Navigating an Aggressive Breast Cancer Diagnosis
- Dallas meteorologist Mariel Ruiz, 33, briefly returned before Christmas to update news viewers on her breast cancer journey, noting she may look different when she’s back on air but remains energized and optimistic.
- Her update highlighted the physical and emotional impact of treatment, while viewers responded with overwhelming support as she navigated surgery and recovery.
Triple-negative breast cancer has a high recurrence rate, with up to 50% of early-stage patients experiencing a return of the disease, according to JCO Oncology Practice. She says her second diagnosis was emotionally and physically harder to deal with. - Triple-negative breast cancer is an aggressive form of the disease, but it often responds well to chemotherapy as opposed to targeted therapy like hormone therapy because this type of breast cancer is not fueled by any of the three main types of receptors: estrogen, progesterone, or the HER2 protein. Typically, chemo is the first line of treatment; however, more recently, immunotherapy has emerged as an option for some triple-negative breast cancer patients.
- According to Dr. Heather McArthur, previously medical director of breast oncology at Cedars-Sinai Medical Center, studies suggest that giving patients immunotherapy early on in the treatment of metastatic triple-negative breast cancer works better than when taken after chemotherapy.
- SurvivorNet experts say treating triple-negative breast cancer may involve chemo before surgery (neoadjuvant chemotherapy) to shrink the tumor, making it easier to surgically operate on. Neoadjuvant chemo can also tell doctors if you’ll need additional treatment after surgery. Some patients with triple-negative breast cancer may also need radiation after surgery.
- A major health challenge that causes noticeable changes to your appearance can impact how you feel, physically and emotionally. Psychiatrist Dr. Marianna Strongin encourages cancer warriors to look at and appreciate the parts of their bodies that were affected by treatment to take back ownership.
Ruiz had just celebrated her 33rd birthday this summer when she shared the news that she was facing triple-negative breast cancer, an aggressive form of the disease, on a social media video.
Read More“Any triple-negative cancer that’s over half a centimeter or has lymph node involvement needs chemotherapy. This is usually two different types of chemotherapy for three months each, with two different classes of drugs. One is called taxanes, and one is called anthracyclines,” Dr. Nangia continued.
Triple-negative breast cancer is known for its high recurrence rate: up to 50% of patients with early-stage disease (stages I to III) experience a return of cancer, according to JCO Oncology Practice. Bessix became part of that statistic when she discovered another lump—this time, in the exact same location.
“You won’t see me on air for a few weeks. I had planned surgery this week as the next step in beating cancer. All went well, and I am recovering,” Ruiz said.
In her holiday update, she acknowledged that she may look a bit different when she’s back on air, but her passion for life—and for guiding North Texans through the forecast—remains as strong as ever.
“Recovery from surgery has been slow. I’m still very limited with mobility and endurance, which is so frustrating for me,” Ruiz said in a December update.
“Doctors say I’m recovering just fine. I miss you all,” she continued.
Cancer treatment often leaves lasting physical and emotional imprints. For many breast cancer patients, surgeries such as mastectomy can alter how they see themselves. Even with breast reconstruction, new breasts may not look or feel exactly the same, deepening the sense of change and adjustment.
The fear of how others will respond to these visible changes in appearance can weigh heavily on patients. But for Ruiz, that worry was met with warmth. Viewers flooded her with messages of encouragement, offering a powerful reminder that she isn’t facing this journey alone.
“As a longtime WFAA viewer, I have been praying for you from the moment you announced your cancer diagnosis,” Facebook user Louise Richardson Douglas Yates commented.
“You look great. Prayers for a speedy recovery,” Facebook user Rose Gerace commented.
“Mariel, you’re looking good. Keep your faith strong and a positive attitude, and we all pray for you,” Facebook user Eddie Tutt said.
During her recorded video announcing her diagnosis, Ruiz said, “If you see me out and about and I look a little different, just know, I’m still me, I’m still Mariel, I’m just facing a different kind of storm right now.”
When a Diagnosis Interrupts the News
Ruiz is among many news personalities who announced their cancer diagnosis over the years, and like many before her, handled the unexpected diagnosis with grace and grit.
Robin Roberts
“Good Morning America” host Robin Roberts, 65, was 47 when she was first diagnosed with breast cancer after discovering a lump in her breast while preparing for a news segment. Then, a few years later, she was diagnosed with myelodysplastic syndrome (MDS), a rare type of blood cancer. The two-time cancer survivor is just one example of a woman who is diagnosed with breast cancer under the age of 50 and finds themselves diagnosed with a second primary cancer afterward.
Amy Robach
Amy Robach’s cancer journey began after being encouraged by Robin Roberts during a “Good Morning America” segment on the morning show. Like Roberts, the 52-year-old former ABC News reporter, who also learned of her cancer diagnosis while undergoing a self-exam, and underwent a mammogram on the morning show to promote breast cancer awareness.
Robach’s screening led to her diagnosis of stage 2 invasive breast cancer. She also learned cancer had spread to her sentinel lymph nodes. After her tumor was detected, she underwent a bilateral mastectomy (also called a double mastectomy), where both breasts were removed. Following the procedure, Robach underwent six months of chemotherapy. Luckily, her treatments helped her reach remission.
