Second Primary Breast Cancer with Julie Lohre

Second Primary Breast Cancer

Second Primary Breast Cancer Graphic

Second Primary Breast Cancer… seriously, again?!?!

Invasive Breast Cancer – Take 2

“Hey honey, will you check this out?” At this point, my husband, Rick, was used to feeling my boobs. After going through breast cancer a year and a half ago, I was routinely asking for his opinion about various lumps. I had just finished a self-breast exam in the shower and felt a small, seed-sized mass in the lower right quadrant of my left breast. Incredibly small and hard to feel, it was just different than the normal lumps and bumps that I routinely feel in my cystic, dense breast tissue.

“Hmmm…. yes, I feel it. How long has it been there?” Just noticing it was my answer. Regardless, he told me to go ahead and make the call after a few minutes.  

Reaching out to my nurse navigator was easy. They literally answered the phone directly, and even though I had an MRI 6 months ago and a diagnostic mammogram three weeks earlier, I was scheduled for an ultrasound later that day. One of the perks of being a breast cancer survivor is that it is immediately taken seriously when you feel a lump.

Second Primary Breast Cancer Journey
Don’t let the smile fool you. Being diagnosed with a second primary breast cancer will test you in ways that are hard to imagine. THIS is my fight hat.
Breast Cancer Fitness
Staying fit and active in the weeks before a double mastectomy is critical both for your mind and to help recovery.

At this point, breast ultrasounds were old school for me. I had been through more than 10 in the last several years and actually knew what I was looking at when the sonographer placed the transducer down. Multiple breast cysts made it difficult to find the super small cluster, but she eventually did. It was small but definitely there. As she was wrapping up the ultrasound, I had a nagging feeling in my stomach.

“You know what, can you go ahead and check this other spot at the top of my breast? I think it is just a muscular knot in my pec muscle, but it has been here for a bit.” 

Seeing that lump under ultrasound, my heart skipped a beat. Normal cysts or fibroadenomas have clearly circumcised edges with fluid-filled centers. Both of these lumps under ultrasound had edges that bled outward into the surrounding tissue and were solid appearing. Bad. The radiologist came in shortly after, showed me what I already knew in imagining, and ordered biopsies on both areas.

Listen to the Podcast Episode

Second Primary Breast Cancer: Seriously, again?!? An Intimate Journey - FITBODY Podcast Episode 21
Ultrasound for Palpalble Breast Lump
Snapping a quick selfie with the ultrasound machine in the background. The only thing to smile about here is that this second primary breast cancer was caught super early!

It turns out the lump I initially came in for was benign. But, the second one, the one that I thought was a knot in my pec muscle and only had checked at the very last second as an afterthought… THAT was invasive ductal carcinoma. Breast cancer. Again.

In sharing my journey here, I hope to answer questions, inspire other women, and most importantly share that WOMEN HAVE TO DO SELF BREAST EXAMS! Catching breast cancer early gives you the best possible chance of a positive outcome.

God puts us on specific paths for a reason, and while I am not quite sure what the reason is or what this path will involve, I feel called to share my story. The good, the bad, and the ugly, as I like to say with my online training clients.

What is Second Primary Breast Cancer

A second primary breast cancer is a distinct and separate cancer that develops in the same breast or the opposite breast after you’ve already had breast cancer. It’s not a recurrence of the original cancer; instead, it’s a new, unrelated cancer that forms on its own.

I was definitely confused and concerned at first but quickly realized for me at least, this is significantly better than having the first cancer spread or reoccur. Here are some points about second primary breast cancer that can be helpful to know:

  1. Distinct from Recurrence: A second primary breast cancer is different from a cancer recurrence. A recurrence is the return of cancer cells from the original tumor site or nearby lymph nodes after treatment. In contrast, a second primary breast cancer is a completely new and unrelated cancer that may develop in the same breast or the opposite breast at a later time.
  2. Unrelated Tumors: Second primary breast cancers occur when new, unrelated breast cancer cells develop independently of the first cancer. These cells have their own genetic mutations and characteristics. One of the tell tales that this was indeed a second primary for me was that the categori
  3. Risk Factors: The risk factors for developing a second primary breast cancer are similar to those for developing a first primary breast cancer. These risk factors can include genetics, hormonal factors, lifestyle choices, and environmental exposures.
  4. Surveillance and Monitoring: People who have been treated for breast cancer are often closely monitored for the rest of their lives to detect any signs of cancer recurrence or the development of a second primary breast cancer. This monitoring typically involves regular follow-up appointments, imaging studies, and laboratory tests.
  5. Treatment Approach: The treatment approach for a second primary breast cancer depends on various factors, including the stage and characteristics of the new cancer, the treatments previously received, and the overall health of the patient. Treatment options may include surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy, among others.
  6. Prognosis: The prognosis for a second primary breast cancer varies depending on many factors, including the stage at diagnosis, the type of breast cancer, and the effectiveness of treatment. Survival rates can vary widely, but early detection and appropriate treatment can significantly improve outcomes.

