As a mother baby nurse at Morristown Medical Center, Lauren D. spent her days and nights guiding women through childbirth to bring new lives into the world. She was 37 years old and building her family, nursing her eldest son and pregnant with her second child, when she received devastating news. Lauren was diagnosed with advanced stage 3 breast cancer in August 2021 during her second trimester of pregnancy.
According to the National Cancer Institute, breast cancer affects one in 3,000 pregnant women between 32 and 38 years old. For these young mothers, diagnosis often comes at later stages due to body and breast changes that are often dismissed as part of the pregnancy.
For Lauren, the first sign came during a nap in April 2021 when she felt a pain in her right breast. She adjusted her bra, then felt a small hard, fixated lump. At first, she dismissed it. After all, she was a mother baby nurse and knew it was common to have a clogged milk duct now and again from breastfeeding. But that was her brain talking. Intuition was telling her it was something more.
Seeking Answers from the Experts
When Lauren’s gynecologist saw and felt the lump, she immediately scheduled an ultrasound, which came back clean. But Lauren had a family history of breast cancer. Her maternal grandmother died at age 40 from the disease, which led both mother and daughter to BRCA genetic testing – all with negative results.
By June, Lauren started noticing visible skin changes in her breast: swelling, dimpling, nipple inversion, then pain in the lymph nodes under her armpit – all telltale signs. After a second breast ultrasound, this time with a biopsy, the truth began to reveal itself in August 2021.
A Team to Save Mother and Baby
Lauren was referred to breast health nurse navigator Karen de Renzi who introduced Lauren to her multi-disciplinary team at Morristown Medical Center. Breast medical oncologist, Shilpi Gupta, MD, would manage the chemotherapy and medications that would kill the cancer cells while protecting the fetus. Breast surgical oncologist, Marcella Fornari, MD, would consult on the treatment plan and perform Lauren’s double mastectomy once the baby was born. Mita Sharma, MD, would deliver the baby, and maternal-fetal medicine specialist, Karen Russo-Stieglitz, MD, would manage all mother-and-baby health concerns before, during, and after the delivery.
“I had an amazing support system,” says Lauren, lauding everyone from her nurse navigator, doctors, nurses, staff, and coworkers to her husband, friends, family, and parents. “I was just trying to stay alive and keep my baby alive, too. That was all I had to think about. My support system took care of the rest and carried out a complicated treatment plan to get me through this.”
Navigating the Alarming Diagnosis
Lauren had stage three inflammatory breast cancer -- a rare, aggressive form of cancer that doesn't always appear on a mammogram or ultrasound. Her tumor was HER2 positive and 90% fed by estrogen, which tends to occur in younger women, grows and spreads quickly, and is more aggressive than other forms of breast cancer.
“We are uniquely positioned here at Atlantic Health to treat and cure young pregnant women diagnosed with breast cancer, and help them move towards survivorship,” says Dr. Gupta. “Lauren was diagnosed in our radiology center and was immediately connected to Karen, our breast health navigator and a vital member of the entire team. From cardio-oncologist to psychiatrist, social workers to nutritionist, there are lots of complexities to successfully treating pregnant women and we have all the resources right here.”
Little Miracles at Every Turn
With chemo killing off the cancer cells in Lauren’s body, most days she found it difficult just to get out of bed. But the little boy growing inside her, Ryan, motivated her to get up. Drink a glass of water. Eat something.
“Ryan was the little miracle that got me through this entire ordeal,” she says. “I was nauseous and vomiting through my whole pregnancy, and chemo made it worse. I was just trying to stay alive and keep my baby alive, too. That was all I had to think about, and Dr. Gupta and her team would take care of the rest. I absolutely love Dr. Gupta.”
In the middle of chemo and 33 weeks into pregnancy, Lauren went into labor on October 30, 2021 -- and more little miracles began to happen. First, her white blood cells began to normalize, a natural process where the baby’s white blood cells work to save the mother. Next, Ryan should have been born immunocompromised after bouts of chemo, but he wasn’t, and his underdeveloped lungs should have needed mechanical support, but they didn’t. Finally, Lauren’s nausea and mindset improved after delivery, giving her a renewed ability to cope through more chemotherapy, immunotherapy, and double mastectomy surgery. “Ryan was born perfect,” says Lauren.
Candid Thoughts from a Breast Cancer Survivor
Although the first month of Ryan’s life was spent in the neonatal intensive care unit, today he is home with his parents and older brother, Lucas. Lauren has returned part-time to Morristown Medical Center as a mother baby nurse and now serves as a harbinger for women about trusting their instincts and advocating for themselves.
“Cancer touches women of all ages and my breast was screaming at me to get it checked,” says Lauren. “Staying vigilant about your health means listening to your inner voice and taking action. Know your body. Check your breasts regularly. If you think something’s wrong, call your doctor. The sooner you find a sign and get it diagnosed, the better your prognosis will be.”
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.