critical moments, which is why they express difficulty in managing it and appreciate the caring assistance from the professionals.

It is identification with yourself , you know , it’s what you’ve seen in the mirror , what you think you’re like and , suddenly , you’re no longer like that; there’s an incredible personal crisis because you no longer recognize what you’re seeing . (Patient 11) I closed my eyes and I removed the bandaging and I didn’t dare look … with my eyes , I imagined the worst . (Patient 12)

Acceptance or demand for more aggressive intervention . The patients perceive the surgery as essential to recovering their health, which is why the process is widely accepted. Some patients who demand a more invasive intervention, normally a bilateral mastectomy, do so because that way, they feel safer with respect to a possible relapse, as well as more comfortable esthetically.

If they have to remove my breast , let them take it; what I want is to get better . (Patient 16) They say that I am in full remission , so they only removed the lump , but at first , I said that I wanted my whole [breast] removed ; then they assessed how to do it . (Patient 13) They told me that I had a genetic mutation and more possibilities of developing breast cancer and , since I felt such rejection toward my remaining breast , I decided to get rid of that one , too . (Patient 20)

Chemotherapy/loss of identity

The chemotherapy phase is one of the phases that affects the women’s lives the most, because of its physical impact and how long it lasts. No differences have been found in how they experience chemotherapy depending on whether it was neoadjuvant or adjuvant.

Negative impact of side effects . Chemotherapy is associated with many side effects that vary from one woman to another. Many indicate that they have suffered physical discomfort, such as fatigue, dysgeusia, pain, nausea and vomiting, mucositis, diarrhea, etc.

One day when I didn’t want to go to bed , I went to bed crying because I had the feeling that I wasn’t going to wake up . That day it was because I felt awful . (Patient 1)

Furthermore, all of the women suffer hair loss, which is one of the most-feared effects. Likewise, their body hair also falls out, especially on their face, and their weight fluctuates. All of these changes lead to a loss of identity that is experienced as taking away from their femininity. It must be remembered that oftentimes, chemotherapy is administered after surgery, further exacerbating this physical change. On top of all that, several women comment having to decide at the beginning of treatment whether to freeze their eggs or not; at that moment, many of them forfeit the possibility of becoming a mother or of becoming a mother again, which also adds to this loss of femininity.

Losing my hair was hard , but when it grew out again , I had an identity crisis . I didn’t recognize myself; people said I was really pretty like that , with my hair so short . I looked at myself in the mirror and I said that I’m not that woman , I can see that that woman is pretty , but it’s just that I don’t recognize myself . That’s not me or , it was like , I looked at myself and I didn’t recognize myself . That’s when I suffered a serious identity crisis , psychologically serious , but also serious because I sobbed because I looked at myself , but it wasn’t me . (Patient 6) Where’s that sexy lady , where is she ?, because you don’t feel good . I didn’t like myself at all . I was several sizes larger and I looked at myself and said , “What a monster . ” I didn’t feel good about myself . (Patient 1)

Many patients say that chemotherapy decreases their libido and dries up their mucous membranes, which is why they prefer not to have sex. For those who live as a couple, this situation can strain the relationship.

Sexually , I just didn’t feel like it , I wasn’t in the mood; not only did I not feel like it , my mucous membranes were dry and , what’s smore , I just couldn’t , I couldn’t , I felt bad for my husband , but he said , “Don’t worry .” (Patient 16)

Finally, some interviewees expressed a feeling of being poisoned by the treatment. These women tend to be highly focused on taking care of their body and have a very natural attitude toward life.

I had to really work my awareness that I was poisoning myself; at night I was at home and I thought that all that red liquid was circulating through my veins … I think I even had nightmares . (Patient 4)

Balance between caring for oneself and caring for others . The patients feel that it is time to take care of themselves, so they prioritize resting when they need it. Moreover, they worry about getting a haircut and, most of the times, they look for turbans and wigs. Some also learn how to put on make-up, which they rate as being very positive. On the other hand, those who have children or another person in their care, try to take care of them as much as they are able.

Around 11 : 00 , I no longer felt good , so I’d go to the armchair to rest and it’s like I had an angel , because I’d wake up a minute before I had to set the table and get lunch for my son who would be coming home from school . (Patient 1) While I was getting chemo , I went with the gadget and I told myself , “I’m going to teach you to apply make-up; for instance , your eyelashes are going to fall out . Make a line like this ” and at that moment when you look in the mirror , and we look like Fester in the Addams family . (Patient 13)

Vulnerability . The women experience great uncertainty and feelings of vulnerability the first times they receive chemotherapy, since they don’t know what side effects they will suffer.

With chemo , I started with a lot of fear and , later on , I became familiar with it little by little until the time comes when you go to the hospital like someone who’s going to pick up a bit of paper . (Patient 9)

In addition, those participants who join a social network or who are more closely tied to the hospital setting, know about the relapses and deaths of people around them diagnosed with breast cancer, which makes them feel highly vulnerable.

There are some people who leave the group because … it’s not like there are a lot of relapses and , geez , I think that it messes with your head . (Patient 13) We were almost always the same people at chemotherapy ; there was one guy who was really yellow who looked terrible and , there was one time when we stopped seeing him and another lady asked and the nurse said that he had died . (Patient 15)

At the same time, given the physical changes, especially those that have to do with body hair, many women feel observed when they leave home.

If I have to go out and take off my scarf because I’m hot or go straight out without any scarf on my head and whoever wants to look… let them ; I think that it’s up to us , the patients , to normalize the situation; unfortunately , there are more and more cases . (Patient 9)

Telling the kids . Since when the chemotherapy stage is going to entail many physical changes, the women look for ways to talk to their children about the treatment. Most of them comment that it is a complicated situation and all of them try to talk to their children in such a way as to protect them as much as possible.

I asked the nurse for help before I started chemotherapy to see if she had any pointers about how to talk about this with the kids and she recommended a story , but when I saw it , I didn’t like it … so , in the end , I decided to do it off the cuff . (Patient 10)

Radiotherapy/transition to normality

The “last” treatment . When the patient reaches radiotherapy, normally, they have already spent several months undergoing physically aggressive medical procedures, which is why they feel exhausted. There is a physical exhaustion resulting from the previous treatments and made worse by the radiation therapy. Furthermore, many women also report feeling emotionally drained by the entire process. However, this is generally accompanied by joy and relief because they feel that they are in the final stage of treatment.

Emotionally , it’s a marathon that has to end up at some point . (Patient 10) For me , radiotherapy was like a lull in the battle , with a winning mind-set . (Patient 4)

Comparison with chemotherapy . There is a widespread perception that radiotherapy has fewer side effects than chemotherapy, although later, when they receive it, several patients suffer discomfort, above all fatigue and dizziness. Several report that at this point, they are mentally worn out and just want to be done with the process, which is why they have less information than about chemotherapy.

I feel like radiotherapy is unknown , that you think it’s more “light ” and it turns out not to be so light . (Patient 13)

Follow-up care/the “new” day-to-day

Difficulty in getting back to normal . Once the patients are discharged, many feel that they need some time to recover, that it will be slow, in order to restore a more normalized pace of life. They are still working on their emotional and personal process.

