HR-Positive Breast Cancer: Sara's Patient Story

What happened, in summary

Sara Glenn was 38 when she felt a peanut-sized breast lump during a self-exam in summer 2024, while her family was moving from North Carolina to Southern California. Mammogram, ultrasound and biopsy showed a 2 cm grade 1A-1B ER-positive, HER2-negative breast tumor. At first, her oncologist discussed lumpectomy followed by radiation, and Sara began to believe treatment might be straightforward. Genetic testing changed everything. It found a TP53 mutation, causing Li-Fraumeni syndrome, a rare inherited condition that sharply raises lifetime risk for many cancers. Because radiation can trigger new cancers in people with Li-Fraumeni syndrome, lumpectomy and radiation were no longer appropriate. Sara had a bilateral mastectomy in September 2024, 3 weeks after arriving in La Jolla, then reconstructive surgery in April 2025. She also planned to take tamoxifen for 10 years. City of Hope helped set up intensive surveillance: physical exam and blood tests every 6 months, annual skin screening, brain and whole-body MRI monitoring, and colonoscopy every 2 to 5 years. Her daughters were also tested and both carried the TP53 mutation, so they entered their own screening plan. As of June 2025, Sara was recovering physically and emotionally while learning to live with lifelong cancer-risk monitoring.