Lina's story: Balancing motherhood and a breast cancer diagnosis
From deciding birth plans to managing childcare and deciding on the all-important name, there’s enough to be thinking about when you’re expecting your third child. But for Lina, 45, from Kingston upon Thames, south-west London, an unexpected breast cancer diagnosis at 23 weeks’ pregnant understandably came as a complete shock.
Finding out
“I had a painful lump come up on my left breast which originally felt like a blocked milk duct cyst - but it didn’t go away. My breasts were also quite swollen, which I somehow knew was not right for this stage of pregnancy. I knew that I needed to get it checked out.”
Within a few days, Lina had seen her GP and was immediately referred to Consultant Breast Surgeon, Miss Nicola Roche, who saw Lina at her breast clinic in HCA UK’s Chelsea Outpatients, closely associated with The Lister Hospital. Following examination by Miss Roche, Lina had a breast ultrasound and biopsy of the breast lump arranged, but did not have a mammogram as a result of her pregnancy.
“It was all very quick” Lina says. “I had no family history of breast cancer, but I had a bad feeling about it.”
Getting the results
“We got the results back within a week of my first meeting with Miss Roche which confirmed breast cancer; specifically, oestrogen-positive, progesterone-positive, HER2-negative breast cancer,”
At The Lister Hospital, all cancer cases are discussed at weekly multidisciplinary meeting with other surgeons, oncologists, radiologists, pathologists and specialist breast care nurses in order to draw up an appropriate and timely treatment plan. Given Lina’s pregnancy, her obstetrician was also involved. The decision was made to proceed with surgery first. The scans had not indicated any problem with her lymph nodes, but dual surgery was planned to remove the lump (a lumpectomy) and take a biopsy of the lymph nodes (a sentinel node biopsy) at the same time.
Following this, there was more news to come.
“I found out that the cancer had also spread to my lymph nodes ” Lina says. “Suddenly, the whole diagnosis was far more complex and would require additional interventions.”
After surgery, and having become aware of the impact on the lymph nodes, Lina’s case was again discussed at a multidisciplinary meeting. Chemotherapy was planned.
A way forward
Now having to undergo chemotherapy in the last few weeks of her pregnancy, Lina was carefully managed and monitored by a multidisciplinary team.
“Miss Roche referred me to Professor Paul Ellis, Consultant Medical Oncologist at HCA UK’s Leaders in Oncology Care, conveniently just around the corner from Chelsea Outpatients. They both met regularly with my obstetrician to discuss how many chemo sessions I should have before giving birth, how many after, what I could and couldn't tolerate. I felt very well taken care of.”
Also working with a team of breast care clinical nurse specialists (CNS), Alex Olayo (Breast Care CNS), was appointed to support Lina on a one-to-one basis.
“When you treat a pregnant woman with cancer, you need to balance the risk and benefits of treatment very carefully. You need to slow the progress of the cancer, whilst bearing in mind the risk to the baby. This needs a very careful, collaborative approach across medical disciplines. It’s a real multidisciplinary team effort.”
It was only once her third child, Evan, had been safely delivered in January 2022 (three months after her initial cancer diagnosis), was it that Lina was able to have a PET and CT scan to check that the cancer had not spread to other areas. These scans involve radiation and would have been harmful to her baby during her pregnancy, so had to be deferred until after birth. Thankfully the scans were clear, but chemotherapy needed to continue.
When this final course concluded, Lina needed another surgery to remove the remaining lymph nodes and her breast. She then opted for an immediate breast reconstruction using a silicone implant. After recovering from her surgery, she completed a course of radiotherapy and started oral anti-cancer medication, continuing to feel incredibly supported throughout, whilst balancing being a mother to three, very young, children.
“Miss Roche was always available and ready to arrange care for me whenever she knew I was in a delicate state. To this day, she responds straight away if I’ve got a query of any kind.”
Happily, Lina is now cancer-free, three years after starting her treatment and has a healthy and very happy toddler, Evan.
So, what advice does Lina have for other women?
“Check your breasts. Especially during pregnancy when the body and hormones are changing all the time. Anything that raises your suspicions should be investigated. We’ve just had Breast Cancer Awareness Month (October), and seeing I have been through it, I'm a huge advocate. It’s also so important to stay healthy. There’s no magic answer, but keeping fit really helped with my recovery and mental wellbeing also. I’ve always gone to the gym, but now I do strength training, cardio, some yoga, and I try to eat as well as possible.”
“I’ve recently just gotten the all-clear from Miss Roche and the team” she says. “It’s a huge relief. I feel particularly thankful to Miss Roche and Professor Ellis, but am just so thankful to the whole team in general who were just amazing. As soon as I gave birth, I took the baby (Evan) into the unit so the nurses there could meet him.”
“They literally saved my life – and now I can concentrate on being Mum again.”
Find out more about Ms Roche’s services and the breast screen and cancer services available at Chelsea Outpatients. To book an appointment call 0203 770 5870.
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.