When they tell you that you have cancer , they make it very clear : you have a goal; you have some months of chemo , some months of radio , and when you finish , you say , “And now , what do I do ?”. I say that because now I have to get back to my normal life , but I don’t feel normal . I still don’t feel cured , I’m not 100% . And you’re glad you’ve that you’ve finished it all and you’re alive , but at the same time , you say , “Gosh… this is very odd . ” It was a very strange feeling . (Patient 8)

Most patients report that their quality-of-life has diminished, due to the sequelae from the treatments. Lymphedema is one of the sequelae they name most often, although they also mention other symptoms, like digestive upset, weight issues, eye problems, scar pain, etc. The women who are on hormone therapy also suffer side effects, such as joint and muscle pain.

I have lymphedema and , although I have good mobility , I’m a little bit weak; when I go out for dinner , I generally order fish , because I can’t always cut meat well . (Patient 6)

Several interviewees also express difficulty in their affective-sexual relations. Many of them feel insecure because of all the physical changes; others have sequelae that hinder their relations, and still others are suffering symptoms of early menopause. This can cause problems in the couple and for those who don’t have a partner, suffer many complications when it comes to meeting other people.

I haven’t had sex with my husband for 2 years because , it’s also really complicated to get over; I’ve gone for pelvic physical therapy; I’ve used gels , but nothing works . (Patient 8) It’s taken me many months for me to have a relationship again; it’s been really hard because , even though everyone told me that I looked fine , I didn’t feel fine . My breast cancer had taken away all my attributes as a woman . (Patient 6)

Some women also experience difficulties when it comes to returning to work. Several state that they had been fired when they went back. They also report that when interviewing for a job, it’s complicated for them because they have to explain what happened and they mention the schedule of doctor’s visits that they have. Other women comment that they’ve been given early retirement or disability.

You go to the interview and if you tell them that you’ve had the disease , they look at you like you’re a weirdo . (Patient 13)

Breast reconstruction . How reconstruction is experienced, as well as its timing, are highly contingent upon they type of reconstruction. Each one has its pros and cons, but the opinions collected with respect to the type of reconstruction have been positive.

Although it took 18 months for the entire process to be over , I’m delighted with reconstruction with the expander . (Patient 16)

Some patients state that after the whole process, which has been long and complicated, they prefer not to undergo reconstruction immediately. In these cases, they report having felt a subtle pressure from the outside to undergo reconstruction.

Every time I went for my check-ups , they said , “You’re the only one left [who hasn’t undergone reconstruction]” and in the end , the truth is that I’m really happy because I think I look pretty . (Patient 12)

Check-ups and fear of relapse . Check-ups are one of the times that generate most worry and insecurity. The women remark that, starting a few days before and until they receive the results of the follow-up studies, they are more anxious about the possibility of relapse.

At every check-up my legs start shaking again and my stomach is in knots, although at my last one, everything turned out okay and I’m thrilled. (Patient 6) During the first stage , I did everything I had to do and I got over it , but it’s a lottery . You can do whatever you want , but it’s the luck of the draw and when you start going for check-ups , it’s like going to play Russian roulette . (Patient 8)

Maintenance hormone therapy . Hormone therapy is understood differently depending on age and on the major decision of whether or not to be a mother or to have another child. If the woman does not want to have more children, the treatment is accepted better. The patients who take it also report effects derived from menopause, for instance, joint pain or dry mucous membranes.

I did notice joint pain , but since I exercised , [I felt it] much less than my fellow women , although , for instance , when it comes to getting up from a chair , you get up like an old lady . (Patient 10)

Position of support . Several patients mention that, after discharge, they stay active on social media, they volunteer when they find out about someone or to participate in activities related to breast cancer, with the aim of being able to help other people who are in this situation.

It’s really good to meet other people who are going through the same thing , so , now that I’ve finished , I like it and I always help whenever I can , because I can share what was good for me . (Patient 13)

Relapse/starting over

Emotional impact . The diagnosis of a relapse is experienced much the same as the initial diagnosis. All of the women report fear, although they also state that they are more familiar with the processes. Other emotions emerge, such as why me, blame, disbelief, etc.

Since they had told me that it wasn’t going to happen again , I believed it , of course , I wanted to believe it and it totally surprised me; I couldn’t stop crying and crying . (Patient 17)

Telling the family again . Patients repeat that telling the family about it again, especially the children and parents, is tough and they try to minimize it in an attempt to protect them emotionally.

On the very same day that I had my mammogram , my mother says that she wants to come a see the kids . We’re in the park , when she arrives , I have to tell her that everything’s fine and when we get home , I tell her everything . My mother’s devastated again and I tell her not to worry , that everything is going to be fine . (Patient 16)

Thinking about whether something could have been done differently . Several women comment that, after their relapse, they think about whether the treatment was enough or there must have been something they could have done to avoid the relapse.

You get furious , because you say , “I wasn’t supposed to get sick , because if , 2 years ago when the first microcalcifications appeared I had had them removed , then I wouldn’t have metastasis , or maybe I would . (Patient 19)

Metastatic breast cancer/time-limited chronic

Re-interpreting the concept of metastasis . Most of the participants in this stage state that they have had to give new meaning to the word, “metastasis,” since their first perception was directly related to death. In this way, they come to understand that cancer can become chronic, although they now have to take medication and go to the hospital on a regular basis. Nevertheless, they know that their life expectancy may be a few years. The women who are involved in a group point out how hard it is to see their fellow member pass away.

What I now call my “ new normal” consists of lots of visits to the hospital and never going back to work . (Patient18)

They also state that at this stage, they do not identify with the disease generally known socially as “breast cancer”, where there is great emphasis placed on early detection and on their chances of being cured. This causes them to feel more isolated.

These pink ribbon campaigns hurt us because they tend to underscore that everything is going to turn out fine because breast cancer has a very high cure rate; there is huge lack of awareness . (Patient 20)

Physical and emotional discomfort . Most of the women in this stage report side effects from the treatments, although some comment that good quality-of-life can be preserved. On an emotional level, they say that they sometimes feel a certain agony due to not knowing how much longer the treatment will be effective. They live in a state of uncertainty that they try to cope with by focusing on their day-to-day and experience the good times deeply.

When I’m not in pain , I try not to even remember what I have and go out and have fun with my family and live . (Patient 20)

Several women who have children express with regret that they worry about their children enjoying them and remembering them when they were well. They are sad that they won’t be able to grow up in a normal family. Some also comment the impact this diagnosis is having on their partner.

What I don’t want is for them to carry this baggage of having a sick mother . (Patient 18)

A conflict with disability also appears, as many women report their desire to continue working, but feel that they can’t keep up with the pace of work. Additionally, several state that going through the medical board is a strenuous process, given that they look good physically.

It’s hard to deal with , I’m a non-practicing lawyer and I have degrees galore , but I worked the first year and I couldn’t continue . (Patient 21) Every year they call me again for the disability monitoring and they always threaten me . To be honest , the treatment doesn’t make me sick , but I don’t know how long it’s going to be like this . (Patient 19)

Social invisibility . The participants say that they do not have any physical signs of being ill, that they look fine, although they know and feel that inside, they are not well. They say that it is sometimes hard to manage socially, since on occasion, they feel misunderstood and disparaged.

I’m much sicker now , but people think or want to think that I’m fine . When I was doing chemo , it was like wearing a sign that said “cancer . ” (Patient 17)

This study describes the patient journey of women with breast cancer, specifying the different phases with the most relevant aspects of each, as well as the different cross-sectional features they report throughout the entire treatment process.

