I don’t need to tell you what was happening between 2019 and 2023. By May of 2022, I’d received four COVID-19 vaccinations and felt confident to attend a musical production with my niece. We were front row centre and seemed to be the only patrons with masks, soon discarded I must confess. When I found myself coughing a few days later I assumed it was COVID that I’d picked up in the theatre and left it to my presumed immunity to deal with.

Having a solid strategy for gathering trusted and dependable information is critical for making informed treatment decisions when it comes to your health.  It is also important to be able to communicate assertively with healthcare practitioners as an equal partner in shared decision-making.

Today, I want to dive into the role genomics has played in my journey. As an MD specialized in genomics, this journey has been an eye-opener regarding the clinical implementation of genomics and the accessibility of genomic profiling for real patients in British Columbia, Canada, and beyond. There have been good surprises and also situations where I've directly faced barriers and limitations surrounding the clinical use and implementation of genomics.

I don’t know what it was like for you but for me, saying “I have breast cancer” out loud felt fake, like I was lying. Every time the words came out of my mouth I wanted to hide. Rationally, I knew my diagnosis was real, but the horrible emotions that preceded and followed each proclamation filled me with shame. And the voice inside my head was relentless. It just kept goading me on.

Since 2014, May 20^th has been promoted as Clinical Trials Day by the Association of Clinical Research Professionals. It is a moment to recognize the pivotal role clinical trials play in advancing research and treatment for many diseases, including breast cancer. This day was chosen to honour Scottish surgeon James Lind, who, in May 1747, conducted what is generally acknowledged as the first clinical trial.

I was unprepared for the results received on a brilliant April afternoon. Looking back, I may have wondered at being the last patient in the waiting room, or the offer of a cup of tea as I was shown a seat. The lump was an invasive ductal carcinoma – I had breast cancer.

Advances in the screening and management of breast cancer have resulted in substantial improvements for those diagnosed with the disease. Patients are living much longer after a breast cancer diagnosis, which is a major accomplishment of modern medicine. However, since patients are living longer, the complications associated with treatment (such as surgery, radiation, and chemotherapy) are becoming increasingly apparent. One such complication is the development of persistent pain in the area of breast cancer resection.

As I tried to process my diagnosis and what it meant for me, along with the future I’d envisioned for myself, I went into research mode. It’s my comfort zone. I’m curious by nature and profession (being a writer and all), and having information, knowing everything that I need to know, makes me feel in control. So, I dug deep, Googled like a crazed person, and asked my doctors hundreds of questions while I tried as best as I could to prepare myself for the unknown that was to come. Here’s what I learned about being diagnosed with early-stage breast cancer.

I hadn't been feeling well in December of 2021. My family physician was not taking me seriously, so my husband intervened. He insisted on a full work up with all of the necessary tests. I don't know where I would be if my husband had not stepped in when he did. Tests were ordered and a mammogram was scheduled but not until March of 2022.

In the 1960s silicone gel breast implants came into use, allowing for breast reconstruction post-mastectomy or augmentation to be possible, but at that time, there was no clear standard for the implant placement. At first, surgeons placed the prosthesis in front of the chest (pectoralis major)  muscle, but the chance of postoperative complications was high.