Breast cancer continues to be a significant health concern, with over 4 million women in the United States currently living with the disease, and 13 percent expected to be diagnosed in their lifetime, according to the National Cancer Institute. While diagnoses have seen a slight annual increase of 0.6 percent, there is encouraging news: the death rate from breast cancer is falling by 1.2 percent. This positive trend means more women are navigating life with and after a breast cancer diagnosis, leading to a demand for a redefinition of what life looks like beyond the initial diagnosis. To shed light on these evolving experiences, a new content series, Voices of MORE™, provides a platform for open discussions about living with breast cancer and its aftermath.

One such voice is Mona, a 55-year-old single mother and grandmother from the Bronx, New York, who received her diagnosis in early 2024. After a routine mammogram prompted further testing, an ultrasound and biopsy confirmed she had HR+/HER2- early breast cancer (eBC), the most common subtype. Mona recalls a whirlwind of emotions upon receiving the news, initially feeling disbelief and sorrow. However, she quickly resolved to view her diagnosis as a challenge she was determined to overcome, embracing a fighting spirit.

Since her diagnosis, Mona has gained profound insights, not only about breast cancer but also about her inner strength. She shares three crucial realities of living with the disease, offering empowerment to those diagnosed, their loved ones, and anyone seeking to understand this prevalent condition. The first reality is that a breast cancer diagnosis does not diminish one's identity. A study by the Harris Poll on behalf of Novartis, the Breast Health & Experience Index, found that 90 percent of women with breast cancer desire to be seen for who they are, not solely their diagnosis. While the disease can cast a shadow, Mona emphasizes the importance of not allowing it to define one's sense of self. "Being diagnosed with breast cancer didn’t define me," Mona asserts, stating her choice to prioritize happiness. For her, this means actively engaging in her roles as a mother, grandmother, and caregiver for her own mother and sister, all while retaining her inherently positive, bubbly, and smiling personality. As a suggested tip, individuals can make a list of everything that defines them beyond their diagnosis and reflect on why it's important others see their whole self, not just their breast cancer.

The second reality highlights the therapeutic power of discussing one's diagnosis. Women living with breast cancer are encouraged to empower each other by asking questions, openly sharing their experiences, and confidently choosing their paths, recognizing they are more than their diagnosis. The Breast Health & Experience Index revealed that 40 percent of women diagnosed with breast cancer wished for more support in understanding the disease's long-term impact. Mona found immense support in joining a breast cancer support group, describing it as vital for managing her emotions. Being part of a community of individuals who have walked similar paths provided a safe space for shared questions and experiences. Mona advises those diagnosed to seek local support groups and confide in family, friends, and colleagues, always striving to "hold your head high and stay smiling." She also stresses the critical need for early screening and personalized treatment, especially for women of color, who are disproportionately affected. Although Black women are diagnosed slightly less frequently (by 5 percent) and American Indian/Alaska Native women by 10 percent, Black women face a 38 percent higher risk of dying from the disease than white women, and American Indian/Alaska Native women have a 6 percent higher risk, according to the American Cancer Society. Black women are also more prone to younger age and late-stage diagnoses.

The third reality acknowledges that the fear of recurrence is a persistent concern. One in nine people with early-stage breast cancer who complete initial treatment will experience recurrence. For those with stage 2 or 3 HR+/HER2- eBC, one in three are at risk of their cancer returning, even with available treatments. This risk persists because some cancer cells may remain after initial therapies, potentially leading to exponential growth. When cancer returns and spreads to other parts of the body, it is termed metastatic breast cancer, which is not curable. This enduring risk underscores that breast cancer is a continuous journey, not just a chapter. Mona, like many, worries about recurrence, which drives her commitment to consistent breast health. She candidly shares that she missed two annual mammograms prior to her diagnosis due to caregiving responsibilities for her ill mother and sister, coupled with personal fear. Women without breast cancer should typically be screened every two years starting at age 40, while those with a diagnosis should consult their provider for a personalized screening schedule. Prioritizing these screenings, though challenging, is imperative for health.