The results portray breast cancer as a process in which there is a striking feeling of loss of health and self-identity, changes in routines, personal and employment transformation, as well as emotional hardship during and after breast cancer treatment, aspects that are also reported in the literature [ 41 , 42 ]. Earlier studies state that experiencing cancer is highly stressful. It involves a major threat to life or physical integrity, in addition to mental health, interfering with the path, projects, and plans patients have for their life over the short, medium, and, on occasion, long term as well [ 6 ]. Along with reporting adverse physical and psychological impacts, patients also report positive ways in which they have grown psychologically or emotionally from the experience [ 7 , 42 ]. The diagnosis of breast cancer not only impacts the women individually, but also affects their surroundings. As reported in the literature, despite going through a very challenging time, the women struggle to put on a positive face and attempt to conserve the family’s well-being, specifically that of their children [ 7 ]. At the same time, the family is a fundamental source of support and usually provide indispensable support; however, it is not always effective, because family members do not fully understand the stresses involved in living with cancer [ 43 ]. Previous studies also reveal that for some women, their partners are one of their most significant supports; nonetheless, research also suggests that a cancer diagnosis predicts marital breakup more strongly for female survivors than males [ 44 ]. Our results reflect that the women frequently resort to other women in the same situation, possibly because they face significant unmet supportive care needs [ 30 ]. The need for social support may lead patients to seek social support groups consisting of people who are experiencing similar health crises, because such groups allow them to interact with those who best understand their suffering [ 43 ]. Another aspect that appears across the board is the relationship the participants have with the medical team. In this study, we have noted their trust in the medical team and acceptance of the treatments proposed without going into the clinical data of the disease and without needing to know the benefit provided by the treatment. Cancer patients are confronted with a potentially life-threatening [condition], feeling vulnerable, and need to rely heavily on their care providers, expecting the physician to act in their best interests [ 5 ]. Therefore, they need to have a close relationship, as well as comprehensive care [ 30 ]. Patients’ trust in a physician has been associated with a reduction of their fears and anxiety and [increased] satisfaction and adherence to treatment [ 5 , 30 ]. We believe that it would be important to provide patients with accurate information, so as to avoid misunderstandings (such as cancer being synonymous with death, regardless of stage) as several participants in this study have reported, which can lead them to believe that the risk of relapse with and without chemotherapy is much greater than the oncologists estimate [ 45 ]. We believe that in future studies that it would be worthwhile to examine the peculiarities of each kind of patient information with the aim of determining how to break it up and make it both comprehensible and tolerable to promote patients’ well-being.

A breast cancer diagnosis is generally unexpected and practically all patients suffer psychological distress, such as feelings of uncertainty, disbelief, hopelessness, vulnerability, anger, fear, anxiety, and sadness [ 46 , 47 ]. The literature has reported that many women experience peritraumatic distress or dissociation during the medical conversation in which they are given their diagnosis of cancer [ 48 ], which might account for the reactions of the respondents. Given that, when they receive their diagnosis, additional information is generally given to them, such as clinical aspects and preferred treatments. Repeating this information at subsequent appointments could contribute to improving communication with patient, since several participants stated that they found it hard to pay attention to the physician, given the emotional impact. Additionally, breast cancer patients tend to be diagnosed when they are relatively young, and often when they are in the middle furthering their career or raising children [ 12 ]. In spite of everything, the women try to put on as brave a face as they can and focus on maintaining their children’s well-being [ 7 ]. Telling children about their diagnosis is reportedly one of the biggest challenges; parents are usually unsure of how to tell them, because at the same time that they want it to be open and honest and cover their children’s developmental needs, they also want to protect them children [ 49 ].

Once diagnosed, breast cancer patients go through different treatments. The most salient experiences of these phases pertain to the impact of side effects on physical quality-of-life and psychological well-being, which is consistent with the literature [ 11 ]. Moreover, cancer therapy entails physical changes that affect their feminine identity, fertility, self-esteem, sexual functioning, and makes them more vulnerable [ 10 , 50 ]. Women described their inner self as being on an emotional rollercoaster with highs and lows throughout the various phases of treatment [ 7 ]. Given treatment side effects and sequelae, these women are more likely to experience physical symptoms and psychological disorders than patients with other kinds of tumors [ 51 ]. The side effects involve an acute sense of loss of health and quality-of-life, as well as identity and femininity. It would be interesting for future research to explore the therapies used in grief counseling with cancer patients, as understanding and exploring this perspective could comprise an additional clinical aid.

Once the women have completed their treatments, they gradually get back to normal and many contemplate returning to work. However, in line with our results, the literature reveals that even though they want to normalize their lives, female breast cancer survivors feel that they will never return to their baseline status [ 7 ]. A significant number of patients experience difficulties in physical, cognitive, and emotional functioning after their treatment, such as symptoms like lymphedema, fatigue, pain, sleep disorders, cancer-related cognitive impairment, emotional stress, symptoms of depression and anxiety, problems with relationships, reduced sexual identity, fertility problems, and fear of cancer relapse [ 13 , 14 ]. Furthermore, patients with hormone therapy suffer hot flashes, sweats, joint pain, weight gain, decreased libido, and low energy [ 52 ]. A sizeable number of these women also experience changes in employment status which can happen even 5–10 years following diagnosis [ 15 ]. Given that all these changes alter the structure of the woman’s everyday life, personalized care and treatment plans in cancer survivors are highlighted in the literature with extended specialized support being proposed that enables them to make a better psychosocially adjusted transition from treatment to follow-up [ 53 ] and advocating for the patient’s participation in all decisions that affect her during this period [ 54 ]. Further research is needed concerning how to structure the follow-up and support offered to these women during this stage so as to meet their needs and help them adjust to their new reality with the chronic sequelae caused by cancer and its treatment. On the other hand, the personal transformation of the initial stages of the journey are best seen during this phase. The literature shows that women who have had breast cancer report changes in their philosophy of life, such as embarking on a new life path, changing their priorities in life, as well as valuing life in general [ 42 ]. Most of the participants in our study place special emphasis on appreciating life, enjoying it more, and living each day to the fullest. Cancer survivors report being aware of how precarious life is, while also feeling the joy of being alive [ 55 ]. Similarly, they have been found to be more resilient and better able to repair their mood than healthy women [ 56 ].

About 5% of all patients with breast cancer are diagnosed when the disease is metastatic, whereas some 30% have suffered a relapse of an early breast cancer [ 17 ]. We saw that some women suffering a relapse after initial treatment with curative intent tend to wonder if the treatment was sufficient or if they should have done something more to prevent the relapse. Metastatic breast cancer is uncurable, which is why these women’s main psychosocial challenges are not the same as those who are diagnosed in early stages [ 18 ]. Faced with incurability, the women react with shock and fear of imminent death, but this anxiety diminishes once they begin treatment and learn that there are more treatment options [ 17 ]. During this phase, the interviewees reported impaired physical QoL and functioning, being hindered by pain, fatigue, or menopausal symptoms. Emotionally, they report suffering bouts of depression and anxiety, as well as fear because of the spread of their cancer. As for their relational QoL, their children’s welfare is their number one concern, especially for mothers of young children [ 17 , 57 ]. What’s more, these women felt isolated from society in general and, more specifically, from the non-advanced breast cancer community, inasmuch as they feel that nobody understands what they are going through [ 18 ]. A psychosocial approach is especially important in this phase to help these women to continuously adapt to the changes of their individual clinical situation and to the progression of the disease, thereby improving their coping.

Clinical implications

Having first-person information enables us to comprehend in detail the experiences of breast cancer patients, their situation, and emotional state, which favors holistic cancer care for health professionals.

