Kristen Jordan Shamus|Detroit Free Press
Breast cancer survivor Heather Jablonowski of Berkley has this message for women — and men, too: Perform monthly breast self-exams and knowyour body. If something feels amiss, push doctors for answers.
That approach just might have saved her life.
There was no lump, often a telltale signfor women withbreast cancer. But Jablonowski felt a troubling pain in her right breast in the fall of 2014.
If her bra rubbed it the wrong way or if she bumpedthe sore spot, Jablonowski said it "stopped me dead in my tracks because it was painful."
A registered nurse and lactation consultant, Jablonowski, then 32, knew what was normal for her, and this was definitely not normal.
Her family history of cancerwas also worrisome.Hergrandmother died of breast cancer when she was in her 30s; her great grandmother died of breast cancer, too.
More: Frank Ragnow 'so thankful' for his mom, a breast cancer survivor
More: Livingston mom battles breast cancer with experimental treatments
She mentioned the pain to her obstetrician-gynecologist in early 2015; he suggested a mammogram and ultrasound.
He also offered this advice, which hasremained with Jablonowski years later: " 'No matter what happens at the imaging center, I want you to try to get into the breast care center to see the specialist.' "
The mammogram and ultrasound revealed nothing suspicious.
A radiologist told Jablonowski that the pain she was feeling was "probably related to the breast-feeding and the lactating. It could be dense breast tissue,' " Jablonowski recalled.Shehadbreastfed all three of her daughters—Charlotteand twins Audrey and Ashlyn. The twinshad been weaned forabout a year when she started feeling the pain.
She suggested Jablonowski come back in six months to be re-evaluated. She wastold:'Breast cancer is not painful.' "
Except for when it is.
"In a medical world that does have a lot of definites, a lot of blackand white, there still remainsthis gray area, and that’s where I fell," Jablonowski said. "I had to be my own advocate and had to push for things a bit."
Pressing for answers
Jablonowski asked to see a breast surgeon.The radiologist wouldn't give her a referral, so Jablonowski instead made an appointment at the breast care center with a specialist.
There, shemet resistance again.
Thebreast specialist, Jablonowski said, "was positive that things were OK," and mentioned that the pain in her right breast was mostlikely linked to lactating.
Jablonowski was emphatic. "I don’t know what to do, but something about this doesn’t feel normal," she said.
Shewas given three options:Come back for a recheck in three months, have a fine-needle aspiration of the tissue to check for cancer cells or schedule an MRI of the breast.
Jablonowski chose the fine-needle aspiration.
A couple weeks later, an email message loaded with warnings and alerts about abnormal test results appeared in Jablonowski's inbox.
"My heart just sunk," she said. "I knew, not even having to read it."She called her husband, Adam Jablonowski, who also is a registered nurse, with the news.
"I just blurted out, 'It’s cancer,' " she said,"and he was like, 'I will be right home.' He came home about 20 minutes later, and I hadn’t moved. I was sitting on the floor, crying in the bathroom. The shower was running. He comes in, sits down next to me and just holds me. We’re both sobbing."
Soon after, Jablonowski met with a surgeon and againwas met with skepticism.
"The surgeon comes in and she pretty much said to me, 'I don’t believe these results.
I don’t feel like this is cancer. ... I feel like lactating cells can look abnormal,' " Jablonowski said.
But when the surgeon did a breast exam, Jablonowski said, the conversation abruptly changed.
"I could just see it on her face, and I was just like, 'OK. I know she feels this. There it is,' " she said. Although there was no lump, the tissue on the lower part of her breast was firm and felt more dense than the rest of her breast.
Jablonowski later learned that she had ductal carcinoma in situ in her right breast,at the earliest possible stage — 0 — but it was grade 3, which means it was fast-growing and aggressive.
The cancer had spread across a large section of her breast and included her rightnipple. A multidisciplinary team of doctors recommended a mastectomy followed by radiation.
Jablonowski had both breasts removed in May 2015.
"When we got those pathology results back, I just remember sitting there thinking, had I listened to that radiologist, where would I have been six months from then? Technically, it was stage 0, but it was grade 3, so fast growing.
"Who knows what would have happened? I kept thinking ...the whole time I was having to be my own advocate. Alayperson, who doesn’t have a medical background, who maybe doesn’t do breast exams" would be in trouble, she said, adding that a lot of people put blind trust in their doctors.
"My gutwastelling me it was cancer, and I felt like I had to push through those roadblocks. It makes me think, man, there are people who don’t advocate for themselves."
She hopes that by telling her story, it might help someone else whose symptoms are nagging or suspicious to keep pushing for answers even when doctors insist nothing is wrong.
