The young woman was studying to become a cancer doctor when at age 32, she brushed her hand across her right breast while washing in the shower and felt a hard lump.
Dr. Anne Michele Safley had graduated from Duke Medical School and was then in her residency at University of Iowa. She was planning to head back to Duke for a fellowship in hematology and oncology.
Even with all her medical knowledge, Anne Michele didn’t want to immediately think of cancer. Soon after, however, she noticed enlarged lymph nodes under her arm and suspected that she had breast cancer. She was quickly evaluated and treated at the Mayo Clinic in Rochester, Minn. Because she got help at an academic medical center, she was able to access the newest treatments.
And, a remarkable thing happened. During the next four months of intensive chemotherapy, “The tumor melted away,” Anne Michele said.
She has been cancer-free since and today is a primary care doctor who enjoys giving hope to patients who are coping with challenging diagnoses themselves. She practices at UCHealth Primary Care – Greenwood Village.
“I love sharing a story that’s optimistic,” she said.
A cancer cure and two bundles of joy
“I decided to change course and focus on our family,” she said.
That meant having the children that the couple had hoped for. Anne Michele got the go-ahead from her doctors to start trying after she completed radiation therapy and was fortunate to quickly become pregnant with their oldest daughter, Lily, who was born in April of 2010. Then her husband took a job at Denver Health and the family moved to Denver later that same summer.
Just 16 months after Lily arrived, her little sister, Alex, made her debut. Anne Michele is overjoyed to be the mother of girls who love to swim, dance, ski, play the piano and travel. Anne Michele ran track and was a competitive swimmer in high school and college. She still swims, runs and cycles to stay fit. And she recently joined her girls at camp, serving for a week as the camp doctor at Camp Lake Hubert in Minnesota, a place that she attended camp as a child.
Anne Michele and her former husband are now divorced, but they live near one another so they can team up to co-parent the girls.
One of Anne Michele’s first stops after her move to Denver was a visit for follow-up care to Dr. Virginia Borges at the UCHealth Diane O’Connor Thompson Breast Center at the Anschutz Medical Campus. Borges is the Director of the Young Women’s Breast Cancer Translational Program, which provides unique care to younger patients with breast cancer and has a strong focus on life after breast cancer, including post-treatment family planning and support for childbearing.
“When young women get breast cancer, it is often more aggressive. Seeking care at an academic medical center is vitally important to ensure all aspects of the cancer are appropriately addressed and all the unique aspects of having breast cancer at a young age are co-managed,” Borges said.
New hope with new treatments
The chemotherapy that Anne Michele received was cutting edge when she was treated, but is now a standard tool.
Borges’ program is one of only a handful in the country that provides unique care to young women with breast cancer and performs cutting edge research to improve outcomes for young women.
“Young women’s breast cancer is different in its biology and one of the biggest differences is also the young women themselves,” Borges said. “We have specialized expertise in gene testing, fertility preservation and counseling, co-treating women who are pregnant at diagnosis, to name a few differences. And we have specialized treatments and clinical protocols that are directly aimed at the more aggressive aspects of these cancers.
“We are always incorporating new drugs and cutting-edge medicine on top of the standard care,” Borges said.
Among the most exciting new treatments is immunotherapy.
“We’re seeing some incredible results,” Borges said. “We have patients doing phenomenally well with metastatic breast cancer and these medicines are now being researched to hopefully enhance the cure rates of earlier stage disease as well.”
Anne Michele’s outlook is excellent now and having children after treatment does not elevate the risk of a breast cancer recurrence.
“For someone like Anne Michele, there was no reason on Earth not to move forward and live,” Borges said. “Young women often face the hardest road to recovery and wellness after breast cancer. We have initiated a very important long-term survivorship clinic and sexual health clinic to support women dealing with the aftermath of their breast cancer diagnosis, if needed.”
A calling to primary care
Like many of her patients, Anne Michele had a history of breast cancer in her family. Her maternal aunt was diagnosed in her 50s. After Anne Michele’s diagnosis with breast cancer, her mother and sister initiated more aggressive screening protocols, using ultrasound and MRI. This protocol detected her mother’s breast cancer at a very early stage, and her mother is now healthy and disease-free following her treatment. All three women tested negative for the BRCA genes, two of the several known genetic causes of breast cancer.
For most families with breast cancer, the exact causes are likely multiple in nature and not linked to one identifiable gene mutation. It is vital for women to understand their risk and decide if they should get gene testing or go through screenings tailored to those with elevated risk.
These days, Anne Michele is relishing life with her daughters and providing care for her patients.
After getting treated for cancer, she decided to shift her professional focus to internal medicine and primary care has been a perfect fit.
“I love it. First and foremost, we create wonderful connections with our patients and their families. Our mission is to advocate for our patients and promote wellness and preventive care.” Anne Michele said.
Of course, she knows what it feels like to be the person sitting on the exam table. And, if young women come in and tell her that they have a family history of breast cancer, she refers them right away to the high-risk breast cancer screening program at the Diane O’Connor Thompson Breast Center, so they can get customized care and early screenings. If they get cancer, she refers them to Borges’ program.
“It’s always a hard moment. And it always touches me on a personal level,” Anne Michele said. “I want to listen closely to my patients and provide a lot of compassion, empathy and support.”
Feeling strong and relishing joyful moments
Anne Michele loves swimming and running. She recently completed a sprint triathlon and said physical activity helped her recover from experiencing cancer as a young woman.
“I leaned into my athletic background to feel strong. I run. I spin. I swim. And I also looked to my relationships with my family, my good friends and my faith.”
Once her girls were old enough to begin to understand cancer, Anne Michele began sharing her story with them.
“I’m very matter-of-fact. I say, ‘Before you were born, mommy was treated for breast cancer.’”
She tells them how having cancer as a young woman helps her celebrate life every day now.
A year ago, Anne Michele took the girls to the mountains for a weekend to celebrate her 10th anniversary of being cancer free.
“We had so much fun. We soaked it all in,” she said.
Her older daughter kept telling strangers that they were celebrating her mom’s 10th anniversary.
Lily explained it this way: “My mom had breast cancer before I was born and now she has hot pink breast implants.”
Anne Michele replied: “You are absolutely right.”
She relishes the sweetness and humor that these moments bring.
“This experience showed me that nothing can be taken for granted,” she said. “I feel very grateful for the gifts of family, friendship and health. It is now my privilege to serve as a physician and support UCHealth’s mission of caring for our patients.”