Christina Miller had just finished her second chemotherapy treatment when her hair began to fall out.
It was a Saturday morning, half an hour before she had to leave the house to take her son to a birthday party, when she realized, "I couldn't go any longer without doing something about my hair," says Miller, 39, who was diagnosed with breast cancer in January.
So she handed her husband the hair clippers and asked him to shave her head. Although the decision had been difficult, Miller says the process itself felt liberating.
"My little 4-year-old looks up at me and gives me the biggest hug," says Miller, who is from Ellicott City, Md. "And he says, 'You're still the best-lookin' mommy.'"
Thanks to recent advances in therapy -- and support from her friends and family -- Miller says she's coping well with the dual demands of fighting cancer and raising three children, Alexandra, 5, Thomas Joseph (T.J.), 4, and Nora, 1.
Miller's oncologist, Claudine Isaacs, says she's impressed by Miller's strength and ability to convey a sense of calm and hope in front of her kids. "There's never a good time to get breast cancer, but the postpartum period is particularly challenging," says Isaacs, a professor at Georgetown University's Lombardi Comprehensive Cancer Center. "With a baby, you're so protective, and you're supposed to be this even, comforting presence. Yet now, you have to wonder about your future."
For reasons doctors don't completely understand, a woman's risk of breast cancer actually increases in the five years or so after she has a child, says Pepper Schedin, a professor at the University of Colorado in Denver. These cancers also tend to be particularly aggressive.
It's likely that the hormones of pregnancy play a role, says Eric Winer, director of breast oncology at Boston's Dana-Farber Cancer Institute. Hormonal surges may speed up the growth of a pre-existing cancer, leading a woman to be diagnosed sooner than she might have been if she had never been pregnant.
Miller, who was still breast-feeding Nora when she was diagnosed, says her toddler now has no memory of her mom being anything but bald. Her 5-year-old, Alex, "doesn't seem to worry about the future. She asks, 'How many more treatments until your hair grows back?' I don't sense fear," Miller says. "What I want them to remember is that Mom might have looked different, but she was still involved in our daily lives."
pregnancy-cancer equation
Pregnancy has a complex relationship with breast cancer risk, Schedin notes.
Having a baby early in life lowers a woman's lifetime risk of developing postmenopausal breast cancer but increases her short-term risk of postpartum cancer, Schedin says. In the past, scientists assumed that postpartum cancers were mainly fueled by the hormones of pregnancy. Schedin's work suggests inflammation also plays an important role.
The immune system becomes active in the breast, Schedin says, when women start to wean.
That's a time of dramatic change, when the breast needs to shrink back to normal size, and the extra cells created during pregnancy and milk production have to go away.
The body choreographs this "remodeling" partly by turning on a process similar to that used in healing wounds, says Patricia Ganz, a professor at UCLA's Jonsson Comprehensive Cancer Center.
Most of the time, the process goes smoothly.
Breast-feeding for at least six months actually reduces a woman's breast cancer risk, although doctors can't say with certainty how this works, Ganz says.
But inflammation can go awry.
By age 35 or 40, the precancerous changes in a woman's breasts may be too advanced to simply slough off after breast-feeding. Even worse, these abnormal cells may be stimulated by the inflammatory chemicals.
This research is becoming more compelling, Ganz says, as more women delay childbearing. A woman who has her first child at age 40 or later has about twice the risk of breast cancer as a woman who never has children, she says. Schedin says she hopes her findings won't add to women's anxieties. And women don't need to rush into pregnancy just to avoid breast cancer, Ganz says. On average, most breast cancers are diagnosed in women in their 60s.
better guidance for her kids
Schedin says she hopes her research will one day contribute to new prevention strategies. After all, doctors have a variety of ways to turn down inflammation. In mice, Schedin found that giving anti-inflammatory drugs stopped the growth of postpartum breast cancers.
Schedin cautions that her research hasn't been tested in humans yet, and it's far too early to give women any real prevention advice. Anti-inflammatory drugs can cause severe bleeding and bruising.
Miller, who is participating in a clinical trial of a new drug, says she's glad researchers are making progress. She hopes scientists will be able to offer better guidance to her own daughters about their risk of breast cancer one day.
And while Miller says she and her husband weren't sure about having a third child, they can't imagine life without Nora. She cheers them up just by toddling into the room and keeps them too busy to worry.
"Everything is exactly the way it was supposed to be," Miller says. Speaking of Nora, who is taking an afternoon nap in her crib, she adds, "I will always look at her and be so grateful."
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2012 USA TODAY, a division of Gannett Co. Inc.