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When Sarah Lien was diagnosed with an especially aggressive type of breast cancer, she feared the treatment that could save her life would also destroy her dreams of having children.
Lien, who lives in Lake Stevens, Washington, opted to postpone chemotherapy for a nerve-wracking two weeks so she could begin fertility treatments. Doctors collected her eggs to produce embryos with her husband’s sperm —to be frozen and used when she was healthy again. It was worth it to have a chance at the life she’d envisioned for herself.
“My identity was being taken away and my physical appearance was just stripped from me, but I held on to the hope that one day I would become a mother,” Lien said.
Lien already knew how damaging breast cancer could be. Her mom Barb Hawkins found a lump in her breast in 1994, when Lien was in third grade. After a lumpectomy and radiation, Hawkins’ cancer went into remission and stayed that way until 2009 when a routine mammogram caught another lump.
After radical mastectomy, chemotherapy and reconstructive surgery, Hawkins figured she’d once again beaten back the cancer.
Then the unthinkable occurred. Her daughter Sarah found a lump of her own just two years after her marriage to her high school sweetheart, Kirk.
“One day, I did my self-exam and I felt a very large lump in my right breast and of course I called my mom and started crying because I knew in my heart that it was breast cancer,” Lien said. “It was Stage 3 breast cancer and I was just 24.”
Though it might at first glance appear that Lien’s cancer had come from genes she inherited from her mother, in reality she inherited the BRCA gene mutation from her father. In fact, Lien’s grandfather had been diagnosed with breast cancer three years before she was.
Women inherit BRCA mutations from their fathers just as often as they do from their mothers, said Dr. Susan Domchek, director of the Basser Center for BRCA at the University of Pennsylvania. “That’s why we emphasize the importance of the family history beyond mom and dad,” Domchek said.
The problem is that “it can be relatively hidden in men,” Domchek said. Although the gene ups the risk for breast cancer in men, the impact is far less than in women.
Because the risk is so much lower in men than in women, the presence of the gene can go on unnoticed especially if there are a lot more males on the dad’s side of the family.
Once Lien’s embryos were safely stored away, the cancer treatments started. The schedule would be as aggressive as the cancer: 18 weeks of chemotherapy and 30 radiation treatments over just six weeks. Lien received her chemotherapy treatment, followed by a double mastectomy at the Seattle Cancer Care Alliance.
Still, Lien said, “We didn’t let cancer rule the day. Every single chemotherapy we had a party. In my chemo room, we had sparkling cider and we had tiaras and balloons. When I had to shave my hair off, my dad and my husband shaved their heads with me. We thought of each treatment as one step closer to the finish line, one step towards being done.”
Three years after her initial diagnosis, Lien and her husband decided to give those frozen embryos a shot. When doctors told the couple that Sarah was pregnant, the Liens were elated.
“It was incredible knowing that all this disappointment that we faced, all these difficulties, they didn’t mean anything because my husband and I were going to become parents,” Sarah Lien said.
Audrey Lien was born last November, but even as the family rejoiced, they also had to deal with devastating news: Sarah’s mom had once again been diagnosed with cancer. This time she wouldn’t win the battle.
“You hate cancer,” Lien said. “You hate cancer for taking someone so special from you, so incredible. She is the woman I want to become. She is the mother I want to be like."
Just five days after her mom passed away, Lien, now 28, completed a race they had planned to do together.
“I carried her race bib and her shirt across the finish line with me and it was very powerful to have my mom’s presence with me as I finished that walk as a survivor,” Lien said.
Even after the pain of losing her mother and grandfather to the disease, Lien is hopeful about life after breast cancer — and growing her family. She and her husband Kirk still have a handful of embryos left, and in the next few months, hope to make Audrey a big sister.
Linda Carroll is a regular contributor to NBCNews.com and TODAY.com. She is co-author of "The Concussion Crisis: Anatomy of a Silent Epidemic” and the recently published “Duel for the Crown: Affirmed, Alydar, and Racing’s Greatest Rivalry”