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Last fall, Carolyn Searles had just returned home from a weekend getaway to celebrate her 36th birthday when she noticed a “golf ball-sized lump” under her arm.
At the time, she was 16 weeks pregnant with her and her husband’s second child, a “miracle” baby after in vitro fertilization and two miscarriages.
The sudden appearance of the lump prompted Searles to quickly seek out testing and a biopsy – hoping for the best but fearing the worst. Breast cancer ran in her family, and years ago, she had tested positive for a genetic mutation that put her at high risk.
“The next day, I found out that it was malignant while I was sitting in the ultrasound chair with a new sonogram of my perfectly healthy baby boy,” she said.
The devastating reality of the situation began to sink in.
“I was absolutely despondent,” said Searles, who lives in Wallingford, Pennsylvania with her family. “I was scared that I wasn’t going to be able to carry out the pregnancy and be able to get treated. And I kind of kept that fear to myself because it was such a deep dark nightmare after everything we had been through.”
Breast cancer during pregnancy is still considered uncommon, occurring in roughly one out of every 3,000 pregnancies, according to the National Cancer Institute. But cases are becoming more frequent, national data shows, as more women have babies at older ages, when risk for all cancers increases.
In the past, doctors and health providers were more likely to recommend that women delay cancer treatment until after childbirth to avoid possible toxin exposures and safety risks to their unborn babies. Some may have suggested terminating the pregnancy to begin aggressive therapy sooner.
But more research in the last couple of decades has shown that treatments like chemotherapy and surgery can be done successfully during pregnancy, and in a way that is safe for the babies.
Despite the long fight ahead of her, Searles said it was a relief when doctors told her that based on research and other patient outcomes, they were confident she could safely begin chemotherapy in her second trimester, which would give her the best chance of delivering a healthy son and beating the disease. It’s something she feels more cancer patients need to hear about.
“To have the medical professionals so confident that there is a way to treat you and not affect the baby, it should be known,” she said.
Genetic risks for breast cancer and preventative actions
Searles’ breast cancer journey started long before she was ever diagnosed with the disease.
Her aunt has lived through three occurrences of triple negative breast cancer, which put the family on high alert, especially Searles and her two sisters.
Then in 2019, one of her sisters, who is a nurse practitioner in women’s health, was offered genetic testing through her health care employer. All three women and their father got tested. All were positive for the BRCA1 cancer gene.
It meant the sisters had up to a 72% likelihood of developing breast cancer and up to a 58% likelihood of developing ovarian cancer in their lifetimes.
There are options women can take to reduce their chances of developing disease or an advanced case, including frequent mammography screenings and preventative surgical procedures like a double mastectomy and the removal of fallopian tubes and/or ovaries.
But it was a lot to think about at the time, Searles said, who had just started dating the man who’d become her husband, Andrew.
“You have to think about kids way down the line. You have to think about if you’re going to breastfeed your potential children in the next 10 years,” she said. “It’s really heavy. I didn’t realize how intense it was until I was handed pamphlets for support groups on how to tell your loved ones and I was like, ‘Oh, this is pretty serious.’”
She did start getting routine mammograms every six months. But when a close friend was diagnosed with breast cancer at 38 weeks pregnant, Searles decided she needed to take more drastic action.
“At that point, I just couldn’t sit there and watch what she was going through with a newborn, and understand this could happen to me,” she said. “If I could do something about it, I really should.”
Searles had a double mastectomy right before she and Andrew wed in 2022. Soon after, they became pregnant and had their daughter, Corinne, who was born with no health complications for mom and baby.
Meanwhile, Searles was no longer getting routine mammograms, as the screening test isn’t generally recommended for people who’ve had mastectomies and breast reconstruction.
When she finally got pregnant with her son, her “miracle” baby, doctors told her that they might have to remove some residual breast tissue, as a preventative measure — just before she was diagnosed with cancer.
Breast cancer treatment during pregnancy, childbirth and postpartum
Searles was treated at Penn Medicine, where she started chemotherapy two weeks after her diagnosis in September 2025.
“I couldn’t believe that you could actually have chemo when you were pregnant,” she said. “I was just reassured that the placenta is an incredible thing and the baby would be protected.”
She tolerated the therapy well, she said, aside from the inevitable fatigue she would feel from a combination of treatments and pregnancy. But she was still working full time and had a lot of support from her husband, family, friends and colleagues, she said.
About three months into chemotherapy, she was induced at 33 weeks to deliver her son. Doctors wanted to add an immunotherapy medication to her cancer treatment, but it could pose more risk for the baby. At the same time, her health care team reassured her that her son had grown enough to be delivered safely and receive follow-up care in the neonatal intensive care unit.
Searles was able to labor and give birth vaginally, and in the early hours of a chilly January morning, her son, Blake, was born.
“I kept my wig on the entire time until right before I had him, because I’m like, I just want to be a regular patient who’s having a baby,” she said. “And he came out screaming, he really didn’t need that much intervention. It was just such a happy, happy day.”
But Searles still had a fight ahead of her and immediately returned to cancer treatment within the first week of postpartum.
“I had Blake on a Saturday and I was at chemo on Friday,” she said.
She had stopped working to take her maternity leave, which gave her the opportunity to recover in postpartum and spend time at home with her newborn and her daughter, who was nearly 3.
At the same time, months of toxic and harsh cancer drug treatments began catching up with her body. She started feeling weaker and sicker, she said.
“It is pretty devastating watching your family and your life kind of going on in front of your eyes and you’re on the couch and you’re not really able to be super present,” she said. “There’s something pretty heartbreaking about that.”
Searles completed chemotherapy in April and then had surgery to remove remaining breast tissue. She also had her fallopian tubes removed, her first step toward preventing ovarian cancer, she said.
Doctors soon declared her disease-free and in remission.
“There was nothing like finding that out,” she said. “It’s been a long journey.”
Fighting for cancer research funding and future breakthroughs
Searles still needs follow-up infusions and maintenance medications following her primary breast cancer treatment to lower the risk of the cancer returning, but she’s gone back to work and is enjoying time with her husband, watching their kids grow.
“She does love him,” she said of her daughter and son. “It’s really cute because he started laughing and smiling in the last couple months, so it just lights her up and she just loves making him laugh.”
Searles has also become an advocate with the American Association for Cancer Research to push for more cancer genetic testing, screening and research funding. She recently traveled to Washington, D.C., for the annual Rally for Medical Research, a national movement calling on policymakers to invest in the National Institutes of Health and medical research grants.
She joined other cancer patients and survivors as they met with lawmakers to share new findings from the American Association for Cancer Research’s 2026 Progress Report, which detailed “a steady decline in cancer mortality and an increase in the number of individuals living longer, fuller lives after a cancer diagnosis” in the United States.
The report also noted that inconsistent research funding could “threaten the nation’s ability to sustain scientific innovation and deliver future breakthroughs.”
“Without this cancer research, who knows where I would have been, where my son would have been,” Searles said.
And her journey with cancer isn’t over, she said, as she still faces an increased risk of developing ovarian cancer because of the gene mutation.
“And I’ve already taken one step … but research is going to dictate what I do in the next couple years,” she said.
She also thinks about her children, the next generation of her family who may have to deal with cancer genes and other risks someday.
“Everyone has loved ones who are affected by cancer and it’s a sad reality,” she said. “So the more research there is, the better chance everyone’s going to have when it hits their home.”
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