Sarah Lien was 24 when she was diagnosed with breast cancer, yet she was not unprepared for the news.
She had spent six years going from doctor to doctor to ask about being tested for cancer. They all told her she was too young to worry about it.
Lien suspected otherwise. Ever since she learned that her mother, UW School of Nursing alumna Barbara Hawkins, was first diagnosed with breast cancer at age 37, Lien wondered what her own chances were for getting cancer at a young age.
She found out in March 2010, after feeling a lump in her right breast during a self-exam. She received her first mammogram the next day, and shortly after was diagnosed with stage 3 breast cancer.
Lien learned at the UWMC Medical Genetics Clinic that she has the BRCA2 breast cancer gene, inherited from her father’s side of the family. (Her mother and sister subsequently tested negative for the gene.) Several doctors she saw recommended a mastectomy, but were focused only on eradicating the cancer.
“Doctors told me that I couldn’t worry about my fertility or appearance, that I should only be concerned with longevity of life, but as a newly married woman who wants four children, I was concerned about those things,” Lien said. “I felt that no one knew what to do with a woman in her 20s asking about cancer.”
She became the patient of Dr. Kristine Calhoun, a surgeon and breast specialist, and Dr. David Mathes, a plastic surgeon At UW Medical Center and the Seattle Cancer Care Alliance. Calhoun is a UW associate professor of surgery in the Division of General Surgery, and Mathes is a UW associate professor of surgery, Division of Plastic Surgery.
After discussing treatment options with them at the SCCA Breast Health Clinic, Lien opted for bilateral mastectomies, which is the removal of both breasts.
“The bilateral mastectomies made sense based on Sarah’s family history of breast cancer,” Calhoun said. “I supported her decision, and was struck by her desire to maintain her fertility. She was very, very upfront about her desire to have children. She wanted to do everything possible to beat her cancer so she could achieve that goal.”
Mathes likewise listened to Lien’s concerns about how her body would look after surgery. He told her he would do his best to rebuild her breasts the way she wanted.
“Honestly, I just wanted to look great in a bikini, and I wanted to feel comfortable with my body,” Lien said. “I’m extremely happy with the results.”
Lien remained optimistic throughout her experience. She said that she modeled her mother’s approach to overcoming the disease.
Their cancer journeys are interwoven. Hawkins was diagnosed with breast cancer again in 2008, and for a third time in 2010, after which she chose to have a double mastectomy. Last October, Hawkins was diagnosed with stage 4 bone disease.
Mother and daughter have taken turns supporting each other through diagnosis, radiation, chemotherapy, surgery, and recovery. When Hawkins went through radiation, Lien had a card waiting for her at the hospital five days a week for six weeks, the duration of her treatment.
“There is a special bond between Sarah and me because we have gone through cancer together,” Hawkins said. “We know what each other is thinking and feeling.”
Hawkins is receiving bone-strengthening treatment and takes oral chemotherapy, yet still works full-time as a critical-care nurse. Lien is in remission and pregnant with her first child, a girl whose middle name will be Elizabeth, after both her and Hawkins’ middle name. Her due date is Nov. 20, Hawkins’ birthday.
“Cancer affected every part of my life and my mother’s life, but blessings came out of our cancer journey: new friends, support from so many people, and my relationship with my mom has grown,” Lien said. “Cancer has devastated our lives, but the struggles are well worth the blessings and knowledge that resulted. I wouldn’t wish cancer on anybody, but I’m happy with how it turned out. There is life after cancer.”
Lien and Hawkins and the story of their family journey with breast cancer is scheduled for NBC Nightly News with Brian Williams tonight, Friday, Oct. 18. In Seattle, the newscast appears at 6 p.m. on KING TV, channel 5, and is expected to be rebroadcast on KING-5 News.