Hoda Kotb
Former “Today Show” host Hoda Kotb’s diagnosis came after doctors found lumps in her breast tissue during a routine exam. Kotb, 61, underwent a mastectomy, a surgical procedure that removes breast tissue to treat or prevent cancer. She later had breast reconstruction surgery to restore the breast’s shape and appearance.
Following surgery, Kotb continued treatment with tamoxifen (Nolvadex) for five years. Tamoxifen is a selective estrogen receptor modulator; it blocks estrogen from promoting the growth of cancer cells. It’s also prescribed to women at high risk of developing breast cancer due to family history.
Jill Martin-Brooks
“Today Show” host Jill Martin, 49, was diagnosed with stage 2 breast cancer in 2023. Her diagnosis came shortly after she underwent genetic testing and learned she carried the BRCA gene mutation, which increased her cancer risk.
After Brooks learned she carried the BRCA gene, she planned to get a preventative mastectomy to minimize her cancer risk. The procedure Brooks attempted to pursue is a prophylactic or preventive mastectomy, which removes breast tissue to prevent cancer from developing. This procedure is an option for women at higher risk, such as Brooks, who carries the BRCA gene mutation.
Brooks’ treatment involved chemotherapy, radiation, and a double mastectomy (removal of both breasts), and she had 17 lymph nodes removed.
She also underwent chemotherapy, which she openly documented on her social media channels, most notably her fight to preserve her hair with a scalp-cooling device also called cold caps.
WATCH: TODAY Show’s Al Roker & Prostate Cancer Survivors
Al Roker
Roker, 71, was diagnosed with an aggressive type of prostate cancer. He shared his diagnosis publicly on the “Today Show” in March 2020. During his comments, he explained that he would have surgery for treatment.
“My first reaction was, ‘I just want this out. I don’t want to do radiation,” Roker previously told SurvivorNet.
Roker had his prostate removed and some surrounding tissue and lymph nodes in a procedure called a radical prostatectomy. During this procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. The surgeon can perform this through a traditional open procedure called laparoscopic surgery with one large or several small incisions.
As of this year, Roker celebrated five years since his prostate cancer diagnosis, and his latest check-up revealed there’s no sign of cancer beyond the prostate.
Coping With Post-Surgery Scars, Body Image Amid Cancer
Many patients deal with some sort of change to their body and physical appearance, and coping with that change isn’t always easy. When you are in the middle of a health challenge, you may notice some physical changes in your body. The changes may include weight gain or loss, hair loss, or something invisible to the naked eye.
One way to prepare yourself for possible body changes during cancer treatment is to understand that changes are possible but also frequently temporary. This can also help build up your self-confidence. Your support group, filled with loved ones, can also help you during this stage of your journey.
While surgery, chemotherapy, and radiation are treatments that can cause visible changes to one’s physical appearance, other treatments that are less noticeable include endocrine or hormone therapy.
Hormone therapy “slows or stops the growth of hormone-sensitive tumors by blocking the body’s ability to produce hormones,” according to the National Cancer Institute.
Psychologist Dr. Marianna Strongin shares with SurvivorNet some additional tips cancer warriors can explore to help manage the emotional toll body changes can have during treatment.
Dr. Strongin encourages cancer warriors to take ownership of the part (or parts) of their body impacted mainly by cancer treatment. She says that although they may represent “fear and pain,” they also represent “strength and courage.”
“Research has found that when looking in the mirror, we are more likely to focus on the parts of our body we are dissatisfied with, which causes us to have a negative self-view and lower self-esteem. Therefore, I would like you to first spend time gazing at the parts of your body you love, give them time, honor them, and then thank them,” Dr. Strongin said.
Dr. Strongin then suggests looking at the part or parts of your body impacted by the cancer or cancer treatment. She recommends creating a regular practice of accepting your body image because it helps you accept your cancer journey emotionally and physically.
“As you allow yourself to spend more time looking at all of you, you will begin having a new relationship with your body. It may not happen immediately, but with time, you can begin honoring and thanking your new body,” Strongin adds.
Treating Triple-Negative Breast Cancer
SurvivorNet experts say that triple-negative breast cancer often responds well to chemotherapy. Early stages of this disease (stages 1, 2, or 3) mean that the cancer is confined to the breast and/or lymph nodes that are located right under the arm.
“Our primary line of attack is chemotherapy, and this is regardless of the cancer stage,” medical oncologist Dr. Elizabeth Comen said.
Chemotherapy before you have surgery, also called neoadjuvant therapy, has the primary goal of trying to shrink the tumor before the primary treatment is given, which, in the case of breast cancer, is usually surgery.
WATCH: Undergoing Chemo During Triple-Negative Breast Cancer Treatment
In some cases, doctors may recommend chemotherapy after surgery, also known as adjuvant therapy. This additional treatment may be necessary if there are still cancer cells present, or it might be given to lower the risk that the cancer will come back.
There are different chemotherapy options depending on the burden of disease, which refers to how sick someone is with their disease.
