It was an honor to share my personal story with attendees at fellow-survivor Marge Morena’s 6th annual Marge Madness fundraiser luncheon. The event, and her nonprofit, raises money for the UNC REX Mobile Mammogram Unit, which helps provide mammograms and follow-on care as needed to North Carolina underserved and uninsured women, especially for Black and Hispanic women and those in underserved areas of North Carolina.
The following is a video from the event, as well as the text of my speech with the images displayed.
Thank you, Marge. And thank you also to my loving family and friends here today. This story is possible because of all of you.
Breast Cancer.
There is not a time in my life when I recall someone sitting me down to explain cancer. It was just always THERE.
I was born in 1984 – I am 39, no need to do the math – and at that point in time, my aunt was several years into a stage 4 inflammatory breast cancer journey. She was 25 when she was diagnosed.
She’s on the left in this photo with my mom and sister.
I was named Kate Nancy for her – my Aunt Nancy. My dad’s older sister.
I had and still have a real sense of pride about being the one to carry her name as part of mine. I always knew she was special in a badass-kind-of way. I wanted to be like that.
Fortunately, I was blessed with a lot of women in my family who provided me with that example.
We spent a lot of time with Aunt Nancy growing up.
I don’t look back and ever think of her as sick, she definitely did NOT come across as fragile.
She was just Aunt Nancy, someone I was always happy to see. Sometimes she had hair, sometimes she didn’t, but I don’t ever remember noticing that as a kid.
For a chunk of time, she was in a hospital bed at my grandparents’ house. I remember climbing on to it to be with her.
Aunt Nancy passed away when I was four. It was not until I was older that I truly understood how incredible that was.
Looking back on it, she said that she didn’t initially understand the severity of the diagnosis but the prognosis was not good from the start.
As she said, “I was 25 and I didn’t have a real good chance of living and they didn’t have a real good idea of what to do about it.”
So she let them try it all. Dr. Susan Love, who many of us now know for her Breast Book, was one of her doctors.
Aunt Nancy was not ready to go. She felt like she had a lot of life left to live and if she could stick around long enough, maybe they would find the magic bullet to kill this beast inside her.
She went through surgical, radiation, and medical interventions for seven years. This was after some said she likely would not be alive in a year.
My entire life, I knew this story.
I knew the tenacity and the guts that she, and all of my family there caring for her, demonstrated. It shaped me deeply.
In my late 20s, Angelina Jolie was making news for her decision to have a preventative bilateral mastectomy. She explained that genetic testing identified a BRCA mutation and that she was at an extremely high risk for breast cancer.
I went to my annual physical and as soon as the doc finished the exam, she started to leave the room. I said, “Wait! I have a question.
I have a family history of breast cancer. Would I be a good candidate for genetic testing?”
Her hand still on the doorknob, she replied, “sure, just have them book it on your way out if you’re interested.”
Seriously?!
I felt this was a topic that warranted a liiiiitle bit more of a discussion. I found a new doctor and learned that I am, in fact, a perfect candidate for genetic testing.
My results came back and identified an ATM mutation, which creates an elevated risk of breast cancer. It is nowhere near as high as BRCA, but my doctor referred me to a breast specialist and I began getting early screening.
My first mammogram and MRI were uneventful.
In March of 2016, my mammogram tech did not tell me to go change. Instead, she had me come back in the room for more images. Then they sent me down the hall for an ultrasound. I knew that day that this was not going to be good.
We went through the biopsy and on April first, I was diagnosed with breast cancer, stage 0, the earliest possible catch.
I was 31 and set to get married in seven weeks.
Thankfully the team at Rex hopped into action to get my lumpectomy scheduled ASAP. I would have the surgery then do radiation and hormone therapy following the wedding.
Two days after my lumpectomy, the surgeon called. They didn’t get clean margins. I need to go back a week later for them to try again.
The morning of my second surgery, Luke and I went to the Wake County Courthouse and got our marriage license.
Luke actually held my engagement ring for every surgery. When they let me get dressed to leave, he would get down on one knee to give it back to me and propose to me again. It was pretty special.
Surgery two yielded the same results – there was cancer in the margins.
At that point, it became a different conversation. The recommendation, and my preference, was to proceed with a bilateral mastectomy after our wedding. We talked and realized that we already had two weeks off for our honeymoon so the best course of action was probably to cancel that and schedule my surgery.
I married Luke on May 21, 2016. Three days later, on May 24, I had a bilateral mastectomy. We honeymooned at Rex and, while it was not Hawaii, they did treat me very well.
I mean, look at that – room service, fancy pillows, IV cocktails. It was swanky.
The bilateral mastectomy was the right decision. The cancer was throughout the ducts in my entire right breast.
It was a difficult recovery. I obviously KNEW people with breast cancer and the disease was not unfamiliar to me, but this was an incredibly challenging process.
It was then that I got involved with the local breast cancer community. It’s how I met Marge. Connecting with other survivors really helped me talk through things and vent about how hard this all was on my body, but mostly my mind.
The Komen Race was an easy place to plug in and we walked it that first year and every year for a few years afterward.
This is my grandmother and I at the race one year. Gram is here today. She is also a breast cancer survivor. Gram was the primary caregiver for Aunt Nancy. You can see Pop in the background too – in his pink pants, always a special cheerleader.
I chaired the race in 2018. This is my family there with me.