Support in recovery
Jablonowski underwent two months of radiation treatment to her right chest wall, andalso had breast reconstruction surgery. Sheis now three years cancer-free.
Getting through that time was challenging.
"When I was diagnosed, I remember feeling ... very alone, and not knowing what was going to be happening," Jablonowski said.
She reached out to a high school classmate who'd had breast cancer in her 20s, and a woman whose daughter attended the same preschool as hers who also was a breast cancer survivor.
"Those two helped me get through the initial shock and what to expect," she said. Eating well and exercising became more important than ever before. She found catharsis in journaling and yoga.
But it took years for Jablonowski to come to terms with the thoughts about what might have happened if she hadn't pushed for answers. And she still worries that there could be a recurrence.
"I am three years out, and I am just now to the point where I can go to a follow-up appointment, and I’m not in a dark place anymore," she said.
"Your treatment might be done, and you’ve been given the all clear, but I think emotionally, and mentally, it’s still a struggle. Like I was telling Adam,it’s three years out, and I’m finally not thinking about it every single day."
Last year, Jablonowskitook the stage to model a Wonder Woman art brain the annual Bras for a Cause fund-raiser forGilda's Club Metro Detroit. Her song was Eminem's "Not Afraid."
"There aresome pretty powerful lyrics on that one," she said.
It took courage, she said, and she was nervous, but getting up there felt great.
"I remember standing backstage, and it was so loud, and I was so nervous. I walked out, my nerves were gone. That crowd was so inspiring, she said. "I remember being like, 'oh my gosh, this is amazing.' "
Jablonowski loved it so much, she was to do it again this year when Bras for a Cause returned for its 10th anniversary event Oct. 13 attheRoyal Oak Music Theatre.
"How incredible each of these survivors are, in that each of them have a different story, a different journey," Kevin Watson, a member of the Gilda's Club board of directors said before the event. His wife, Shannon Iezzi Watson, founded Bras for a Cause in 2009; she died of breast cancer a few monthsafter the first event.
"They get up there and ... they're vulnerable. They're wearing an art bra and some of them have walked the catwalk bald or going through treatments and some of them are in pain when they're up there. But they check all ofthat baggage at the door and they're up there and they are so awe-inspiring. The people that attend the event get more out of it than the survivors do, even though it's intended to showcase the bravery and the strength and the resolve that each of them have."
Jablonowski hoped every step showed othersfacingsimilar diagnoses that they, too, can be brave in the face of a cancer diagnosis.
That, she thinks, is one of her life's missions. She recalls an appointment with her plastic surgeon about two months after her mastectomy surgery.
"He was like, 'Heather, I just can’t figure out why this happened to you. I can’t figure it out.' " she said.
"And I said, 'You know what, the only silver lining I can think of right now ... is I’ve been out of mastectomy maybe eightweeks, and I’ve had three people reach out to me already because they’ve needed help. I’ve given them information and tips and tricks to get through things that physicians aren’t going to tell them.…
"He looks at me, and he was like, 'That’s it. That has to be why this happened to you.'
"I held it together, but when I was done, I got into the car and I sobbed."
Contact Kristen Jordan Shamus: 313-222-5997 or kshamus@freepress.com. Follow her on Twitter @kristenshamus.
5 tips breast cancer patients should know
Heather Jablonowski, a 36-year-old mother of three fromBerkley, has been cancer-free for three years, but here are five things she wishes someone would have told her when she was diagnosed with breast cancer.
1.) Journal. "Your story gets told over and over. You forget things. Do real-time journaling because there are things that people say to you that you may have a reaction to —but it may not be appropriate to have that reaction. Journaling can be great form of therapy because you can say to a piece of paper what you may not want to say to somebody."
2.)Don’tGoogle it. The Internet is full of information that may or may not apply to you or to your cancer.Instead, "write down your questions," Jablonowski said. "Any question, no matter if you think it’s a dumb question or not. Just so you can get answers."
3.)Bring an objective advocate."Any appointment you go to initially, take somebody with you that can remain objective," she said. "Adamand I were both so just overwhelmed that we felt we needed an objective person ...with notebooks to write stuff down because it is a lot. You hit this emotional roller coasterand it’s up and downs until you get your plan. Then you get your plan, and you know, that could change."
4.) Know your normal, and push for answers if something seems out of the ordinary."If you feel it in your gut, push through (the no). Get a second opinion. Or try to get in to see somebody else. Stay strong, for sure," Jablonowski said.
5.)Do monthly breast exams. "Just because you’ve had a mastectomy doesn’t mean you don’t have to do your breast exams," Jablonowski said, noting that it's important for those who've had a mastectomy to check theirscars for changes or lumps.
