For 4 Long Island women, facing breast cancer at different life stages comes with its own challenges

At 33, Rori Zura was newly married and still deciding whether she and her husband wanted children. Then she was diagnosed with breast cancer.

Within weeks, Zura underwent an egg retrieval procedure, and the couple created one embryo, which she nicknamed "Vanilla Ice." When that effort did not work out, she continued trying to preserve her fertility through medically induced menopause.

"Am I doing this for no reason? Is this even going to work?" Zura recalled thinking. "Am I gonna even be here for this to work?"

Zura’s age put her among a relatively small share of breast cancer patients. About 10% of all new U.S. breast cancer cases occur in women younger than 45, according to the Centers for Disease Control and Prevention. Women 65 to 74 accounted for 27.5% of new female breast cancer cases from 2019 through 2023, the largest share of any age group, according to National Cancer Institute SEER data.

Long Island’s age-adjusted breast cancer incidence rates also exceed state and national rates. From 2018 through 2022, the rate was 150.1 cases per 100,000 women in Nassau County and 144.4 in Suffolk, compared with 135.6 statewide and 131.3 nationally, according to State Cancer Profiles.

The concerns that come with a diagnosis can look different depending on when in a woman’s life it occurs.

"A breast cancer diagnosis can be life-altering at any age," said Melisa Siris, Long Island program manager and oncology social worker at CancerCare. Younger women may be building careers and families, middle-aged women balancing children, aging parents and work, and older women concerned about independence, quality of life and future family milestones, she said.

‘It took that decision away from us’

During the COVID-19 pandemic, Zura, now 39, noticed a lump in the shower. She had a history of benign lumps, but this time a biopsy showed stage 1A triple-negative breast cancer. Microscopic cancer was later found in lymph nodes after her double mastectomy, prompting additional treatment.

Zura, of Commack, underwent chemotherapy, mastectomy and lymph-node surgery, radiation and oral chemotherapy.

"Family was definitely something that changed," Zura said. She and her husband, who had previously survived testicular cancer, had already considered IVF, but her diagnosis sped up that timeline. "It took that decision away from us," she said.

For younger patients who want children, fertility discussions should begin as soon as breast cancer is diagnosed, said Dr. Iris Zhi, a breast medical oncologist and interim chief of the Division of Hematology and Oncology at NYU Langone Hospital-Long Island. That gives fertility specialists time to preserve eggs or embryos before cancer treatment begins, she said.

Zura, now a cancer exercise specialist and patient advocate, said cancer in the 30s can make ordinary milestones feel far away.

Friends may be "starting families and buying houses and making milestones," she said, "whereas someone who might be in their 30s, their milestone is just getting through chemo."

While Zura and her husband do not currently have children, they have "two fur babies" that she said she considers her own. She is currently in remission. 

‘Concerned about my kids' future’

Valerie St. Bernard, of Deer Park, was in her 40s when she felt a lump in her right breast. The retired New York City correction officer was running a licensed home daycare and raising two preteens when she learned she had breast cancer.

"As a parent, you always want what’s best for your kids," St. Bernard said. "I was very concerned about my kids’ future."

After surgery, St. Bernard underwent chemotherapy, which forced the mother of two to slow down and rely on others for day-to-day tasks. A volunteer helped with the daycare because treatment weakened her immune system, while her husband, Eddie, took over cooking and getting their children ready for school.

Siris said such role shifts can be especially difficult for mothers. "Many mothers describe a lot of guilt," she said, as treatment disrupts family routines and women hand off responsibilities they previously managed.

With cancer changing her daily life and no personal connection to anyone who had been through it, St. Bernard reached out to the one person she knew of who had: television anchor Robin Roberts.

After St. Bernard left a message with the station, Roberts called back and spent roughly an hour talking her through what to expect, later sending a book and other materials that St. Bernard said helped reassure her.

"This is not the end of your road," St. Bernard recalled Roberts telling her. "It’s a detour in your journey."

Sixteen years later, St. Bernard said she still holds on to those words. Currently living with no evidence of disease, St. Bernard says she tries to offer the same kind of encouragement to others facing breast cancer.

‘I became the patient’

Karla Waldron had spent years helping people with cancer as executive director of Mondays Cancer Care in Sayville, a nonprofit that provides free beauty and wellness services to people undergoing cancer treatment. Then an overdue mammogram led to her own breast cancer diagnosis at 56.

"Everything I thought I knew disappeared completely," said Waldron, 57, of Bayport. "I suddenly wasn’t the person helping somebody else navigate a diagnosis. I became the patient."

The diagnosis carried another layer of fear: Waldron said she was around the age her mother had been when she was diagnosed with breast cancer. She died at 59.

"Every time I looked in the mirror, that’s what I saw," Waldron said. "I saw my mom."

She was also just entering menopause before her diagnosis. In the months surrounding surgery and recovery, she said, she experienced brain fog, interrupted sleep, hot flashes and increased anxiety.

"It’s a double whammy if you’re going through menopause while you’re going through cancer treatment," Waldron said. "It’s like the worst sucker punch in the world."

It’s a double whammy if you’re going through menopause while you’re going through cancer treatment. It’s like the worst sucker punch in the world.

— Waldron, of Bayport, who was diagnosed at 56

Some breast cancer therapies can cause early or medically induced menopause. "They can have more pronounced menopausal symptoms because it’s an abrupt menopause," said Dr. Alison Stopeck, associate director for clinical research at Stony Brook Cancer Center, "as opposed to the slow menopause women naturally go through over several years."

Waldron said decisions about hormone replacement therapy for menopause symptoms became more complicated after her breast cancer diagnosis. She said her diagnosis and treatment influenced her decision not to use hormone replacement therapy. "It was a very difficult time. It still is for me," she said.

Waldron is currently in remission. 

Role reversal

Vanie Tuthill was 71 when she stepped out of the shower and noticed rippling in her left breast. Despite a clear mammogram less than six months earlier, she was diagnosed with stage 2 breast cancer that had reached her lymph nodes. 

Tuthill, now 76, splits her time between Calverton and Naples, Florida. Before cancer, her retirement meant a full calendar of lunches, gatherings with friends and family, cooking and travel.

The diagnosis quickly forced her to slow down. Tuthill underwent a lumpectomy and surgery involving affected lymph nodes, followed by six weeks of radiation. For a woman used to being on the go, the change was abrupt.

"I suddenly could only do the bare minimum of what I needed to do to live day to day," she said.

Treatment also meant leaning on family in ways she was not used to. Her daughter, Bernadette Tuthill, 52, a breast cancer survivor herself who was diagnosed at age 42, went to appointments as a "second listener," helped her remember what doctors had said, ran errands and checked in regularly.

When Bernadette had been diagnosed years earlier, Tuthill remembered thinking, " 'Why did it have to be her? She’s so young. It should be me.' And a few years later it was."

Accepting help, however, did not come naturally. Before treatment, if Tuthill needed groceries, she simply got in the car and went. During treatment, routine errands became things she sometimes had to hand off to her husband.

"I might be 70 years old, but I feel like I’m 50," she said. "I’m so independent."

Stopeck said preserving daily function and the ability to live independently is an important consideration when treating older cancer patients. "Quality of life is huge," she said.

Now in remission, Tuthill said she wants to keep traveling, spending time with family and friends and being present for her grandchildren. Cancer, she said, gave that time new meaning.

"I want to appreciate life every day that I can," she said, "because it can change on a dime."