Miss the first? Check out my initial breast cancer diagnosis and story:

My Breast Cancer Journey

Here is my second primary breast cancer journey with initial videos…

While I did not document everything, here are a few intimate videos I took during this second primary breast cancer diagnosis.

This crazy emotional video was shot at the beginning of June 2022, the morning that I received my second primary breast cancer diagnosis.

After the biopsy results reveal that I do have invasive ductal carcinoma in my left breast this time, I am sent for an MRI to confirm that we are only dealing with one tumor.

Deep in the process of getting test results back I shoot a video describing my wait to hear about the HER2 status of this tumor and share some concerns about having a double mastectomy after having previous radiation therapy.

Two days before my skin and nipple sparing double mastectomy, I had a Molli Localizer placed so that the surgeon can see the specific area and make sure that they get clear margins. This is more common with lumpectomies, but since my tumor is just beneath the skin and they plan to take some

I did not do a lot of video from here, but below is a photo journey of this process for me.

Breast Ultrasound & Biopsy Results

Ultrasound for Palpalble Breast Lump
Snapping a quick selfie with the ultrasound machine in the background. Coming out of this room in the dressing room, I dropped to my knees, sobbed, and prayed. Not my will, by His. If I have to have breast cancer again, I knew that God would give me the strength to get through.
Ultrasound Image of Invasive Ductal Breast Cancer
Here is the actual ultrasound image of my invasive ductal carcinoma, breast cancer tumor, at the 12 o’clock position. This solid looking mass is just below the skin and easily felt. I thought it was a knot in my pec muscle.
Thumbs down medical office patient
Well, here we go again. Biopsy results confirm that I do indeed have a second breast cancer tumor. This new diagnosis is known as a second primary breast cancer because it is unrelated to the first and not a metastasis.

Decision Time – Meeting with the Medical Team

Family support with breast cancer
Having my husband by my side for every single doctor visit and appointment was a huge source of strength for me. He took notes, listened, and reminded me of questions that I had. Husbands… THIS is what will help your wife the most!
Cancer Care Center St Elizabeth Hospital
More appointments! I met with several different teams of breast surgeons, plastic surgeons, and oncologists before settling in on a team that I felt confident with.

Making the most of days before the Double Mastectomy

Julie and Tre Lohre
In the weeks leading up to my surgery, I tried to fit in as much fun, family time as possible. I will always remember June 23, 2022, about 2 weeks before my surgery when my then 19 year old son spent the day riding roller coasters with my at Kings Island. We rode more than 20 times that day and did not throw up once!
Julie Lohre Workout before surgery
Last chance workout! The day before my double mastectomy, I hit the gym one last time knowing that it would be a long time before I was cleared to lift upper body weights again.

Skin and Nipple Sparing Double Mastectomy with Tissue Expanders Placed

Pre-Op Emotions Before Double Mastectomy
I had ‘all of the emotions’ before surgery. From the pre-op I was excited, scared, nervous, and relieved… Mostly, I was just grateful to be closer to going under so I could forget how hungry I felt. I am terrible at pre-op fasting!!!
Morning After Double Mastectomy Breakfast
I made it! The morning after my double mastectomy I was famished. Luckily the hospital offered some healthy choices! I was thrilled to be able to order my normal egg white veggie omelet with oatmeal! After not eating for a full day, this was some of the best hospital food I have had.

Post-Op Recovery with Jackson-Pratt JP Surgical Drains

Post Mastectomy Bra with JP Drains
5 days post-op in my mastectomy surgical bra with JP drains in place. To help keep the tissue expanders in the right place, this bra is packed with adhesive backed foam inserts. Talk about padding your bra! I have not had this much extra material in my bra since I was 12!
Double Mastectomy Breast Cancer with Drains Julie Lohre
Still with drains… these things took a long time to come out, but I LOVED the bra that I received from Masthead Pink Bra. Velcro front with super soft material and hooks where I could hang the drains, this became my go-to bra once I was able to take out some of the gauze and spacers.
Jackson-Pratt JP Surgical Drain Hose and Bulb on Drain Belt
The port siphoning off fluid from my surgery site is part of the Jackson-Pratt JP Surgical Drain. Here is shown the hose and collection bulb on drain belt. These say on 24 hours a day. Two drains were placed, one on each side of my body. I had significant trouble with fluid drainage and ended up having one of the drains in for more than 4 weeks. Ideally you want these out in 1-2 weeks to decrease the risk of infection.
Jackson-Pratt (JP) Surgical Drains After Double Mastectomy Port
To allow fluid to drain away from the surgical sites, Jackson-Pratt (JP) Surgical Drains are placed after most all double mastectomies. This is the port at the side of my ribcage which lead to the drain itself. These drains had to be cleared out several times a day.