Beyond screenings, discussing treatment options with a doctor, based on individual risk levels and goals, is crucial. The Breast Health & Experience Index indicates that 67 percent of women living with breast cancer desire more information about available treatments. Today, there are more options than ever, including KISQALI® (ribociclib), a CDK4/6 inhibitor manufactured by Novartis. KISQALI is used in combination with aromatase inhibitors for adults with HR+/HER2- stage 2 and 3 early breast cancer at high risk of recurrence. It can also be used with endocrine therapies to treat advanced or metastatic HR+/HER2- breast cancer that has worsened or spread. Mona was encouraged by this option and has been using KISQALI to help reduce her risk of recurrence. Studies show that KISQALI combined with an aromatase inhibitor (AI) reduced the risk of cancer returning by 25 percent compared to an AI alone. At three years, 91 percent of people on KISQALI + AI were cancer-free, compared to 88 percent on AI alone, a 3 percent difference. A suggested tip is to consult your doctor to determine the appropriate treatment based on your risk and goals, and to visit KISQALI.com for more information.

KISQALI® (ribociclib) is a prescription medicine used to treat adults with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Specifically, it is used in combination with an aromatase inhibitor for stage II and III early breast cancer with a high risk of coming back that has either gotten worse or has spread to other parts of the body (advanced or metastatic breast cancer). For advanced or metastatic breast cancer, it can also be used in combination with an aromatase inhibitor as the first endocrine-based therapy, or with fulvestrant as the first endocrine-based therapy or after disease progression on endocrine therapy. The safety and effectiveness of KISQALI in children are unknown.

IMPORTANT SAFETY INFORMATION for KISQALI includes potential serious side effects. Lung problems, which can be severe or life-threatening inflammation, may occur, potentially leading to death. Patients should immediately report any new or worsening symptoms like trouble breathing, shortness of breath, cough (with or without mucus), or chest pain. Severe skin reactions, such as worsening rash, reddened skin, flu-like symptoms, skin pain or burning, blistering of lips, eyes, mouth, or skin peeling, with or without fever, require immediate medical attention. Heart rhythm problems (QT prolongation) can also occur, causing an abnormal heartbeat that may be fatal. Healthcare providers should perform heart and blood tests before and during treatment. Patients should report changes in heartbeat (fast or irregular) or feelings of dizziness or faintness immediately. Liver problems are another serious concern, requiring blood tests before and during treatment. Signs of liver issues include yellowing skin or eyes (jaundice), dark urine, extreme tiredness, loss of appetite, upper right stomach pain, or easy bleeding/bruising. Low white blood cell counts (neutropenia) are very common and can lead to severe infections; white blood cell counts should be checked before and during treatment, and patients should report fever and chills immediately. A healthcare provider may adjust the dose, temporarily stop, or completely stop KISQALI if serious side effects develop.

Before taking KISQALI, patients must inform their healthcare provider about any heart problems (including heart failure, irregular heartbeats, QT prolongation, past heart attack, slow heartbeat, uncontrolled high blood pressure), decreased thyroid function, issues with blood potassium, calcium, phosphorus, or magnesium levels, fever or infection signs, liver or kidney problems. It is crucial to inform the provider if pregnant or planning to become pregnant, as KISQALI can harm an unborn baby. Females who can become pregnant should use effective birth control during treatment and for at least 3 weeks after the last dose. Breastfeeding is not recommended during KISQALI treatment and for at least 3 weeks after the last dose, as it's unknown if the medicine passes into breast milk. Patients should provide a complete list of all medicines, including prescription, over-the-counter, vitamins, and herbal supplements, as KISQALI can interact with other drugs. To avoid increased KISQALI levels in the blood, grapefruit and grapefruit juice should be avoided during treatment.

Common side effects of KISQALI in people with early breast cancer include decreased white blood cell counts, decreased red blood cell counts, increased liver function tests, infections, increased kidney function tests, decreased platelet counts, nausea, headache, and tiredness. For those with advanced or metastatic breast cancer, common side effects include decreased white blood cell counts, decreased red blood cell counts, increased liver function tests, infections, nausea, increased kidney function tests, tiredness, decreased platelet counts, diarrhea, vomiting, headache, constipation, hair loss, cough, rash, back pain, and low blood sugar. KISQALI may cause fertility problems in males. Patients should report any bothersome or persistent side effects to their healthcare provider. For more information, patients can ask their healthcare provider or pharmacist, or report negative side effects to the FDA. The Voices of MORE™ series and VoicesofMORE.com offer additional stories of strength for those affected by breast cancer.

Today, Mona embraces each day with optimism and a focus on living in the moment. Her grandchildren are her "sunshine," and she looks forward to being present for their special moments, viewing the experience of having grandchildren as a fresh start.