From battlefield to breast cancer survival

For many veterans, the skills they learn during military service continue to help them overcome challenges they face once their time in uniform has ended.

That’s true for Kara, who deployed to Iraq in 2003 with the New York Air National Guard during Operation Iraqi Freedom.

“The military taught me that I could do hard things,” she says. “You focus on the task ahead, do the work, and get through it.”

Service made her resilient. Still, her “tough girl” exterior, as she calls it, had a downside.

“I never really learned how to process trauma or fear,” she says. “The military builds self-reliance, which can be isolating when you’re facing something like cancer.”

Kara’s breast cancer diagnosis arrived at a moment that should have included only happiness. She had just gotten married, had moved to be closer to family, and had begun a teaching career. She felt healthy. Two weeks after her wedding, she found a golf ball-size lump in her left breast.

She saw her doctor, and then the news came: stage 3 breast cancer. When exploring treatment options, Kara opted for the Oncotype DX Breast Recurrence Score test. Her test results indicated a moderate risk of cancer recurrence, which helped her decide to have chemotherapy as part of her treatment.

“When my score came back with moderate risk — not low — I knew I would choose to do the chemo,” she says. “It was the piece of information I needed to make a really hard choice, and it reassured me that I’d made the right decision.”

Serving veterans with precision oncology

The U.S. Department of Veterans Affairs (VA) has increased its support for veterans in recent years, particularly for those who served in the Gulf War in the late 20th century and for post-9/11 veterans like Kara. Passed in 2022, the bipartisan PACT Act expands VA health care and disability benefits for veterans exposed to burn pits, Agent Orange, and other toxic substances during their service.

The act established a list of cancers and other illnesses that are presumed to have resulted from military service in certain countries or the airspace above them. Breast cancer is on that list of presumptive conditions. According to the National Breast Cancer Foundation, women in the military are up to 40% more likely to develop breast cancer than their civilian counterparts.¹

Exact Sciences serves patients with tests that include the Oncotype DX Breast Recurrence Score test and the Cologuard^® colorectal cancer screening test. The company supports veterans through a national contract with the VA’s National Precision Oncology Program, which uses molecular testing to analyze a veteran’s genomic profile. This helps determine their cancer prognosis and the best course of treatment.

As part of its offerings, eligible veterans diagnosed with breast cancer can access the Oncotype DX Breast Recurrence Score test, now incorporated into the VA’s clinical pathways for stages 1-3 ER+/PR+ and HER2- invasive breast cancer. The test uses the genomics of a breast cancer tumor sample to determine if a patient with early-stage (HR+, HER2-) breast cancer may benefit from chemotherapy and to quantify their individual risk of recurrence.^2,3,4,5 Over the past five years, more than 1,000 veterans have benefited from the test.⁶

That number is likely to rise. From 2010 to 2020, the number of female veterans served by the Veterans Health Administration nearly doubled, to half a million women.⁷ In 2020, women made up about 17% of the total Department of Defense military force,⁸ suggesting an increasing need for health care solutions tailored to women who are veterans. 

Kara encourages qualified veterans to take advantage of VA benefits provided by the PACT Act, whether they’ve just been diagnosed or have already gone through treatment and are facing future care.

“Get the help you deserve,” she says. “Thanks to the PACT Act, I’ve been able to access the care and support I needed.”

She’s grateful that care included the Oncotype DX Breast Recurrence Score test, which has been helping patients make cancer care decisions for 20 years.

“I think about all of those who suffered from this disease before such advanced testing was available,” she says. “I think about those that had chemo that maybe didn’t need it and how the treatment has impacted their long-term health. And I think about people who chose not to get chemo when they should’ve had it. Some of them faced recurrence, metastatic disease, and even death, which might have been avoided had they had the key information needed to make a different choice.”

Beyond physical care, Kara reminds veterans to take care of their mental health, too

“Go to therapy,” she says. “Stop pretending everything’s fine. You don't have to be strong all the time.”

With the right support, veterans are equipped better than ever to fight — and win — against cancer.

This story reflects one individual’s experience and is not clinical, diagnostic, or treatment advice for any particular patient. Not every person will have the same treatment, experience, outcome, or result. The Oncotype DX Breast Recurrence Score^® test is ordered by your healthcare provider. Talk to your healthcare provider about whether the Breast Recurrence Score® test may be right for you. To learn more, visit www.chemoyesorno.org. If you've used an Oncotype DX^® test and are interested in sharing your story with our team, please get in touch here. We'd love to hear from you!

References

1. Military women’s patient relief fund. National Breast Cancer Foundation. https://www.nationalbreastcancer.org/nbcf-programs/military-womens-patient-relief-fund/ 
2. Paik S, Shak S, Tang G, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004;351(27):2817-2826.
3. Paik S, Tang G, Shak S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24(23):3726-3734.
4. Dowsett M, Cuzick J, Wale C, et al. Prediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study. J Clin Oncol. 2010;28(11):1829-1834.
5. Albain KS, Barlow WE, Shak S, et al. Prognostic and predictive value of the 21- gene recurrence score assay in postmenopausal women with nodepositive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol. 2010;11(1):55-65.
6. Exact Sciences internal data.
7. Breland JY, Frayne SM, Saechao F, et al. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 5: Longitudinal Trends in Sociodemographics and Utilization, Including Type, Modality, and Source of Care. Women’s Health Evaluation Initiative, Office of Women’s Health, Veterans Health Administration, Department of Veterans Affairs, Washington DC. June 2024.
8. U.S. Department of Defense . 2021 Demographics profile of the military community(2021).
   https://download.militaryonesource.mil/12038/MOS/Reports/2021-demographics-report.pdf