Healthcare professionals should prepare women for a changed life situation, as well as to face prolonged, multimodal treatment (surgery, chemotherapy, hormone therapy, radiotherapy), and to confront physical and psychological sequelae, as well as the fear surrounding an uncertain prognosis. It is important to help them manage their expectations and fears and, to identify and address the issues and concerns that arise at different time points during treatment. The information and support offered should be adjusted to each woman’s individual needs, her life situation, her coping style, and the time and stage of their cancer. This more empathic, understanding outlook can also contribute to improving the physician-patient rapport, promoting communication, understanding, and shared decision-making.

Finally, a comprehensive understanding of the women’s psychosocial support endorses their belonging to groups of women with breast cancer, in which there is a relationship among equals. Further research is needed to specify the type needed so as to decrease both the impact of the death of women in the group, as well as the vast amount of information that they may end up obtaining, without needing it or requesting it.


This study was performed with Spanish participants, which is why certain aspects cannot reflect the experiences of breast cancer patients from other countries, given the particularities of both the Spanish healthcare system and Spanish culture. Likewise, the data attained were specific to women with breast cancer, which can scarcely be extrapolated to individuals with other cancers. Moreover, the findings do not reflect men’s experiences with breast cancer and research with this group would enrich the field further. In addition, the age of our participants ranged from 34 to 61 years; hence the results should be interpreted for a middle-aged population and do not reflect the experiences of women diagnosed at very early or very old ages. Finally, we believe that there may be a bias regarding the women who agree to participate, as this group has probably accepted their condition more, as well as having worked on it more.

Despite these limitations, we hope that our findings can contribute to better understanding the experiences of women with breast cancer.


The authors are grateful to the investigators of the Neoetic study and the Bioetic Group of the Spanish Society of Medical Oncology (SEOM) for their contribution to this study. We would like to thank all the women who generously shared their experiences with us, the support of HealthyOnco ( ), and Priscilla Chase Duran for editing and translating the manuscript.

Funding Statement

This work was funded by the Spanish Society of Medical Oncology (SEOM) in 2018. The sponsor of this research has not participated in the design of research, in writing the report, or in the decision to submit the article for publication.

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stage 2 breast cancer journey

Stage 2 breast cancer

Stage 2 breast cancer means that the cancer is either in the breast or in the nearby lymph nodes or both. It is an early stage breast cancer.

The stage of a cancer tells you how big it is and how far it has spread. It helps your doctor decide the best treatment for you. There are different systems used in the UK to stage breast cancer. Stage 2 is part of the number staging system. Doctors may also use the TNM staging system.  

Staging for breast cancer is very complex. Many different factors are considered before doctors can confirm your final stage. Speak to your doctor or breast cancer nurse specialist if you have any questions about your staging.

Stage 2 can be divided into 2A and 2B. Below is a simplified description of stage 2A and 2B breast cancer. 

Stage 2A means one of the following:

stage 2 breast cancer journey

  • the cancer is larger than 2 cm but not larger than 5 cm and there is no cancer in the lymph nodes

Stage 2B means one of the following

  • the cancer is larger than 2 cm but not larger than 5 cm and there are small areas of cancer cells in the lymph nodes
  • the cancer is larger than 2 cm but not larger than 5 cm and the cancer has spread to 1 to 3 lymph nodes in the armpit or to the lymph nodes near the breastbone
  • the cancer is larger than 5cm and hasn't spread to the lymph nodes

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour (cancer)
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

In the TNM staging system, stage 2A breast cancer is the same as:

Stage 2B is the same as:

  • Read more about the TNM staging system for breast cancer

The number staging helps your doctor decide which treatment you need. Treatment also depends on:

  • the type of cells the cancer started in
  • whether your cancer cells have receptors for particular cancer drugs
  • the grade of the cancer 
  • other health conditions you may have

Your doctor will take many different factors into account when deciding which treatment is best for you.

Surgery is usually one of the main treatments for stage 2 breast cancer. You may also have drug treatments such as chemotherapy and hormone therapy as a first treatment. This is called neo adjuvant treatment. You then have surgery.   

Your surgeon might remove the cancer and a border of normal breast tissue. This is called breast conserving surgery or a wide local excision. After breast conserving surgery, you might have radiotherapy to the rest of the breast.

Or you might have the whole breast removed. This is called a mastectomy. You can then choose to have a new breast made (breast reconstruction). You might also have radiotherapy to the chest wall after having a mastectomy.

  • Find out more about surgery for breast cancer

Checking the lymph nodes

Before your surgery, you have an ultrasound scan to check the lymph nodes in the armpit (axilla). This is to see if they contain cancer cells. If breast cancer spreads, it usually first spreads to the lymph nodes close to the breast.

Depending on the results of your scan you might have:

  • surgery to remove the lymph nodes under your arm
  • Find out more about surgery to remove the lymph nodes

Other treatments you might have

You usually have other treatments too. These include:

  • hormone therapy
  • chemotherapy
  • targeted cancer drugs 
  • drugs that strengthen the bones called bisphosphonates 
  • Read about the treatment options for breast cancer

Other stages of breast cancer

  • TNM staging

Related links

Breast cancer treatment.

Treatment for breast cancer depends on a number of factors. Find out about breast cancer treatments, where and how you have them, and how to cope with possible side effects.

Tests for breast cancer

You have a number of tests to check for breast cancer. This includes a breast examination, a mammogram, a biopsy and scans. 

TNM staging for breast cancer

The TNM system is a way of staging breast cancer. TNM stands for Tumour, Node, Metastasis.

Surgery for breast cancer

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Understanding a Stage II Breast Cancer Diagnosis

Here's an overview on what you need to know about stages, symptoms, treatment and survival rates for this mid-stage cancer.

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The staging of the cancer is based on several factors, and it helps your medical team advise you about the best course of treatment and provide you with a realistic prognosis, says Dr. Larkin.

Note: Every person and case is different. While this is an overview of stage II breast cancer, it's important to ask your doctor and their team any questions you have about your diagnosis, treatment and aftercare. Your mental health is also especially important during this time. Reach out to your physician for a referral to a licensed mental health professional to help support you if needed.

First, what exactly does stage II mean?

Breast cancer has traditionally been classified in five stages, from 0 to IV, based on how large the tumor is and how far it has spread in the rest of your body. Stage 0 generally means you have noninvasive cancer or pre-cancer that has not moved outside the breast; as you go up the scale, the tumor generally gets larger and the cancer becomes more invasive— all the way to Stage IV, which means the cancer has spread to other parts of the body, such as the liver, bones or brain.

“Breast cancer stages have historically been based on three different factors,” Dr. Larkin. explains. “The first is the size of the tumor, the second is whether or not the tumor has metastasized to any lymph nodes and the third is whether the tumor has spread to any other places in the body, which is known as metastatic breast cancer.” This staging system is known as TNM, for Tumor, Nodes and Metastasis.

Stage II breast cancer is broken down further into stage IIA and IIB, with these criteria:

Stage IIA: • Either there is no tumor found in the breast, or there is a tumor up to 2 cm (about the size of a grape) AND cancer has spread to 1 to 3 lymph nodes

• There is a tumor of 2 to 5 cm (the size of a lime), but the cancer has NOT spread to the lymph nodes

• There is a tumor of 2 to 5 cm, AND cancer has spread to between 1 and 3 lymph nodes

• There is a tumor larger than 5 cm, but cancer has NOT spread to the lymph nodes or reached the chest wall or skin.

What else do I need to know about cancer staging?

