Up until I turned 60, I had never had surgery in my life. That changed in November 2023, when I underwent my first surgery—a lumpectomy on my right breast performed by Dr. Armando Giuliano at Cedars-Sinai Hospital. During the procedure, he also removed lymph nodes from my right underarm to check for cancer spread, which is standard practice in lumpectomies and mastectomies. This step helps confirm the stage of the cancer and guides the next steps in treatment.

Thankfully, the surgery went very well, and my recovery was smooth. Even better news—my lymph nodes were clear, and my cancer was confirmed to be Stage 1. For context, the stage of breast cancer is determined by the tumor’s size and whether it has spread to the lymph nodes.

After surgery, Dr. Giuliano explained that my tumor would be sent for Oncotype DX testing. This genomic test evaluates the risk of recurrence in early-stage, estrogen receptor-positive (ER+) breast cancer and helps determine whether chemotherapy is necessary in addition to other treatments.

He also explained that radiation would almost certainly be required. Regardless of the stage, lumpectomies are always followed by radiation. The Oncotype score would then determine whether chemotherapy would be recommended, even though my cancer was only Stage 1.

To continue my care, Dr. Giuliano referred me to his trusted colleague, Dr. Yuan Yuan, a breast medical oncologist at Cedars-Sinai. Dr. Yuan also serves as the Medical Director for Breast Cancer Research and is both a physician and scientist specializing in breast cancer. Her impressive credentials gave me confidence in choosing her as my oncologist.

I first met Dr. Yuan in December 2023 and again in January 2024, when she had the results of my Oncotype DX test. Here’s how the scoring works:

• · Low score (0–25): Low risk of recurrence; chemotherapy is usually not beneficial.

• · Intermediate score (26–30): Moderate risk of recurrence; chemotherapy may be considered.

• · High score (31–100): High risk of recurrence; chemotherapy is generally recommended.

My score came back as 26. This was incredibly difficult to hear—it placed me just one point above the “low” category. The thought of undergoing chemotherapy for Stage 1 breast cancer felt overwhelming, and I strongly hoped to avoid it.

Dr. Yuan offered me an additional option: the MammaPrint Genomic Test. Unlike the Oncotype, which gives a numerical score, this test provides a simple result of either “Low Risk” or “High Risk” of recurrence.

A few weeks later, I received the results, and to my relief, my tumor was classified as Low Risk. Combined with my own reluctance to pursue chemotherapy, this result gave both me and my medical team the confidence to forgo chemo.

Instead, Dr. Yuan recommended a treatment plan of four weeks of daily radiation therapy to my right breast, followed by five years of aromatase inhibitor hormone therapy.

This concludes Part 2 of my journey and in the coming weeks/months I will be sharing much more of my experience and will share helpful tips for you as well.

Meanwhile you can write a comment for me here or email me directly at  nora@juststylela.com with any questions you may have.

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