“If the disease burden is not too great, meaning that a woman doesn’t have a lot of symptoms, we can often start with oral chemotherapy,” Dr. Comen explains to SurvivorNet.
“After three months of treatment, we can say, how has the response been, has the disease burden decreased, which is what we hope to see, and ideally, we will continue on that treatment for as long as possible. At some point, a woman may become resistant to the treatment that she’s on, which often means IV chemotherapy is next in line.”
The IV chemotherapy cycle can be two weeks on, one week off, alongside monthly doctor visits.
According to Dr. Heather McArthur, previously medical director of breast oncology at Cedars-Sinai Medical Center, studies suggest that giving these drugs early on in the treatment of metastatic triple-negative breast cancer works better than when taken after chemotherapy.
WATCH: Immunotherapy and Triple Negative Breast Cancer
Clinical trials also suggest that for women with non-metastatic triple-negative breast cancer who received immunotherapy and chemotherapy before surgery, 80 percent of these women had a “pathologically complete response” at the time of surgery, meaning there were no cancer cells left in the breast. These trials led to the approval of Keytruda (pembrolizumab) for the treatment of early-stage triple-negative breast cancer. Keytruda can be used with chemotherapy before surgery and then continued alone after surgery if you are at high risk for your breast cancer returning.
RELATED: Triple-Negative Breast Cancer More Deadly Among Black Women
Genetic Testing to Gauge Triple-Negative Breast Cancer Risk
A research team at Mayo Clinic has identified a group of genes linked to an increased risk of developing triple-negative breast cancer (TNBC)—a discovery that could pave the way for improved screening and earlier detection of this aggressive disease.
“Everybody is nervous about triple-negative breast cancer,” says Dr. Marleen Meyers, a medical oncologist at NYU Perlmutter Cancer Center. “Of all the breast cancers, it’s considered the most aggressive and the most difficult to treat.”
WATCH: Genetic Tests for Triple-Negative Breast Cancer Risk
In the 2018 study involving more than 10,000 people diagnosed with TNBC, researchers found that mutations in five genes—BARD1, BRCA1, BRCA2, PALB2, and RAD51D—were associated with a significantly higher risk of developing the disease. Among Caucasian participants, these mutations also correlated with a greater than 20% lifetime risk for breast cancer overall. Similar patterns were observed in African-American participants.
While this genetic insight is promising, experts caution that only about 10% of breast cancers are hereditary. “Most women who undergo genetic testing won’t test positive for these mutations,” explains Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.
WATCH: When to Get Genetic Testing?
That’s why genetic testing is typically recommended for women with a strong family history—especially those with relatives who’ve had breast or ovarian cancer, rare cancers, or cancers linked to Lynch Syndrome, a hereditary condition that increases cancer risk. Early identification in these high-risk groups can be critical for prevention and timely treatment.
Treating Triple-Negative Breast Cancer
Different chemotherapy drugs are used to treat triple-negative breast cancer, and they are often used in combination with one another. “Patients may see names like ACT, TC, or CMF, but those just stand for the regimens that we use,” says Dr. Comen.
For example, a CMF regimen is an abbreviation for the combination of chemotherapy drugs cyclophosphamide, methotrexate, and fluorouracil. AC stands for doxorubicin (Adriamycin) with cyclophosphamide, and ACT just indicates that a taxane drug is added to the regimen. Likewise, TC is an abbreviation for a regimen consisting of Taxotere and cyclophosphamide.
The FDA approved the immunotherapy drug pembrolizumab for the treatment of early-stage triple-negative breast cancer (TNBC).
For patients with stage 2 or 3 TNBC, adding the immune-boosting medication pembrolizumab to combination chemotherapy before surgery increases the chances of living free of breast cancer, explains oncologist Dr. Sylvia Adams, director of the Breast Cancer Center at NYU Langone’s Perlmutter Cancer Center.
Breast Cancer Symptoms & Self-Exams
Women are encouraged to do regular self-exams to become familiar with how their breasts feel normally, so when something unusual, like a lump, does form, it can be easily detected. A self-exam includes pressing your fingertips along your breast in a circular motion.
For some women, that means going to their doctor and walking through what a self-breast exam looks like, so they know what normal breast tissue feels like, so if they do feel something abnormal, whether it’s a lump or discharge from the nipple, they know what to ask and what to look for.
Below are common symptoms to look out for:
- New lump in the breast or underarm (armpit)
- Any change in the size or shape of the breast
- Swelling of all or part of the breast
- Skin dimpling or peeling
- Breast or nipple pain
- Nipple turning inward
- Redness or scaliness of the breast or nipple skin
- Nipple discharge (not associated with breastfeeding
When to Screen for Breast Cancer
The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.
The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.
WATCH: When you’re getting a mammogram, ask about dense breasts.
Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.
Questions For Your Doctor
- What stage is my cancer, and how does that affect my treatment plan?
- What are the recommended chemotherapy options for triple-negative breast cancer, and what side effects should I expect?
- Are there any clinical trials or emerging treatments I should consider?
- How will treatment affect my fertility, physical activity, or ability to work?
- What follow-up care and monitoring will I need after treatment ends.
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