The traditional 0-IV staging of breast cancer based on the TNM system, which was developed in the 1940s, gives us lots of helpful information, but it doesn’t tell the entire story. So in 2016, the American Joint Committee on Cancer (AJCC) added new criteria that takes into account the biologic profile of the tumor and considers patterns of recurrence, sensitivities to different treatments and prognoses. Combined with TNM staging, this provides a much more detailed picture of your cancer. “This staging considers all kinds of other things about a tumor,” says Dr. Larkin. “The way I describe it to patients is: Are the cells happy, are they really aggressive-looking or are they somewhere in between? This really helps us look at which therapies the patient may need.”

This more detailed method of staging cancer means there are more nuances to a stage II diagnosis, adds Jessica Maxwell, MD, a surgical oncologist at Nebraska Medicine. “We may now look at something that we would have traditionally called stage II breast cancer, but if it has a favorable biologic profile, it may get downstaged to something that we would have called a stage I breast cancer based on the size. On the other hand, if a cancer that would have been a stage I has a more worrisome biologic profile, it might get upstaged to stage II.”

Biologic factors included in the staging now include:

  • Hormone receptors: The tumor is tested to see if the cells contain proteins that bind to the hormones' estrogen (estrogen-receptors, or ER) or progesterone (progesterone receptors, or PR). If the tumor is ER- or PR-positive, it means it need those hormones to grow; a treatment to block estrogen or progesterone can be helpful in slowing or stopping the growth.
  • HER2 (human epidermal growth factor type 2 receptor): The tumor will also be tested for a protein called HER2, which helps breast cancer cells grow quickly, but also makes them more likely to respond to treatments that target that specific protein.
  • If the tumor does not show signs of ER, PR or HER2, it is called triple negative. If it has all three, it is called triple positive. Those designations will help your team decide on a plan of treatment.

What are the symptoms of stage II breast cancer?

Symptoms of breast cancer can include:

  • Lump in the breast or under the armpit
  • Thickening or swelling of the breast
  • Irritation or dimpling of breast skin
  • Pain in the nipple area or the breast in general
  • Discharge from the nipple (other than breast milk)
  • Any change in shape or size of the breast

But Dr. Larkin points out that in the case of Stage II breast cancer, there may be no symptoms at all — which is why it is so important to get your annual mammogram .

Note: The CDC has a program called the National Breast and Cervical Cancer Early Detection Program , designed to make sure that women who are uninsured, under-insured and low-income get access to screening for breast cancer, as well as diagnostic and treatment help. The program’s interactive map lets you click on your state to get local information.

What are the treatments for stage II breast cancer?

The treatments for stage II cancer depend not only on the tumor size and its biologic markers, but also your age, overall health and personal preferences. “There are usually multiple modalities of treatment — one treatment in and of itself is usually not enough,” says Dr. Maxwell. “The goal of the treatment is to, number one, get rid of the tumor, and number two, prevent it from coming back as much as possible.” The plan will involve some combination of the following:

  • Surgery: The tumor will be removed be either via a lumpectomy (also known as breast-conserving surgery, or BCS, this means the cancer is removed while keeping as much of the remaining breast intact as possible), or a mastectomy (in which the entire breast is removed). “The type of surgery is dependent on a few different things. Number one is the tumor size, but probably more importantly, we consider the tumor size in relation to the patient's breast size,” Dr. Maxell explains. “If someone has a two-centimeter tumor, which is not very big, but she has very small breasts, then she might need a mastectomy , because just taking out the tumor with a lumpectomy would not leave her with a breast that really looks like a breast anymore.” Most surgeries will also remove some or all of the lymph nodes under the armpit on the side of the tumor to determine if the cancer has spread, or to clear out disease if it has indeed spread, she adds.
  • Chemotherapy: This treatment involves a combination of drugs that are administered orally or intravenously to either destroy cancer cells or slow down their growth — you may undergo chemo before surgery to shrink a tumor (known as neoadjuvant chemotherapy) or after surgery. Whereas the type of surgery is generally based on tumor size, medical treatments including chemo are more often based on the biologic profile of the tumor and whether the cancer has spread. “If genomic testing tells us that there's a high likelihood that the tumor is going to come back, then we will recommend chemotherapy for the patient,” Dr. Larkin explains, adding that due to genomic testing, chemotherapies are much more tailored now to the individual tumor.
  • Radiation: This treatment involves using high energy rays to destroy cancer cells. If you had a lumpectomy, radiation may be recommended to make sure no cancer cells linger in the remaining breast tissue. If you had a mastectomy but there were also cancer cells found in your lymph nodes, radiation may also be recommended.
  • Hormone therapy: If your cancer is ER- or PR-positive, your oncologist may recommend hormone therapy to keep the cancer from growing or coming back. Tamoxifen keeps estrogen or progesterone from binding to cancer cells, and is usually taken for 5-10 years after surgery; aromatase inhibitors including Arimidex, Aromasin and Femara, decrease the amount of estrogen in the body.
  • HER2-targeted therapy: Some women with HER2-positive cancer will be treated before and after surgery with drugs that block the signals telling the cancer to grow.
  • Immunotherapy: In certain cases of triple-negative breast cancer, treatment might include an immunotherapy drug called pembrolizumab, both before and after surgery. “Immunotherapy is being aggressively studied and has just recently been approved for treatment of more advanced breast cancers including stage two breast cancers in the right setting,” says Dr. Larkin.

What is the survival rate for stage II breast cancer?

If you are diagnosed with stage II breast cancer, you have an excellent chance of being cured and living a long and healthy life. According to the Susan G. Komen Foundation , the five-year survival rate for stage II is 90-99%.

“I always tell patients that there are certain things that we have to do to get the cancer treated. but overall, the goal for treatment for stage II breast cancer is to be disease-free and to live a long and healthy life afterwards — and there is a very excellent chance that that can happen,” says Dr. Maxwell.

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Marisa Cohen is an editor in the Hearst Lifestyle Group’s Health Newsroom, who has covered health, nutrition, parenting and culture for dozens of magazines and websites over the past two decades.

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Finding Hope and Healing: Mindy’s Journey Through Breast Cancer

Meet Mindy, an emotional contributor at Learn Look Locate, who bravely shares her breast cancer journey to inspire and support others. Diagnosed with triple positive stage 2 invasive ductal carcinoma at 29, Mindy turned her battle into a beacon of hope for many facing similar challenges. Join us as we delve into her story, filled with resilience, healing, the pursuit of joy after cancer, and connecting survivors worldwide.

The Diagnosis That Changed Everything

I was diagnosed in early 2016 with breast cancer (triple positive stage 2 invasive ductal carcinoma), already in one lymph node at diagnosis. I was 29 and a competitive runner at the time.

Relating with those around me suddenly became out of reach. Many friends were getting married and having babies, yet there I was in treatment for cancer, the visions my then-fiancé (now husband) and I had for our future blurred beyond recognition.

Navigating Life’s Unexpected Turns

So I began to carve out this little space where I have been sharing my story and my reflections for a number of years now!

As difficult as it can be to revisit these difficult life events, I’ve found writing helps me to process and let my emotions flow through, out, and around instead of pooling in my heart.

Life Beyond Cancer

I no longer have cancer, as far as we know. I completed my 5 years of post-active treatment endocrine therapies in 2021 and my husband and I are hopeful to be able to begin our family soon, but in the meantime, we have loved growing and nurturing the many sweet little babes on our farm here in Missouri!

Professional Journey and Passion

I am a speech-language pathologist and I am in my 12th year of practice.

