“I didn’t have a horrible diagnosis, but whether life-changing or life-altering, any cancer diagnosis is scary and there are a lot of decisions to make.”
Stephanie Kager leads a very active life. Whether running, hiking, biking, or caring for her six children and the five horses they show competitively, she rarely slows down.
No matter how busy she is, Stephanie is diligent about getting her annual breast cancer screening.
Following her 2019 mammogram, she received a call-back for second look. She had been asked to return after past mammograms, so wasn’t overly concerned.
This time, however, it was different.
The Journey Begins
Further testing, including a biopsy, revealed the 50-year-old had stage 0 ductal carcinoma in situ (DCIS), one of the earliest forms of breast cancer. DCIS is noninvasive which means it hasn’t spread to other parts of the body.
“I didn’t have a horrible diagnosis,” says Stephanie, “but whether life-changing or life-altering, any cancer diagnosis is scary and there are a lot of decisions to make.”
A Series of Hard Decisions
Stephanie and her husband, both with medical backgrounds, began discussions with friends and Stephanie’s doctors to determine the best path forward. They first considered lumpectomy and radiation.
After an MRI showed the area of cancer was larger than originally thought, mastectomy emerged as the best option. A surgical oncologist would perform the surgery.
Stephanie also consulted with plastic surgeon Dr. John Bast who specializes in breast reconstruction. After considering all the options in this highly personal decision, she chose autologous reconstruction that uses a flap of tissue from a woman’s body to rebuild her breast. 
Surgery and Reconstruction
In February 2019, she had a double mastectomy and breast reconstructive surgery. Because her cancer was caught very early, she did not require chemotherapy or radiation treatment.
“There was not one single glitch,” smiles Stephanie. “Everything was well explained and everyone was passionate about my comfort.”
Genetic Testing
Because she is of Ashkenazi Jewish heritage, and Jewish women of Eastern European descent are more likely to have a BRCA1 or BRCA2 gene mutation linked to breast cancer, Stephanie was advised to undergo genetic testing. She was relieved to learn these tests were negative. BRCA1/2 mutations can be passed from either parent, affecting cancer risk in both women and men.
Back in the Saddle
Stephanie was eager to return to her active, independent life, but knew she had to listen to her doctors’ advice and take things slowly.
In April, she happily returned to Saddlebrook Stables in Strasburg. At first, she took long, healing walks in the pastures surrounding the barn while her children and other co-op partners pitched in to care for the family’s horses. By July, she was loading up the horses for a 12-hour drive to a North Carolina competition.
Exploring New Challenges and Helping Others
Today, Stephanie continues to be healthy and enjoy an active lifestyle, grateful to her family, friends and the medical community that supported her every step of the way.
"In the last year I have participated in a 50-mile run and two marathons—one was a shared experience with my oldest daughter and one of my sons. I am so thankful to be healthy enough to train and enjoy this time," says Stephanie.
Stephanie has also supported several friends navigating the first weeks of their own cancer diagnoses.
"I am pleased to be able to share words of encouragement with women who are going through similar times as I did," she adds.
Penn Medicine Lancaster General Health follows the American Cancer Society Breast Cancer Screening Guidelines which recommend women of average risk—which is most women—begin getting yearly mammograms at age 45. Women should have the choice to start mammography at age 40. Schedule your mammogram online.