Because my surgical intervention was so aggressive, it was determined that radiation and hormone therapy would offer me no additional benefit so once I finished reconstruction, I was theoretically “done.”
We welcomed not one, but two pandemic babies.
Quinn Jack Payne was born in June 2020 and Parker Thomas Payne was born in June 2021.
They are now two and three and Luke and I are baaaaaaaarely hanging on to control of the house…and our sanity.
This is me with them on May 24, 2022. It was my six-year cancerversary.
This spring, I noticed a lump under my right arm, it was close to the implant and it hurt.
I had been going crazy powerwashing on the weekends and wrestling with these crazy toddlers so I let it sit a little while to see if it was something swollen or maybe hormonal that would go away.
It didn’t.
Since my first go round, my doctor had left North Carolina. I called to be seen, it had only been two years since my last appointment. They told me they couldn’t get me in for a couple months – I was now a new patient. It would be faster to be seen by my OB-GYN.
Cool.
I got in with my OB-GYN who, as I am sure you are noticing, always rises to the occasion. She did a physical exam and thought it was likely just a swollen lymph node. But, just in CASE, she referred me for an ultrasound – the following week.
The radiologist who did the ultrasound was incredible. She felt like the lump had qualities that could be cancer and qualities that could not. She ordered a biopsy – again, the following week.
I am not a patient person and it takes SO long to stay on top of our health!
The biopsy team was fabulous. Following reconstruction, they had to warn me that there was a risk they could puncture my implant. As the doctor said, “I have never done it before though and I don’t intend to start today!”
They got my sample and the nurse suggested they send me over for some mammogram images, just in CASE a surgeon needed to get involved.
Up to that point, I think I was kind of waffling on whether I thought this would be cancer again or not… but when they wanted to get those images for the surgeon, I tipped over to the worried side.
The biopsy was on a Friday and Monday morning at 9:15, my phone rang with that hospital phone number every survivor knows well. The woman got straight to the point, it was cancer. A nurse navigator would be in touch within the hour with next steps.
Ugggghhhhhhhhhh…
I wasn’t shocked but when I had to say it out loud, I welled up. All I could think was…how far has this gone? I did not come this far to only come this far…PLEASE do not let it have spread.
I think I got a rookie nurse navigator.
She certainly was NOT prepared for me. The first available appointment was in ten days.
On May 24.
The day that would have been my seven-year anniversary of being cancer free.
I cracked a joke about it and she wasn’t quite sure what to do with the information. “Ummm…do you want to come another day???”
No, no, I want to get there, like NOW, not another day.
I got home and, of course, started stewing. I have to wait TEN days to do anything?
I called the nurse navigator team back and told them I wanted to get my MRI done before my appointment with the surgeon. I needed to know ASAP how involved this situation was and that was going to be important information anyway when it came to a plan of action.
They did not LOVE that but the surgeon agreed and it was ordered.
Thankfully, this time around was also an early catch – stage 1A. There was only the one tumor and it was small. Plan of action would be surgery. After that, they would type the tumor to determine if I needed chemo or not, but I would definitely do 6 weeks of radiation and then get started on hormone therapy.
I had surgery on June 5 and they got clean margins – byyyyyeee tumor…
They typed the tumor and my medical oncologist determined there would be no additional benefit to chemo.
So now I have had breast cancer TWICE before the age of 40 and did not have to do chemo either time.
I credit my family for that.
Their consistent commitment to advocating for yourself and prioritizing your health was so deeply ingrained in me that I never stopped pushing. I was able to get access to early screening measures and find these things early.
And let me be clear, I recognize what an incredible privilege that is to have. Most cases of breast cancer are not someone with a family history. There is nothing most people can do to gain access to earlier screening because there is no reason to suspect they would benefit from it.
I finished radiation on September 14.
Three weeks ago, I started hormone therapy.
My first drug is Tamoxifen.
Aunt Nancy was part of the clinical trials for Tamoxifen.
I will go for my first Lupron injection next week. Catch me afterward if you have any tips I need to know about that.
A few people have had the guts to ask, and I have certainly considered, do I have any regrets on my treatment plan from round 1?
Do I wish I had done the radiation and hormone therapy in 2016?
Do I think that would have avoided this second diagnosis?
I have no hesitations when I say, absolutely no regrets.
Because I wouldn’t have my family.
It’s really THAT simple.
I would not have been able to have these almost Irish twins who make my life absolutely incredible and terrifying at the same time.
No doctor would have advised, much less approved, me to take two years off hormone therapy.
And if I had and the cancer still came back, I would wonder if it was my fault.
I have ZERO regrets. I know this unfolded just as it was meant to unfold.
For me, it all comes back to those who came before us.
Without Aunt Nancy, and my family’s promise to keep her memory alive, I might not have done the testing.
I would not have had access to early screenings. I would have started at 40 – which is not until next spring.
Really though… for all of us… it’s about those that came before us.
The treatments that we have access to, the plans of action, they are all based on previous cases and the experiences of those who came before us.
So it is important to remember, that now WE are the ones who came before the next generation.
Aunt Nancy is lifting me up in this photo and I am lifting my daughter, Quinn, up in the other photo.
It is up to us to tell our stories, to invest in causes that will increase opportunities for EVERYONE to know how to advocate for their health and their bodies. It’s why we are here today.
So thank you.
First of all, for the opportunity to tell my story.
But, more importantly, for being those that came before my children.
Together, we might just kick this thing.