Research Is the Reason I’m Here for the People I Love

After she was diagnosed with metastatic breast cancer, Abby Pastyrnak was determined to live her life fully. Because of research, she has done just that. 

When Abby Pastyrnak found a lump in her breast in December 2017, her gynecologist told her it wasn’t a cause for concern but to keep an eye on it. She went for a second opinion, and that doctor said the same. Abby was only 37. She’d already had her first mammogram a year earlier—ordered because she had dense, fibrocystic breasts—and the results had been normal.

Still, she couldn’t let go of the feeling that something was really wrong. At her annual physical, she asked her primary care provider to schedule a mammogram.

“The insurance approval was challenging because I was under 40,” Abby said. “But I told my doctor, ‘I don’t care. I’ll pay for it. I just feel like something isn’t right.’”

Immediately after the mammogram, the technician asked her to stay for an ultrasound. “I was lying on the table and asked her, ‘Do you think it’s something bad?’” Abby said. “Without revealing much information, she let me know that basically things didn’t look good. I knew right then and there that it was cancer.” After the ultrasound came a biopsy.

A few days later, as she was sitting at her desk at the Massachusetts-based pediatric cancer charity One Mission, where she has long worked, she got the call that confirmed her fears.

“I was totally devastated,” Abby remembered. “The first thing that ran through my head was, How am I going to tell my mom? And then everything else: Am I going to die? Am I going to lose my hair? What does this mean?”

Abby’s care team outlined her options: a lumpectomy followed by radiation and hormone therapy (because the cancer was hormone-positive), or a mastectomy also followed by hormone therapy. The doctors told her that the cancer, which they believed to be at stage 1, was slow-growing, and her Oncotype DX score was very low, meaning that she probably wouldn’t need chemo. Before making a final decision, she wanted to get the results from genetic testing. When the tests came back negative for mutations linked to breast cancer, she scheduled a lumpectomy.

After the surgery, doctors confirmed that the cancer was stage 1. A month later, in February 2018, she began radiation. Over the next four weeks, she’d have 19 sessions—a detail she found comforting.

“The number 19 holds a special place in my heart,” Abby said. “My dad used to race cars in his spare time, and 19 was his number. He passed from a heart attack when he was only 46, so I have the number 19 tattooed on my arm. I thought, Okay, my dad is somehow going to guide me through this process.”

Radiation was grueling. She was exhausted and struggled with brain fog. When the treatment was finally over, she had to confront the psychological challenge of absorbing what she’d experienced.

“When you have a plan in place, you’re all about getting through that plan—but when you’re done, you think, ‘What just happened to me?’” Abby said. “It’s like you can’t quite process it until it’s over. At first I crashed—but then I became a different person. I started saying yes to things that I might have said no to before. It’s like I became the person I should have been all along but hadn’t because something had always held me back.”

She focused on living life to the fullest, seeing friends and meeting new people. One of those people was Al, a friend of a friend who chatted with her at a New England Patriots game, then asked her for a date. Soon, they were in love.

About a year after Abby had been deemed cancer-free, she needed another operation, this time to remove internal scar tissue she’d developed from the radiation treatments. The results from her pre-surgery MRI revealed an unexpected irregularity on her liver. Her doctor said it could be a benign cyst and told her to come back three months later for another MRI.

At the second MRI, the irregularity had grown a little larger. CT and PET scans yielded inconclusive results. Her doctor said it was highly unlikely that the cancer had come back. The cancer had been low-grade and slow-growing, and it hadn’t spread to the lymph nodes. But just to be sure, Abby got a liver biopsy.

Before, when she found the lump in her breast, Abby had known it was a malignant tumor. This time, she was just as sure that it couldn’t be.

“I felt it in my bones,” she said. “Things were going too well. I had just met a man I was going to marry. I was living a good life. It couldn’t be metastatic breast cancer. And so, I was blindsided when it was.”

She called Al and asked him to meet her at her place. It was April 2019, and they’d been dating less than a month. Before this diagnosis, Abby had assumed that children would be an option if she temporarily stopped hormone therapy or waited until the course was finished, but now that would be impossible. Her new treatment plan would put her into permanent menopause—and there would be no pausing or stopping temporarily because metastatic breast cancer currently needs lifelong treatment. She and Al hadn’t even had the chance to talk about having a family.

Al hadn’t signed up to date someone who had breast cancer—let alone a form of breast cancer that can be treated but not cured. She tried to give him an out.

“I wanted him by my side, but I also tried to break up with him, because I didn’t want to put him through this,” Abby said. “I told him to leave while he could, before we were too attached.” He just said, ‘I’m not going anywhere.’ And he’s been there for me ever since.”

Al joined her when she met with her oncologist, BCRF investigator and Scientific Advisory Board member Dr. Eric Winer, to discuss what it would mean to live with the disease. Now her treatment goal wouldn’t be about survival but about maintaining the best possible quality of life.

Abby was reeling from the news and that heavy appointment. She was also scheduled to go to a Breast Cancer Research Foundation gala that very evening, but didn’t even have a dress because she’d been too preoccupied to think about it. She could cancel. But she wanted to keep saying yes to things. Dazed, she headed to the store with her mother and Al. They picked out a dress for her, and she went straight to the event.

“That was my way of saying, ‘No, I’m here to stay,’” she said. “I’m going to be here, and I’m going to believe that I can be here for a long time.”

Dr. Winer, who was also at the event, made a donation in her name.

Six years later, Abby, now 45, is still on her first-line treatment: a CDK4/6 inhibitor called Ibrance® along with an aromatase inhibitor. She does the best she can to contend with a host of side effects, including exhaustion, insomnia, and joint pain. The mental aspect has been tough too.

“Every day you’re thinking, When is the other shoe going to drop?” she said. “Well-intentioned people ask, ‘Are you done with treatment? Is the cancer gone?’ And I politely say, ‘No, I’ll be in treatment for the rest of my life. Unfortunately, there’s currently no cure.’ The hardest thing is watching the people I love worry about me. But on a positive note, I will say that you can live a very full life even with metastatic breast cancer.”

Abby has tried to do just that. In 2020, she and Al bought a house, and the following year they got married. None of this could have happened, Abby says, without treatment advances made possible by research.

“Ibrance came out in 2015, and I started it in 2019, which means that just four years before I began taking it, that drug didn’t even exist,” she said. “Research is the reason I get to spend time with my husband—my true love. It’s the reason I get to wake up every day and play with my dogs. Research might save my life—and even if it doesn’t, it’s enabled me to have a really good life. It’s the reason I’m here today.”

Read more stories from BCRF’s Research Is the Reason storytelling initiative here.