My passion to continue to share my story to the newly diagnosed and those who will be diagnosed in 2 days, 2 weeks, or 2 years—the men and women who find themselves dramatically removed from the lives they know, thrust into the frightening and often isolating world of cancer and it’s after-effects.

A Space of Comfort and Understanding with Learn Look Locate

In her cherished space, Mindy dreams of creating a soft landing for those affected by breast cancer. Through Learn Look Locate, she extends her reach, embodying the power of shared experiences and the beauty of connection. Check out letters from Mindy as she shares about her journey in details. Mindy’s journey is a testament to the strength found in vulnerability and the healing power of community.

Thank you for being here, in a space where every story matters, and every voice brings us closer to understanding, healing, and hope.

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Breast Cancer Stages and Staging

Breast cancer stage.

Breast cancer stage describes the extent of the cancer within your body. 

The stage of your breast cancer helps plan your treatment.

Breast cancer stage is the most important factor for prognosis (chance of survival). In general, the earlier the stage, the better the prognosis will be.

Breast cancer staging

Pathologic staging is the standard way to stage breast cancer. It’s based on a pathologist’s study of the tumor tissue and any lymph nodes removed during surgery.

Clinical staging includes results from a health care provider’s physical exam, tests and/or imaging, such as mammography. Sometimes, these findings may add to the pathologist’s findings and may help with staging.

TNM system of staging

The main method of pathologic staging for breast cancer is the TNM system.

TNM stands for:

  • T = T umor size
  • N = Lymph N ode status (the number and location of lymph nodes with cancer)
  • M = M etastases (whether or not the cancer has spread to other parts of the body)

A “p” before the T or N shows these are pathology findings from the tumor or lymph nodes removed during surgery.

In the past, tumor stage was classified using only the 3 TNM measures. Starting in 2018, the TNM system added these measures:

  • Tumor grade
  • Estrogen receptor status
  • Progesterone receptor status
  • HER2 status

Learn more about tumor size (T) and staging .

Learn more about lymph node status (N) and staging .

Learn more about metastases (M) and staging .

Why were new measures added to the staging system?

The new measures give information on the biology of the tumor that affects prognosis. Adding these measures improved staging.

For example, with breast cancer, a large tumor may have a better prognosis than a small tumor based on biological measures. In the same way, a small tumor may have a worse prognosis than a large tumor based on these measures.

What if I was diagnosed with breast cancer before 2018?

If you were diagnosed before 2018, your breast cancer was staged a bit differently than it would be today.

Find information on breast cancer staging before 2018 .

Neoadjuvant therapy and breast cancer staging

Neoadjuvant therapy is treatment, such as chemotherapy , HER2-targeted therapy , hormone therapy or immunotherapy , given before surgery . If you will get neoadjuvant therapy, your breast cancer will be staged differently from someone who has surgery as their first treatment.

Neoadjuvant therapy can shrink tumors in the breast and lymph nodes, changing the original tumor size and lymph node status. So, your breast cancer is staged using information from physical exams, imaging and biopsies done before neoadjuvant therapy, rather than information from the tumor removed during surgery.

The stages shown in the table below are only used to classify breast cancers in people who have surgery as their first treatment.

If you will get neoadjuvant therapy, talk with your health care provider about how your breast cancer will be staged.

Learn about information on a pathology report for people who get neoadjuvant therapy .

Stages of breast cancer

The stages of breast cancer range from 0 to IV (0 to 4).

The highest stage (stage IV) is any breast cancer with metastases (M1), no matter the size of the tumor, the lymph node status or other factors. This is known as metastatic breast cancer and is the most advanced stage of disease. 

Most often, the higher the stage of the cancer, the poorer the prognosis (chance of survival) will be.

The table below lists the TNM classifications for each stage of breast cancer for people who have surgery as their first treatment.

The following is a 3D interactive model showing the stages of breast cancer from 0 to IV. Click the arrows to move through the model to learn more about breast cancer .

Oncotype DX ® and breast cancer stage

Oncotype DX is part of staging for some estrogen receptor-positive , lymph node-negative early breast cancers.

Learn more about Oncotype DX .

Updated 12/21/23



Breast Cancer Prognosis


Interactive Learning

Breast Cancer 101 – Types and Staging

Patient Stories

Surviving and thriving after her2-positive breast cancer.

Jill Schiaparelli is the CEO of a successful healthcare start-up company. Between her work and her family, she is always on the go. Early one morning as she prepared to leave for a business trip in late 2018, she discovered a lump in her breast while showering. 

stage 2 breast cancer journey

She immediately knew that something was wrong. Less than 48 hours later, she had scheduled a diagnostic mammogram appointment at the breast imaging center located on the UC Health West Chester Campus, which then led to an ultrasound and a needle biopsy all in one day.

The HER2-Positive Breast Cancer Treatment Journey

Doctors diagnosed Jill with HER2-positive breast cancer , which is a breast cancer that tests positive for the human epidermal growth factor receptor 2 (HER2) protein.

“It's a really aggressive cancer, and I was diagnosed at stage 3,” she says.

Since her diagnosis, Jill has received 18 chemotherapy treatments, a mastectomy, 30 radiation treatments, breast reconstruction surgery and several other surgical procedures. Despite a very challenging treatment journey, she continued to live her life as best she could–managing her business and taking care of her teenage children.

“I was determined that cancer would not stop me, and I certainly would not let it define me,” Jill states. “Being active and having a positive attitude was a very important part of that. My treatment was extremely successful, and I was declared cancer-free, but I still have lingering effects from treatment.” Jill adds. “You are forever changed by cancer and the journey doesn’t end when treatment is over. I wanted to ensure that I was doing everything that I could to ensure a long, happy and healthy future.”

stage 2 breast cancer journey

Enhancing Life After Cancer with the Cancer Survivorship Program

For Jill, that is where the University of Cincinnati Cancer Center Cancer Survivorship and Supportive Services Program became an indispensable resource for her—providing personalized care that encompassed evidence-based interventions, disease surveillance, healthy lifestyle promotion and support and resources for family and caregivers.

As the largest survivorship program in the region, it offers more than 20 types of services and therapies as well as the region’s first oncology primary care clinic—designed to provide primary care services specifically focused on the needs of adults with a history of cancer.

Melissa Erickson, MD, UC Health primary care physician, medical director for the University of Cincinnati Cancer Center Cancer Survivorship Program and adjunct assistant professor in the Department of Family and Community Medicine at UC College of Medicine, says cancer patients have many side effects related to their illness and treatments.

“The survivorship program was created to improve quality of life and promote overall health and wellness by addressing treatment-related side effects such as fatigue, pain and mental health concerns,” Dr. Erickson explains.

“Patients who participate in these services say that they finally feel heard. They no longer have to suffer in silence or just be grateful that they survived their cancer,” Dr. Erickson says. “They appreciate that someone is specifically addressing these needs and working with them to develop a plan. It aids in their recovery by improving quality of life and increasing the likelihood of adhering to cancer surveillance and/or long-term cancer treatment.”

Jill has taken advantage of several survivorship offerings, including the Cancer Exercise Wellness Program offered within the Daniel Drake Center’s Outpatient Rehabilitation at the UC Health West Chester Campus.

Personalized training and exercise routines for cancer survivors are delivered by a multidisciplinary team of exercise physiologists, respiratory therapists, nurses and physicians. With their help, Jill has adopted an exercise and weightlifting routine that helps with core strengthening and conditioning of her arms, which were hard to lift above her head after reconstruction surgery.

