OTTUMWA — Abby Leonard said she has participated in Ottumwa’s Race for the Cure almost every year there’s been one. “I’ve missed maybe four or five,” she said. “Ironically, last year was one of them, right after I was diagnosed [with breast cancer].”
Missing the 2019 race, however, was not due to her May 2 diagnosis; she had a family event to attend.
In 2020, her role in the May 9 Race for the Cure will be different. In addition to having her own team, Leonard has been named the honorary survivor for the event.
“I was kind of caught off guard and very honored to be chosen,” Leonard said.
Organizers made their selection in early October. “It’s early for us,” committee member Deb Stephenson said at the time. “The bonus of getting our survivor early is they get to be involved as we plan this.”
Leonard’s journey with breast cancer began in early March. That’s when she found a lump in her left breast. “I thought to myself, ‘It’s nothing,’ and didn’t tell anybody,” she said. In mid-March, she had an appointment with Dr. Jeffrey Bittner and had a mammogram the next day. “Dr. Bittner knew something was not quite right.”
From there, Leonard’s journey has been a bit of a roller coaster. She said both the mammogram and ultrasound came back negative because of dense breast tissue. “It’s like finding a sliver of glass in a pile of snow,” she said she was told. “It’s humans that are reading these results. It’s not a perfect system or science.” She would have to keep that in mind as she continued through her journey.
Despite the negative results, Bittner followed his instincts and sent Leonard to see Dr. Edward Ortell for a needle biopsy, which came back positive on May 2.
She was alone when she got the results. She had a follow-up appointment with Ortell scheduled for that afternoon but checked her patient portal first thing in the morning. The results were there.
“I was completely devastated. I immediately took the day off school,” said the Horace Mann second-grade teacher. Her husband Jeff took the day off, too, and she had her appointment moved up to mid-morning. “I was in shock. I thought, ‘This happens to other people.’
“[Ortell] didn’t know I had already gotten the results, but he was apologetic and was able to explain it in more detail,” Leonard said. She was diagnosed with invasive lobular carcinoma.
Leonard was sent to Des Moines to have a breast MRI done to get more information on her cancer’s specifics.
When it came back, she said the tumor was showing larger than what was first thought and that it didn’t show in the lymph nodes.
But her following lumpectomy on May 20 showed different results. Her first surgery removed 3.2 centimeters of the tumor and 15 of 30 lymph nodes in the area. Three of those lymph nodes turned out to be positive.
“They realized I had ‘dirty margins,’” Leonard said. “That type of cancer is sneaky. It infiltrates cells so it’s hard to get clear margins. I’ve had my mammogram every year since I was 40. They told me this tumor could have been there for three years; it just wasn’t large enough to feel.”
After that, Leonard had a decision to make: going with a single mastectomy on just her left breast or doing a double mastectomy.
“With the chances of it coming back, we decided to do the bilateral [double] mastectomy,” she said.
Part of what factored into that decision was her family history. Her paternal grandmother and a first cousin, also on the paternal side, were both diagnosed with breast cancer before age 50. “My cousin and I have both had genetic testing done and it came back negative,” Leonard said. “Because of my grandmother and our similarities, it was probably always in the back of my mind that I was destined [to get breast cancer].”
During her mastectomy, 2 more centimeters of tumor were removed, pushing the total amount over 5 centimeters.
“When it goes over 5 centimeters, and having that many lymph nodes, that made it stage 2,” Leonard said.
After the second surgery came 28 doses of radiation therapy treatments. Every day, Monday through Friday, for 5 1/2 weeks, Leonard went in for sessions.
Originally, she was scheduled for 33 treatments, but her team called off the last five sessions. “The last five were just boost ones, just on the scar,” Leonard said. “My skin was in such bad condition they took pity on me. The pathology was not bad enough to require the last five.”
Leonard took a two-week break from work after completing radiation in order to allow her skin to heal and to get her energy back. “It does zap your energy,” she said.
She is also taking an estrogen blocker as the invasive lobular carcinoma is estrogen-driven. Her particular kind of cancer, she said, did not require chemotherapy. “I’m grateful for that,” she said.
She has also been in physical therapy for a couple of months and continues with that. She has developed lymphedema in her left arm, which causes it to be achy. A special sleeve helps with drainage of waste and toxins that the lymph nodes that were removed once handled. She has plans to begin treatment with a lymphedema specialist in Fairfield.
Leonard will return to Ortell’s office in early November to discuss her reconstruction procedure.
“With my bilateral mastectomy, they said I had clean margins. The cancer is gone,” she said. “I am hoping to have reconstruction done by the middle of May, sometime after race day.”
Leonard plans on having a DIEP flap procedure, which will be done by a plastic surgeon in Des Moines. “During DIEP flap surgery, an incision is made along your bikini line and a portion of skin, fat, and blood vessels is taken from the lower half of your belly, moved up to your chest, and formed into a breast shape. No muscle should be moved or cut in a DIEP flap,” reads www.breastcancer.org.
Her planned timing for the reconstruction has not been chosen on a whim: “I want to make sure I have the summer to recover and come back in August strong.”
Support and advice
Leonard said the amount of support she has received over the past several months has been incredible.
“Jeff is very supportive. I’m very lucky,” she said. She did get emotional talking about her kids. She said they show their concern and handled the news of the diagnosis in different ways. It was difficult for her to discuss.
“The emotions kind of come in waves,” she said. One day she can be very flippant about her diagnosis, but other days she finds it difficult to even say the words, “breast cancer.”
Her biggest piece of advice to others is to do self-breast exams. “That’s the big story right there. The doctor told me 70-80 percent of women don’t do self-exams,” she said. “I thought that was insane.”
She’s got family in town to help her through the process, which she said is very nice. And the school has been supportive as well.
“My co-workers at school and other friends have sent meals and flowers. Just the other day they brought me a gift card to have my nails done,” she said.
In addition, former students have sent her cards and the district is having “Team Abby” shirts made.
Before her lumpectomy, she decided to tell her students about her diagnosis. “I told the students when I had my first surgery scheduled so they knew I was going to be gone and why that was,” she said. “Having to miss the end of last year was tough. I didn’t want to worry them because of Bob,” she said, referring to a staff member at the school who has also been battling cancer. “He was gone a long time.”
She said she also received great support from her treatment team: “I want to stress the amazing care that I have received here in Ottumwa. Dr. Bittner, Dr. Ortell, all the nurses on the fourth floor, the recovery nurses and the radiation therapists at McCreery are all amazing at what they do. We are blessed to have them.”