It’s the news no one wants to hear — especially not a mother of two children.
A self-exam brought Courtney Olsen to schedule a physical and eventually led to a call confirming that she had Stage II breast cancer at age 39.
Olsen, a mother of a 3- and 5-year-old with no family history of breast cancer, said her first thoughts were morbid but she was able to “pick up the pieces” the next day. “You scramble and you figure out, OK, I’ve got to see a surgeon,” she said.
Organization and a support system are some of the best tools against a disease like cancer, and they are what Olsen used. Her husband, family and friends connected her to the best doctors and supported her through the whole experience.
A 30 year-old woman has a .44% chance of being diagnosed with breast cancer before she turns 40, according to the National Cancer Institute. By comparison, between 40 and 50, a woman has a 1.47% chance of a positive diagnosis. About 12% of American women (over 2 million) will develop breast cancer in their lifetime and 39,000 women will die from it every year.
The standard recommendation is for women over 40 to get mammograms every year, or 10 years before the age when a close relative was diagnosed with the cancer, according to Dr. Elisa Port, chief breast surgeon and co-director of the Dubin Breast Center at Mount Sinai hospital in New York. After Olsen’s mammogram and biopsy came back positive for cancer, she was referred to Port.
“There’s no question that the self-exam, in a young woman like Courtney who wasn’t getting mammograms because it wasn’t advised in her age group…was the thing that picked up her cancer,” Port said.
“People give breast self-exams a bad rap,” she said. “The bottom line is that if you examine yourself regularly you’ll become familiar with what’s normal for you.”
Women can get a genetic test for two breast cancer susceptibility genes, BRCA 1 and 2. The mutated genes cause an estimated 5-10% of breast cancers according to the National Cancer Institute.
Olsen said Port was compassionate from their first meeting and that the surgeon’s “aura” assured her everything would be all right.
“I know [patients] are coming to see me at the potentially worst times of their lives,” Port said. “It’s a really privileged position, to be honest with you. It’s one of the most intimate [and] critical moments for them.”
The timeline between Olsen’s diagnosis and surgery was about a week. The cancer in her chest was gone on June 2, 2011, when Port performed a lumpectomy, which only removes the cancer and surrounding tissue or lymph nodes under the arm. The surgery revealed that there was a microscopic spread of cancer in one of the seven lymph nodes removed. By definition, this is Stage II, and the survival rate is over 80%.
The breast cancer rate has decreased in the past few years because of aggressive screening recommendations. The unfortunate cases where cancer spreads beyond the breast is usually due to a failure in diagnosis and accessibility to treatment, Port said.
During their first meeting, Port told her to “turn off the sound machine,” that is, to turn off her computer and not overwhelm herself by researching the disease online. There are many recommendations and treatment options spread across the Internet but each patient’s situation is unique and should be reviewed by a doctor who knows them.
Choosing a hospital is also a difficult process. Olsen chose Mount Sinai based on a suggestion but there are many hospitals in Fairfield County with cancer centers and breast cancer surgeons. The important thing is to find a good team. “There are too many people who for convenience sake go closer to home,” Port said. “A surgeon is really part of a team and a team is only as strong as the weakest link.”
It is not that a city hospital will always have better service, but to have specialists the center needs to have enough volume of patients.
Olsen had chemotherapy treatments every other Friday from July 15 to Oct. 31. In between visits, she took time to recover. The effects would be worst on Saturday but by the middle of the week, she was feeling relatively normal, Olsen said. From November to December in 2011, she went through radiation.
“I was of the mindset that if I feel okay enough to deal, I just want to deal,” she said. “I don’t want everything to change. I’ve got to keep something in control.”
Olsen lives in a private neighborhood where she can wave to neighbors from her front door. When she lost her hair from the treatment, Olsen was hesitant to go out in public where people knew her usual appearance. At home she wore a hat to cover up from her children and a wig in public.
“I can remember going out and my neighbor across the street started crying,” Olsen said. “It was such a shock for her to see me differently.”
The first time Olsen put on a wig, her five-year-old son told her that she looked beautiful. She was worried about the effect the process would have on her children, she said.
“[Kids] pick up on things and I wanted to keep as much normalcy as possible,” Olsen said. “Maybe sometimes I was overtired because of that but it was worth it to me.”
Olsen said that if her children were older at the time, she would have had to explain “the reality of cancer.”
When she was back to a regular schedule—dropping her kids off at school and taking them to the pediatrician—strangers would compliment her hairstyle. “I just played along with it,” she said. These small compliments cheered her up.
Olsen said that she was inspired by her experience and wanted to give back to a community that was so supportive. The Olsens had prepared meals from July through November, three times a week. Her close friends helped to take care of her children and some accompanied her to the appointments at Mount Sinai.
“It’s a double edged sword,” she said. “You don’t want to have cancer to see the best in people but that’s all I saw, and it totally made me want to be a better person.”
Courtney Olsen is “vivacious, energetic and incredibly resilient,” said Yonni Wattenmaker, executive director at the Breast Cancer Alliance. The group is Greenwich-based but Olsen is one of the growing numbers of supporters and volunteers in Darien, Wattenmaker said. Olsen’s invitation to the annual fundraiser lunch last October resulted in a conversation with Wattenmaker, sharing her praise for the Dubin Center and her willingness to volunteer.
The organization’s goal is to raise money towards cutting-edge research, education and outreach in Connecticut and Westchester, Wattenmaker said. They also sponsor breast surgical fellowships every year. Mary Williams, owner of William and Company spa in Darien and a member of the alliance advisory board, hosted the organization’s first coffee in town. Dr. Elisa Port, Olsen’s surgeon, and Dr. Eva Andersson-Dubin, who created the eponymous center, are also on the Alliance’s board.
Olsen volunteered to be on call as a “One-to-One” mentor for recently-diagnosed women. Her own advice is to be confident and believe that people around them only want the best. She suggested that breast cancer patients count down the number of sessions during treatment. “The days go by long, but the years go by fast,” she said. “This was half of a year.”
Olsen will be on Tamoxifen, an estrogen-blocking drug specific to her cancer, for five years. The medication should recuce the risk of recurrence.
“In today’s day and age, there’s all the reason to be optimistic,” Port said. “While cancer itself can be life threatening, women do very well. It’s really a marathon and not a sprint.”
More info: Cancer.gov; Yonni Wattenmaker, firstname.lastname@example.org
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