Tissue Expanders and Sentinel Node Biopsy Scars, Up Close and Personal

Natrelle tissue expander for breast reconstruction
While they serve their purpose, tissue expanders with their plastic tabs that are sewn on to the chest wall and metal port for filling are often described as feeling like an Iron Bra. I appreciated that I was able have them as I healed from surgery, but they are about as uncomfortable as you can get.
Filling Tissue Expanders
Tissue expanders have a medal port that the clinician will use a magnetic device with a needle to connect with. Tissue expanders are filled in small amounts in the months following the mastectomy and tissue expander placement. With a nipple and skin sparing mastectomy, these devices are used to either stretch the muscle for a submuscular implant or as a space holder as in my case with an above the muscle implant placement.
Sentinel Node Biopsy Scar
Just a few of my many, many scars. Under my arm is the scar from the removal of lymph nodes and on top of my breast is where they removed the skin just above the cancerous tumor. With a skin and nipple sparing mastectomy, the skin is not usually taken in this area, but since my tumor was so close to the skin, to ensure that they had clean margins, the surgeon took out about a 2 inch elliptical swath of skin.

Recovering from my Second Primary Breast Cancer Diagnosis

Sunset Walk After Breast Cancer Surgery
Not one to sit for long, 3 days post op, I convinced my husband to get out and let me walk in the neighborhood. It was a beautiful night and Piper loved walking with mom! sponsors church festival 1 week post op
1 week from surgery, our company sponsored our church festival. With drains hidden away under a long shirt, I attended the festival for a bit.
Getting some sun after surgery with Jackson-Pratt (JP) Surgical Drain hidden
By the end of the summer, about 5 or 6 weeks post op, I decided to get some sun and rest with one of my favorite books.

Swap Surgery! From Tissue Expanders to Silicone Implants

Ready for breast cancer swap surgery silicone implant
Can we get these tissue expanders out yet?!?! After 5 months, I was finally able to head toward the swap surgery. Here are the type of silicone implants that my doctors planned to replace them with. I debated briefly between saline or silicone and shaped versus round, but in the end, deferred to my plastic surgeon’s judgement and went with the round, non-textured, silicone implants that were each 310 cc’s.
Surgery Check In Desk Patient
Arriving on the morning of my double mastectomy with tissue expander placement, I head to the surgical check in desk.
Pre-Op Emailing from hospital bed
Squeezing in “just 1 more” email before I go back for the swap surgery where the tissue expanders are replaced with silicone implants.
Double Mastectomy Bra Immediately Post Op
Immediately after the surgery swapping out the tissue expanders for silicone implants you are placed in a large velcro bra to keep everything in place.
Resting after surgery with my son
My son had ACL reconstruction just days before I had my swap surgery. With just a few days until Christmas, we watched Elf and the Christmas Story several times!

Life After Having Breast Cancer Twice

6 Months Post Op Double Mastectomy FITBODY Podcast
At about 6 months post op, I took this cover photo for the launch of my podcast! Check out my FITBODY Podcast!
1 year anniversary double mastectomy
One year from the day of my double mastectomy, I am enjoying family time on vacation. God is good!

Please know, that breast cancer is just one small part of my life. While it can feel all encompassing, my goal has been to not all it to take over my life, ruin the business I have spent 15 years creating, or draw all my attention away from my clients, family, or friends. In fact, I have been so blessed over these last 3 years! My business has prospered and I am living a life I never dreamed possible. Balance has occasionally be challenging, but I was honest when that happened. Women live and thrive with breast cancer every day. I will certainly be one of the thrivers.

I recently shared my thoughts about the power of a positive attitude with my clients, and I wanted to reiterate that. One of the most important decisions you make every day is the attitude you will have when you get out of bed. Don’t take your attitude for granted, or it will get the best of you. When faced with a difficult workout or task, you get to decide how you will face it. Will you come at the problem from a positive or negative attitude? Will you focus on the reasons that things are hard, or will you dig deep and make the decision to find that silver lining? Knowing that you have the POWER to choose is incredibly liberating!

I CHOOSE to be positive. I choose to believe that I have the strength and power not just to survive a second primary breast cancer diagnosis but to use it as a platform to help others.

Read about my first breast cancer diagnosis:

My Breast Cancer Journey

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