As Delphine Ettinger was breastfeeding her son last February, she felt a lump. At first, she suspected it was just a change that occurred during breastfeeding. She called her doctor just to put her mind at ease. She’s glad she did: She learned she had breast cancer.
“When the doctor felt it, I just thought it was a mistake,” Ettinger, 44, a graphic designer in Manhattan, told TODAY. “It just happened really fast. They didn’t wait. They took it seriously.”
Ettinger was stunned by the diagnosis.
“I didn’t know that I could get breast cancer because I breastfed my kids for two and a half years,” she said. “I honestly thought that breastfeeding helped me to not get breast cancer.”
Lump and quick treatment
In February 2020, Delphine was breastfeeding her second son, who was 7 months old, when she felt a mass. She had breastfed her first son until the he was more than 2. When she noticed the immovable lump, she thought it might be a blocked duct until she remembered what her doctor once said to her.
“The doctor said, ‘No, breast cancer doesn’t move. It’s a little stone,’” she recalled. “What that doctor told me just came back in my mind and it was like that."
She called her doctor who immediately scheduled her for a mammogram, ultrasound and biopsy. On Friday, March 13, the day most of America learned that lockdown for the COVID-19 pandemic was starting, Ettinger learned she had stage 1 breast cancer.
“He said it was a malignant tumor,” she said.
She was terrified: “I could see my kids and I just didn’t see the future.”
Ettinger immediately scheduled an appointment with Dr. Sarah Cate, breast surgeon and director, special surveillance and breast program at The Blavatnik Family-Chelsea Medical Center at Mount Sinai. Cate gave Ettinger 10 more days to breastfeed before she needed to stop for surgery to remove the lump.
“It was very difficult. My son was learning how to deal with this,” Ettinger explained. “The baby didn’t like the formula at first. He was getting skinnier.”
While breastfeeding is normally protective for women and lessens their chance of developing breast cancer, Cate said some women do develop pregnancy-associated breast cancer, like Ettinger.
“Pregnancy, obviously, changes the hormonal environment and some women will develop breast cancer while they’re pregnant,” Cate told TODAY. “It's usually a situation where the hormones ramp up the breast cancer's growth ... These breast cancers are very aggressive, meaning they grow quickly, they need chemotherapy, a lot of them spread to the lymph nodes, they move faster.”
Breast cancer that develops during pregnancy or a year postpartum is considered pregnancy-associated breast cancer. It’s is rare, occurring in about 1 out of every 3,000 pregnancies. Doctors urge women to seek treatment right away.
“We usually try to get patients in as soon as the breast cancer is diagnosed so that we can proceed with the surgery,” Cate said. “If patients need chemotherapy they cannot breastfeed.”
Cate removed Ettinger’s tumor in March, one of the last surgeries before the statewide shutdown. Her care team performed genomic testing, giving them a better understanding of how to treat the cancer. Ettinger’s cancer had a high chance of recurrence so she underwent chemotherapy and then radiation. She’s on an anti-estrogen medication for at least five years.
“She’s doing very well,” Cate said.
While her cancer responded well to treatment, Ettinger struggled parenting two children, 19 months old and 4 years old, while grappling with surgery, chemotherapy and radiation during a pandemic. Her boyfriend couldn’t pick her up with the kids from surgery and she needed to find a ride. She was too afraid to take them anywhere to play. Plus, they didn't fully grasp what was going on.
“Children don’t understand that you need to rest. They don’t understand why you are lying down. They want to play with you sometimes,” she said. “It’s a bit difficult.”
But Ettinger was relieved that her kids are too young to know what cancer is or how scary it could be.
“If they were older, they would know, maybe you create more fear for them,” she said.
She worried about losing her hair and used the DigniCap scalp cooling system developed at Mount Sinai, which helped her keep her long hair. While she was feeling better, Ettinger panicked after she found another lump.
“I still feel on edge because a month ago they found another lump,” she said. “The stress, it’s like PTSD, it brings back everything.”
But the lump was benign, and she didn’t need more treatment. Ettinger, who is French, looks forward to celebrating her first Mother’s Day, because she wants to mark every occasion now. She’s glad she’s slowly feeling more like herself.
“My energy is not back to normal,” she said. “But I feel good.
Successful treatment and raising awareness
Ettinger’s positive response to treatment partially has to do with the fact that she found her lump early and sought help immediately.
“We see a lot of patients … that were pregnant and didn't go for a mammogram,” Cate said. “It’s really important for patients to examine their breasts because that’s how Delphine found her breast cancer. And it was found at an early stage that really helped her outcome.”
Ettinger said she hopes that her story raises awareness for others and helps them feel less isolated as they undergo treatment.
“I didn’t know the reasons why people get breast cancer,” she said. “Actually, I didn’t know much about it.”