At the age of 38, the last thing on Juliette Landgrave’s mind was cancer. She was young, healthy, did not have a family history of cancer and was years away from even seeking her first mammogram. But that changed when she found a lump in her breast while showering.
“At 38, you're not thinking you're going to get cancer. My mother has had a history of water cysts in her breast, so when I first felt the lump, I was praying it was just a cyst,” said Landgrave.
“I went and I did some mammograms and some screening tests, and they actually found two tumors. I had the one that I was able to feel and one that was deeper and was only found with an MRI.”
Landgrave was diagnosed with triple-negative breast cancer and began her treatment at a different hospital before finding her way to City of Hope.
Triple-negative breast cancer is an invasive form of breast cancer that proliferates and spreads at a faster rate than other types of breast cancer.
“Triple-negative breast cancer tends to be more aggressive and more difficult to treat than other types of breast cancer. It occurs more often in younger women, in Black women and in Hispanic or Latina women. It is also more likely to recur,” said Irene Kang, M.D., medical director of women’s health medical oncology for City of Hope Orange County.
“Also, triple-negative breast cancer does not respond to hormonal therapies or medications that target the HER2 protein — approaches that can be options in other types of breast cancer. However, newer therapies such as immunotherapy combined with chemotherapy are being used in many patients with triple-negative breast cancer, and advances like these continue to improve outcomes.”
Landgrave was understandably shocked by her diagnosis, but she did not let the news keep her down for long. She swung into action quickly and became fully committed to beating the disease.
“Cancer turns your world upside down. It took time to process it. When I was first diagnosed, I was devastated, but then I turned my thoughts around. I thought to myself, I’m going to be the poster child for surviving triple-negative breast cancer. I'm going to beat the odds.”
Breast Cancer and Family Planning
Before starting treatment, Landgrave knew she had to consider her plans for a family.
“I always wanted to become a mom. As a young woman, I was concerned because I knew this very aggressive cancer was going to cause me to have to have some fertility issues. So, I went ahead and did some egg preservation,” she said.
The egg-freezing process took about two months, and during that time, one of Landgrave’s tumors grew from the size of a bean to the size of an orange. She quickly underwent 16 rounds of chemotherapy, to which she had a complete response.
The next step was surgery, and while Landgrave wanted to keep her breasts, her surgeon was pushing her to do a mastectomy.
“You go through so many changes during cancer, and after I was done with treatment, I still wanted to feel like myself. I didn’t want to go flat. I knew that was going to impact my self-esteem,” she said.
As Landgrave’s surgery date approached, her anxiety grew, but while she waited, a small window of opportunity to seek treatment elsewhere appeared.
“This journey really showed me how to advocate for myself. I really needed doctors who were able to give me all the information available for me to make an informed decision. I felt like the last surgeon I saw was not on my side,” Landgrave said.
Seeking Hope
When Landgrave’s surgeon informed her that he had to push her mastectomy date back by three weeks, she was terrified. Facing such an aggressive cancer, waiting three more weeks for surgery felt like a lifetime. Ever the optimist, however, Landgrave saw this setback as an opportunity to find a new care team she trusted. Her search brought her to City of Hope.
Within four days of her surgery being cancelled, Landgrave was able to arrange a meeting at City of Hope.
“Our multidisciplinary team of breast cancer experts worked hand in hand with Juliette to implement a comprehensive treatment plan that was right for her. This included surgery, chemotherapy with immunotherapy and radiation therapy,” said Dr. Kang.
The first step was surgery. Landgrave was happy to learn that her surgeon, Jennifer Tseng, M.D., the medical director of the division of breast surgery at City of Hope Orange County, supported her desire to undergo a lumpectomy with radiation instead of a mastectomy. Dr. Tseng considered her a good candidate for this approach because of her excellent response to the chemotherapy she completed prior to her surgery.
Landgrave’s successful lumpectomy was followed by 25 sessions of radiation therapy and a year of immunotherapy infusions.
“It’s just night and day being treated at City of Hope. The empathy and kindness I experienced there is so different from other places,” said Landgrave.
Moving Forward
After nearly two years of treatment, Landgrave is now cancer free and committed to sharing her story to raise awareness about triple-negative breast cancer.
“It is important for me to share my journey with my friends, family and community. I’m Hispanic, and Hispanic people don’t talk about cancer. I have friends who went through cancer and didn’t tell anybody. The same with some family members. I want to change that,” said Landgrave.
Her cancer journey also inspired her to pursue a lifelong passion: art.
“I always enjoyed art but never thought of myself as good. After cancer, I have a second chance at life. So, I decided to do something I love. This experience pushed me to start making and selling my jewelry,” Landgrave said.
She is also an avid traveler and is eager to make up for the years of trips that cancer prevented.
“I’ve backpacked through Asia by myself, which was amazing. Next, I want to see the northern lights,” she said.
And, of course, starting a family is still one of Landgrave’s top priorities.
“I did manage to freeze my eggs, but there are so many different ways to have a family. I know I will have one. I’m just blessed to be alive and glad my story has a happy ending.”