“When you are recovering from treatment–radiation, chemotherapy or surgery–you feel unsure about how to get back to normal movements and exercising,” Jill says. “I had surgical scars on many areas on my body and I didn’t know what I could and could not do. It makes me feel much more comfortable working with therapists who are trained in cancer recovery and who can offer personalized therapies to address my specific needs.”

“Treatment for our patients is never cookie-cutter,” Chad Balilo, manager for Cardiac, Pulmonary, Cancer and Vascular Rehabilitation and Wellness at Daniel Drake Center for Post-Acute Care says. “Each person is unique, from diagnosis to recovery.  We assess the multiple needs of each patient carefully as we deliver an individualized, evidence-based solution. Cancer exercise is not as prevalent a topic as exercise science is for heart disease. Providing patients, caregivers and the community with encouragement, education and other resources can help make the benefits of exercise more well known.”

stage 2 breast cancer journey

Expanding Exercise and Wellness to Cancer Patients During Treatment

The University of Cincinnati Cancer Center has a pilot program underway to bring exercise to chemotherapy infusion suites—a clinical model to provide earlier exercise intervention during the patient’s cancer journey. Because fatigue affects patients both during and after treatment, the goal is to expand this service to reach more patients and dispel the myth that patients cannot exercise during treatment.

Discover More

To receive the name of a breast cancer specialist at the UC Health West Chester Campus, please call 513-298-DOCS (3627). 

At UC Health, we lead the region in scientific discoveries and embrace a spirit of purpose – offering our patients and their families something beyond everyday healthcare. At UC Health, we offer hope.

For more information, call:


Breast cancer patient experiences through a journey map: A qualitative study


  • 1 Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
  • 2 Medical Oncology Department Hospital Universitario Central of Asturias, Oviedo, Spain.
  • 3 Social Psychology and Quantitative Psychology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
  • 4 Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain.
  • 5 Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
  • 6 Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain.
  • 7 Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain.
  • 8 Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
  • PMID: 34550996
  • PMCID: PMC8457460
  • DOI: 10.1371/journal.pone.0257680

Background: Breast cancer is one of the most prevalent diseases in women. Prevention and treatments have lowered mortality; nevertheless, the impact of the diagnosis and treatment continue to impact all aspects of patients' lives (physical, emotional, cognitive, social, and spiritual).

Objective: This study seeks to explore the experiences of the different stages women with breast cancer go through by means of a patient journey.

Methods: This is a qualitative study in which 21 women with breast cancer or survivors were interviewed. Participants were recruited at 9 large hospitals in Spain and intentional sampling methods were applied. Data were collected using a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data were processed by adopting a thematic analysis approach.

Results: The diagnosis and treatment of breast cancer entails a radical change in patients' day-to-day that linger in the mid-term. Seven stages have been defined that correspond to the different medical processes: diagnosis/unmasking stage, surgery/cleaning out, chemotherapy/loss of identity, radiotherapy/transition to normality, follow-up care/the "new" day-to-day, relapse/starting over, and metastatic/time-limited chronic breast cancer. The most relevant aspects of each are highlighted, as are the various cross-sectional aspects that manifest throughout the entire patient journey.

Conclusions: Comprehending patients' experiences in depth facilitates the detection of situations of risk and helps to identify key moments when more precise information should be offered. Similarly, preparing the women for the process they must confront and for the sequelae of medical treatments would contribute to decreasing their uncertainty and concern, and to improving their quality-of-life.

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  • Research Support, Non-U.S. Gov't
  • Breast Neoplasms*
  • Cross-Sectional Studies
  • Neoplasm Recurrence, Local
  • Qualitative Research

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Personal Story: Jennifer

At a glance.

Meet Jennifer, who was first diagnosed with breast cancer at age 27. She advocated for herself to get the best care when her cancer came back 4 years later.


Jennifer's story

We decided to do everything that we could. I just wanted my life to keep going. Jennifer

I was first diagnosed with breast cancer at age 27 after noticing a lump in my breast. When my cancer unexpectedly came back 4 years later, I advocated for myself to get the best care.

Speaking up for the right care

I knew breast cancer ran in my family and paid attention to my body. Because of this, when I noticed changes in my body, I didn't let fear stop me from talking to my doctors.

Years after my cancer treatment, I found another lump in my breast that I asked my doctor about. Although he was not concerned, I insisted on getting a scan, which ultimately found cancer a second time.

Standing up for myself helped me get the care I needed.

My Motivated Moment: Jennifer‎

A second diagnosis.

Having already removed my breasts and undergone treatment, my second breast cancer diagnosis came as a shock.

Through this difficult experience, I focused on appreciating each day. I set a goal for myself—to study for my state's bar exam—and passed my exam 5 weeks after completing treatment.

A strong husband-wife team

My husband, Jay, stood by my side through both cancer diagnoses. He encouraged me to talk to my doctor after I found the lumps. And, together, we discussed our options for having children with a fertility specialist.

I am grateful for Jay's support. Now more than ever, we celebrate being a team, including as parents.

My Motivated Moment: Jay‎

Bring your brave.

The Bring Your Brave campaign provides information about breast cancer to women younger than age 45 by sharing real stories.

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Olivia Munn Says She Documented Cancer Journey to Show Son She 'Fought to Be Here'

The actress was diagnosed with breast cancer last year.

Olivia Munn needed only one reason to document her challenging cancer battle: to show her 2-year-old son, Malcolm, that she "fought" for her life.

The actress, who shares her son with John Mulaney , spoke about her breast cancer diagnosis during a Good Morning America sitdown with anchor Michael Strahan recently. Around the 2-minute mark of the video below, Munn shared her biggest reason for documenting the journey via Instagram.

"Well, because if I didn’t make it, I wanted my son, when he got older, to know that I fought to be here. That I tried my best," Munn said. "You want the people in your life–you want the people that maybe don't understand what's going on right to know that you did everything you could to be here."

Earlier in the interview, Munn said that Malcolm was the first person she thought of upon hearing about her diagnosis. "I mean, honestly, I just thought of my baby," Munn said. "You know, cancer is the...that's the word you don't wanna hear. There's a lot of other things that you feel like you can beat. But you know, cancer takes down a lot of people. And I just thought about my baby."

stage 2 breast cancer journey

View this video on YouTube

EXCLUSIVE: Olivia Munn speaks out to @michaelstrahan about her private cancer battle, fertility and what's next for her and her family: “Cancer takes down a lot of people ... and I just thought about my baby.” — Good Morning America (@GMA) May 16, 2024

Munn received her diagnosis last April, when the actress discovered that she had developed stage 1 aggressive Luminal B breast cancer in both breasts. 30 days after the diagnosis, Munn underwent a double mastectomy, followed by a hysterectomy and oophorectomy, in which her uterus, fallopian tubes and ovaries were removed. Munn's latest treatment occurred last month, and throughout her health ordeal, it was Malcolm's presence that helped her further seek treatment.

"Whenever Malcolm would come into the home, he'd run straight to my bed because that's where he knows I am, like, that's what he associated with me," she said. "And that was just too difficult for me to take. I had to find out if there was another option. So I opted to do the hysterectomy with the oophorectomy. And almost immediately after that, my energy just came back full force."

In an Instagram carousel in March, where she revealed her breast cancer diagnosis, Munn wrote that she didn't feel like "there was time to cry."

“In the past ten months I have had four surgeries, so many days spent in bed I can’t even count and have learned more about cancer, cancer treatment and hormones than I ever could have imagined,” she explained in the camption. “Surprisingly, I’ve only cried twice. I guess I haven’t felt like there was time to cry. My focus narrowed and I tabled any emotions that I felt would interfere with my ability to stay clear-headed.”

