After all, Dr. Halaharvi was just eight months into her role as a practicing breast surgeon and had no family history of breast cancer. She never thought she’d become a statistic. Currently, there is a one in eight chance that a woman will develop breast cancer in the United States, according to the American Cancer Society. She was also anxious about getting chemotherapy and wondered if she needed it. “The hair loss from chemotherapy is superficial, but I also worried about all the other side effects,” she says. Fortunately, she was able to access the Oncotype DX Breast Recurrence Score test, a genomic test that launched in 2004, which helps inform patients with HR-positive, HER2-negative breast cancer and their doctors of the treatment options that are best for each patient and, more important, can inform patients of the risk of their cancer returning and predict whether they will benefit from chemotherapy. “This ultimately helps ensure that a woman isn’t over- or undertreated,” says Halaharvi, of the test, which has already been used by over one million women worldwide. “A decade ago I would have automatically had chemotherapy so I’m very glad this test exists.” One month after her diagnosis, she decided to have a double mastectomy with implant expanders, used to increase the tissue that doctors use to re-create the breast, because she didn’t want radiation. But they were removed the following month due to a severe infection. In January 2016, she opted to have a reconstruction surgery called DIEP (deep inferior epigastric perforators) flap. “I was always compassionate before my breast cancer diagnosis, but this has made me aware of the emotional aspect of being told you have cancer,” she says. “I have gained significant compassion and can put myself in my patients’ shoes.” She also uses a personalized approach when tailoring treatments to each patient’s individual tumor and implores women to advocate for themselves and ask their oncologist if they qualify for a genetic test. “Genomic testing is part of our national guidelines for breast cancer patients who are hormone receptor–positive, HER2-negative breast cancer,” she explains. “Unfortunately, not everyone gets this test depending on where you are in the country even though it’s covered by insurance. That’s a shame since this is a well-studied test.” To drive her message home, Halaharvi engages with the breast cancer community in a few ways, including through her podcast, which has been downloaded in 62 countries since she started it almost two years ago. It features interviews with oncologists and plastic surgeons as well as updates from cancer conferences. She’s also on TikTok, helping people with breast cancer and sharing her own experiences. “I see 25 patients a day in the office, but I feel like I could educate way more people via TikTok,” she says. “Since this is for a younger audience and my youngest patient is 19, I knew this would be yet another way I could reach younger patients and talk about treatment options, breast exams, and what to do if you’re high risk.” These days, Halaharvi spends any spare time she has on these two projects, including making videos, like she did during a recent airport layover. “When I’m not working, I’m either working out or making videos,” says Halaharvi, who sees her doctor once a year for checkups and currently takes tamoxifen, a hormone therapy. As for whether she’s connected with other breast surgeons who are also breast cancer survivors, Halaharvi recently met one in California who shared her story. “Talking to her was great,” she says. “I wear this hat of breast cancer surgeon and survivor and, while my role at work is clear, it’s important to think of myself as a survivor and make sure to take care of myself, too.” In the end, her experience with breast cancer has only served to make her a better person — and surgeon. “I tell my residents and fellows, ‘Who better to get breast cancer than a breast surgeon,’” Halaharvi says. “Of course, you don’t think it’s a gift at first, but to be the best breast surgeon possible, my own diagnosis has guided me in ways I never imagined.”
