“In my mind, it was always a matter of, not if but, when,” said Dina Sabra, Canadian-Egyptian breast cancer survivor. With breast cancer making an appearance in her maternal family history for over three consecutive generations, Dina knew breast cancer would be an unwelcome visitor in her life one day; however, she didn’t expect the visit to come so soon. Dina’s grandmother, mother and aunt all battled breast cancer post-menopause, prompting Dina’s shock when her battle came at age 36.
As a result of her family’s relationship with breast cancer, Dina routinely visited a breast specialist in Dubai, UAE, where she, her husband and her three children were residing. In January of 2012, at one of her routine checkups, Dina did a mammogram and a tumor marker test. Her scans seemed clear, but her tumor marker lied at ‘borderline.’ “For whatever reason, I was still super chill and not worried,” said Dina, thinking back to the moment she received those results.
Dina and her family planned to take a trip to Disneyworld in Orlando, Florida during the summer of 2012. Before taking off to the most magical place on earth, Dina’s husband suggested she do a breast check up with a famous breast specialist, new friend and colleague of his at Emirates Hospital. Unhappy with Dina’s scans, the breast specialist, Dr. Sama Tewfik, told Dina to enjoy her vacation and an MRI would be scheduled for her when she returned. “Even at that point, I still wasn’t worried,” said Dina. “I was like, ‘I’m too young, they’re just being cautious… they’re doing their due diligence, [and] they don’t want to feel like they’ve cut corners.”
Soon after returning from a great family vacation, Dina went to see Dr. Tewfik at Emirates Hospital for her MRI. “Even though the MRI was basically clear, she was still not comfortable with what she was seeing,” said Dina. One MRI snowballed into a mammogram and an excision biopsy. Finally, after multiple tests, the results were in… Dina was diagnosed with DCIS breast cancer and grade three comida cells. DCIS breast cancer is, “the very first stage when [the cancer] is still inside the [breast] ducts,” explained Dina.
Unable to emotionally process what was happening to her, Dina had a more proactive response to the news. “Once I got the diagnosis the first thing I did was call my dad… because he’d gone through the same experience with my mom,” said Dina. Thankfully, Dina’s mother has recovered from breast cancer and is still alive and well at 73 years old.
Dina was also tested for BRCA one and BRCA two genes after her diagnosis, and, although her results came back negative, Dina’s oncologist suspected that, given her family history, there may be some other genetic link that encouraged her breast cancer. Dina was then tested for her ancestry, and the blood work showed that she has 5% Ashkenazi Jewish ancestry. According to the CDC, “Ashkenazi Jewish women are at higher risk for breast cancer at a young age.”
With chemotherapy radiation and a bilateral mastectomy on the table, Dina teetered back and forth between the two before turning to others for guidance. Dina’s dad leaned more towards the mastectomy because of her age. “He was like, ‘You’re too young to spend the rest of your life in doctor’s offices and always worrying,’” recalled Dina. Similarly, Dr. Tewfik recommended the mastectomy because grade three comida cells are very aggressive and the chance for recurrence at Dina’s age is high.
Dina decided to undergo the bilateral mastectomy, as well as a skin and nipple sparing mastectomy (reconstructive surgery), in the United States upon her doctor and father’s recommendations. Dina felt this was the right decision for her situation because, although a bilateral mastectomy is more aggressive than chemotherapy, all her breast tissue would be removed, preventing the spread of the tumor and eradicating existing cancer cells.
Confident in her decision, Dina was still more concerned with planning her travel, arranging doctors’ appointments and researching, than dealing with the emotional strain of the situation. “A friend of mine was on the phone with me one day and she’s like, ‘I’m actually worried you haven’t cried about this yet,’ and I really hadn’t because I was just dealing with the logistics,” said Dina. “It didn’t really hit me until we set a date for the surgery.”
With only 10 days between her diagnosis and her planned travel to Manhattan for her treatment, Dina arranged for her mother to fly in from Egypt to look after her three kids – who were 6, 12 and 14 years old at the time. Dina, wanting to protect her children from the reality of the situation, downplayed the news to her kids. “I said, “Nana had breast cancer, look at her, she’s fine so you don’t need to worry about it,” said Dina. A few days after subtly breaking the news to her children, Dina was off to New York for her treatment and the real battle began…