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Olivia Munn reveals heartbreaking reason she documented her breast cancer journey

  • Oops! Something went wrong. Please try again later. More content below

Two months after opening up about her breast cancer diagnosis, actress Olivia Munn is sharing even more about her journey.

“Privately, people are battling things that you would never know,” Munn told Good Morning America’s Michael Strahan after getting cancer treatment for 10 months.

As Munn shared in a lengthy Instagram post in March, her breast cancer diagnosis came as a shock. As she explained in the post and in her interview with Strahan, just months before being diagnosed with cancer, her yearly mammogram and ultrasound were clear.

And the genetic testing she underwent with her sister also came back normal.

Munn says she never would have known she had breast cancer if it wasn’t for her OBGYN, Dr. Thaïs Aliabadi, who made the decision to “calculate my Breast Cancer Risk Assessment Score.”

Her score of 37.3% put Munn in the high-risk category, and she was instructed to get an MRI. It was the results of that MRI that revealed she had cancer.

“I just thought of my baby,” Munn said, referring to her young son, Malcolm, who she shares with her partner, comedian John Mulaney. “You know, cancer; that’s the word you don’t want to hear.”

Munn’s specific diagnosis was Stage 1 aggressive Luminal B breast cancer in both breasts. Her team of doctors told her that if she was “extremely aggressive” with her treatment, she “could fight this and win.”

“But at the same time, once they started finding all of these little spots in my breast, like ‘Oh, there’s another tumor, there’s another tumor.’ There was such an urgency to it because we had to get in and make some really big decisions.”

Thirty days after receiving her diagnosis, Munn underwent a double mastectomy.

Despite going through treatment privately, Munn admitted she initially made the decision to documented her cancer battle for her son.

“Because if I didn’t make it, I wanted my son when he got older to know that I fought to be here. That I tried my best,” she explained. “You want the people in your life, you want that people that maybe don’t understand what is going on right now to know that you did everything you could to be here.”

View this post on Instagram A post shared by o l i v i a (@oliviamunn)

The hormone suppression therapy Munn underwent put her into medically included menopause, GMA reports. As a result, Munn also underwent an egg retrieval prior to have the option to grow her and Mulaney’s family.

The decision to do so was a gamble as the type of cancer Munn was battling fed off of hormones.

“I’m not going to ask for too much more in this life, I promise. I just want one more baby.”

The egg retrieval was successful, Munn shared. They now have two healthy embryos.

“The hormone suppression therapy was brutal,” she explained, leaving her so exhausted she barely had any quality of life. As a result, she opted for a full hysterectomy and ovariectomy instead of continuing with hormone suppression therapy.

Now, Munn is preparing to continue her treatment with a drug designed to “stop her body from producing cancer-growing hormones elsewhere in the body.”

The actress admitted that while she knows she will continue to be aggressive in her fight, she spoke candidly about how exhausting it has all become. “These drugs are so tiring. … It feels nonstop because it is nonstop.”

In the end, Munn said she learned she’s “a lot braver than I thought I was.” She adds that “the most important thing in my life is my family. Everything else can go away.”

Olivia Munn shares she had double mastectomy. Here are other stars who had the surgery

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Olivia Munn Underwent Hysterectomy After Breast Cancer Diagnosis

By Ernie Mundell HealthDay Reporter

stage 2 breast cancer journey

MONDAY, May 13, 2024 (HealthDay News) -- Actress and "X-men" star Olivia Munn has revealed that she underwent egg retrieval and then a hysterectomy after being diagnosed with breast cancer.

In an article published on Mother's Day, Munn told Vogue she opted for hysterectomy because it allowed her to avoid using an estrogen-suppressing cancer drug called Lupron, which left her drained of energy.

Munn, 43, said she made the decision for Malcolm, her 2-year old son with her husband, the actor and comedian John Mulaney.

“It was a big decision to make, but it was the best decision for me because I needed to be present for my family," Munn said. "I had friends try to cheer me up by saying, ‘Malcolm’s not going to remember this. Don’t worry.’"

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stage 2 breast cancer journey

"But I just kept thinking to myself, ‘I’m going to remember this, that I missed all these things,’” she added. “It’s his childhood, but it’s my motherhood, and I don’t want to miss any of these parts if I don’t have to.”

A surprise diagnosis

Munn first announced her diagnosis of breast cancer in an Instagram post on March 14.

Beside a photo of herself in a hospital bed, Munn wrote, “I was diagnosed with breast cancer. I hope by sharing this it will help others find comfort, inspiration and support on their own journey.”

In the post, she explained that in February of last year, she and her sister Sara both decided to undergo testing that looked for 90 different cancer genes.

“I tested negative for all, including BRCA [the most well-known breast cancer gene]. My sister Sara had just tested negative as well,” Munn, 43, wrote. “We called each other and high-fived over the phone. That same winter I also had a normal mammogram. Two months later, I was diagnosed with breast cancer .”

It's been a tough road since then, Munn continued, with four surgeries conducted over the past 10 months, including a double mastectomy one month after her biopsy.

Munn says she's also spent time learning "more about cancer, cancer treatment and hormones than I ever could have imagined.”

She said that her diagnosis came about after her ob-gyn suggested that she have her “Breast Cancer Risk Assessment Score" assessed. The score includes factors such as age, family breast cancer history and history of childbirth.

"Because of that score I went to get an MRI, which led to an ultrasound, which then led to a biopsy,” Munn said. “The biopsy showed I had Luminal B cancer in both breasts. Luminal B is an aggressive, fast-moving cancer.”

According to the Breast Cancer Foundation Susan G. Komen , "women with luminal B tumors are often diagnosed at a younger age."

The tumors comprise about 15% to 20% of breast cancers, but "women with luminal B tumors tend to have fairly high survival rates," the organization noted.

Munn said she feels “lucky” because “we caught it with enough time that I had options."

"I want the same for any woman who might have to face this one day,” she wrote. “Ask your doctor to calculate your Breast Cancer Risk Assessment Score.”


Part of her cancer treatment involved taking the estrogen-suppressing drug Lupron, but Munn said it left her totally exhausted.

“The side effects of the medication hit me almost immediately,” she told Vogue . “It was next-level, debilitating exhaustion. I would wake up in the morning and almost immediately need to get back into bed.”

Doctors offered hysterectomy as an alternative treatment to Lupron.

So, last month, Munn said she underwent operations to take out "my uterus, fallopian tubes and ovaries."

Of course, doing so eliminates the possibility that she can carry future children. But she and Mulaney had undergone several rounds of egg retrieval prior to the hysterectomy.

“After my diagnosis, we decided to try one more round of egg retrievals and hoped it was a good month," she said. "John and I talked about it a lot and we don’t feel like we’re done growing our family, but didn’t know if I would have to do chemotherapy or radiation,” which could affect her ability to get pregnant. 

Munn's doctor soon called to tell her that she and Mulaney had two healthy embryos.

“John and I just started crying. It was just so exciting because not only did we get it in one retrieval, but it also meant that I didn’t have to keep putting myself at risk. It was just amazing,” Munn said.

“This journey has made me realize how grateful I am to have options for not only fighting cancer, but also having more children if we want, because I know a lot of people don’t have those options,” she added.

More information

Find out more about luminal B breast tumors at the Mayo Clinic.

SOURCES: Olivia Munn, Instagram; Breast Cancer Foundation Susan G. Komen; Vogue

Copyright © 2024 HealthDay . All rights reserved.

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