After Heather Cramer had breast cancer at age 34 and underwent treatment, she learned she was cancer free. She devoted herself to regular exercise and eating healthy so that she could enjoy life. But last year she found out she had breast cancer again. This time it was triple negative, an aggressive form of cancer, and it had spread throughout her body, which meant it was metastatic.
“It’s scary,” said the 41-year-old from Maria Stein, Ohio, TODAY. “It’s a tough road. I know they are trying to say that breast cancer is more of a chronic disease, but it’s hard to see it that way. “
The mother of three, wife and school treasurer makes the most of each day and shares her story to encourage others to see a doctor when something is wrong.
“Make sure you get checked out,” she said. “If people feel they have a problem, see a doctor right away.”
Breastfeeding shows something wrong
After breastfeeding, her youngest son Cramer, then 34, did a breast self-exam and noticed that her left breast wasn’t feeling right. When she went for her follow-up in October, she mentioned it to the doctor and asked for a mammogram. Her mother had a benign cyst removed from her breast when she was 34, and Cramer suspected she was experiencing the same thing.
“He found a place he was worried about, so he wanted them to do a mammogram on that area,” she said. “It was like a 50% chance it was cancer.”
Further tests revealed that she had invasive ductal cancer, a breast cancer that was estrogen and progesterone receptor positive and HER2 negative.
“I didn’t really have any other risk factors. I didn’t have any of the genes for breast cancer, ”said Cramer. “I wasn’t overweight. I looked after all of my three children for a year. I trained. I had children before the age of 30. I didn’t have my first period until I was 11 years old. I was pretty surprised that I had cancer. “
When she had her mastectomy in January 2014, they found that the cancer had spread to her lymph nodes. She underwent 16 weeks of chemotherapy, bilateral mastectomy, reconstructive surgery, and radiation. After the treatment, the scans showed no cancer and she was enjoying life without the invasive treatments and too frequent doctor visits.
“2015 to 2018 were good years in which I actually had nothing,” she said.
She enjoyed spending time with her sons, who are now 13, 10 and 8 years old, watching their sporting events or swimming with them. While she was mostly feeling healthy, she worked with a physical therapist to resolve problems with the irradiated tissue injured by the radiation therapy. The therapist noticed two bumps on her skin near an incision near her armpit in late 2018.
“They were like mosquito bites,” she explained. “I knew I was going to see a doctor in February so I just let her look at her.”
The doctor wasn’t worried, so she resumed her normal life. However, by April the bumps appeared abnormal. They didn’t go away, so she contacted another doctor.
“I started freaking out,” she said. “They did a second biopsy and after a few weeks of trying to figure out what was going on, it came back as triple negative breast cancer.”
When she had breast cancer at age 34, 5% of it was triple negative, and doctors used treatment protocols for the larger percentage, the estrogen and progesterone receptor cancer. The triple negative cancer returned and spread to the lungs, lymph nodes, and brain.
“I was considered metastatic, stage 4,” she said.
Breast cancer in younger women is on the rise
While most breast cancers occur in women who are 50 years of age or older, Dr. Sagar Sardesai, Cramer’s attending oncologist, said more younger patients are diagnosed. According to the Centers for Disease Control and Prevention, about 11% of all new breast cancer cases in the US occur in women under the age of 45.
“We’re seeing an upward trend in younger women with new breast cancer diagnoses, and the reason for this is not entirely clear,” the medical oncologist at Ohio State University’s Comprehensive Cancer Center told TODAY. “It has been linked to lifestyle factors related to estrogen exposure.”
Women who have fewer children, have children after 30, start menstruating before 11, and go into menopause later, could help doctors diagnose more breast cancer in younger women, Sardesai said.
“In everything we see, exposure to estrogen has changed significantly in a woman’s life and could be linked to increased risk,” he said. “Other factors that seem to be on the rise have to do with genetics and family history.”
While Cramer said she didn’t have any of these risk factors, she proactively performed breast exams and spoke to a doctor when she noticed something was wrong. Sardesai said that women who observe differences in their breasts should speak to their doctor immediately.
“I would say it’s a very high priority,” Sardesai said. “It is very important that doctors listen to their patients and not ignore their symptoms just because they are younger.”
When Cramer’s cancer came back it looked like mosquito bites and Sardesai said doctors need to remind themselves that breast cancer doesn’t always look one way.
“Breast cancer can occur in many ways. It’s not always just a lump. It could be a discharge from the nipple, chest pain, or skin changes, ”he said. “If it’s a young woman who’s showing any of these symptoms … you shouldn’t be fired.”
Living with Metastatic Breast Cancer
Every day, Cramer wakes up and makes a spiritual dedication before showering to work.
“It’s like, ‘OK. It’s time to leave. I have to get through this day for my children and my husband, ”she said. “I’ll do it for you.”
She still trains as much as possible and attends all of her sons’ events. Some days work feels tough, but she really loves her job.
“I don’t want to wait to die. I think I would go crazy and not still live my life, ”she said.
A strong support system and deep trust will surely help her perform chemotherapy on her face and various radiation surgeries on the tumors in her brain. Crying in the closet when needed doesn’t hurt either.
“I have my crying fits,” she said. “I think people with cancer should know that they also have the right to scream and cry and get everything. I can’t hold it all the time. “
She hopes others will understand that incurable cancer is severe, but not always bleak.
“There is hope,” she said. “When you surround yourself with people who love and build you up and keep you positive and pray for you and help you stay connected spiritually … that helps.”