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Breast Cancer Awareness Month

By Kathleen Kelly, Kristin Culpepper, Paru Mahesh, and Michelle Macy

As we look at October being Breast Cancer Awareness Month, we discussed openly how it has touched so many of us at Pepper Foster Consulting. As such, we asked our employees who would be willing to share their personal reflections and experiences with Breast Cancer. It is our intent to share the voice of a few of our employees. This is not an eloquent article on cancer, but the real, human side of dealing with it as a survivor or as someone impacted by a loved one. It is our hope that in sharing our reflections, we will inspire you to conduct breast self-exams (women and men), get tested, learn more, and be present and loving to those on this journey.

Kathleen Kelly - 21 year BRCA1 survivor

Former Partner in Charge of Pepper Foster Consulting’s Minneapolis - St. Paul office.

wife, and mother of 2 teenagers

I welcome October each year with both relief and empowerment. 

I also take time to pause and reflect on the memory of those brave and courageous warriors that have gone before us and lost their battle with Breast Cancer.

For those of you that have experienced Breast Cancer or have family or friends that have experienced it, it’s not for the faint of heart. The journey is personal and everyone experiences it differently. After all, we are unique human beings and we all handle such life-changing events differently. I share with you today my perspective as I celebrate 21 years Breast Cancer Free and what I learned along the way in the hopes that I can help more people get diagnosed and for those in the care network of the patient - to learn a bit more about the journey and how you can be supportive of the Cancer patient.  For the patient, I wish you strength, the ability to cry AND laugh, the knowldege that there are always others worse off than you (that’s a hard one), and peacefulness. You will have days that are good and days that are bad. Decide what makes you happy, and do more of it. Decide who you enjoy spending time with and do so. It’s okay to not have the answers. There will be twists and turns and setbacks along the way. Know that it is all part of the journey. Cancer is not a death sentence, don’t take it as one. Think if you will embrace life with a glass that is half full or half empty. Sounds trivial, it is not. Take time for you and do what you love.

For family and friends of the Cancer patient, check-in often, make them laugh, plan a trip or a goal as a milestone (it helps immensely to have something to look forward to), be there for the patient (not as someone telling them to get their house in order) but as an active listener. Call out of the blue, drop off/send a small gift just to say you are thinking of them, email them.  Don’t tell them what to do; there are enough medical folks that have that one down. Find ways to bring them joy or make them smile. Create new memories together; don’t dwell on the past and the fact there might not be a future, focus on the present, and plan for the future.

I look at my experience quite differently than most.  My diagnosis of Breast Cancer came at the age of 35.  I was young, single, living in Chicago, and had recently accepted a promotion to run the Minneapolis office of the company I was working for at the time. I was at Northwestern Hospital and they looked at my family history and asked me if I could meet with them before my annual mammogram “Can I look for it”, they asked? “Please do”, was my response. The words from the radiologist in a phone call following my mammogram and ultrasound began. . .  “well, I’ve got good news and bad news; which do you want first”? I responded:  “I’ll take the bad”. He replied:  “Well, the bad news is you’ve got cancer, the good news it’s in the ducts and hasn’t spread yet to your vital organs”, we call it DCIS: Ductal Carcinoma InSitu.

I’m sure not everyone responds to a cancer diagnosis with relief but that’s what overtook me, followed by even more relief that my cancer was diagnosed so early. It wasn’t about the stage of cancer but it was the answer that I finally knew...I was one of the ones in my family that was going to get Breast Cancer. We all knew it would hit one of us but which one(s)….Relief - whew. Now I can start living, no longer living in fear waiting to hear those words.

You see, my mom died at the young age of 44 after an almost 3 year battle with aggressive Breast Cancer. She left this world as a loving spouse and mother of 6 children ages 2 to 16 years old; with my youngest brother, Brett, having Down Syndrome.  She had a radical mastectomy, Cobalt treatment (the protocol of the day), a bedside table of narcotics for pain and spent more time in the hospital than home in those years. It was awful to watch someone suffer to that degree. The saddest part of it all, is that she had finally won the battle with cancer and was being released from the hospital for good. Unfortunately, she ended up dying of a blood clot to her heart because she was never put on a blood thinner at discharge. Oh, the irony of it all. It saddens me that she was so strong, courageous, and yet suffered so much to lose the battle to no fault of her own.

As a result, we all grew up quickly, took on responsibilities beyond our young years, and as time went on, learned more and more about the likelihood that as siblings, we had a 50:50 chance of inheriting one of the Breast Cancer genes (BRCA1 or BRCA2).  You don’t just get breast cancer in your early forties unless you have the gene. So, we lived with this hidden, nagging fear:  will I get Breast Cancer? What will my fate be? Who will get it? As it turns out 3 of us have the gene (and not all girls). Men can get Breast Cancer. It accounts for 2% of all BRCA.

Relief. I knew I had cancer, time to get rid of my breast tissue and start living. My initial plan of lumpectomy followed by radiation didn’t go as planned. Since my cancer wasn’t visible to the human eye, I had a wire inserted into the area of questionable tissue for it to be removed via surgery. Unfortunately, the edges reviewed post-surgery were not clean. After discussion with my surgeon it was time to get more aggressive - remove the breast. And the odds of the other breast getting cancer: a whopping 85 %; not odds I wanted to deal with. I quickly decided to get rid of both and do radiation and reconstruction at the same time.  I met with my plastic surgeon that same week:  “help me understand why you have stage 0, DCIS, likely BRCA+ and you are here to discuss mastectomy reconstruction; who is your surgeon?” My response:  Monica Morrow.  His response: If Dr. Morrow told my wife to go jump off the Michigan Ave. bridge, I’d tell her to get marching”. No more questions needed; “she’s the best. Pioneered the lumpectomy; husband at the time, invented Raloxifen and Tamoxifen; you’ve got the best.” I had to wait from May until August to have a bi-lateral mastectomy.  At the time it seemed like an eternity. It took time to heal:  emotionally and physically but well worth it to be free of potential cancer-causing cells.

I’ve embraced life since then:  married a wonderful husband, had 2 children and a couple more surgeries:  Breast - after my daughter was born to remove residual breast tissue that came in after delivery (as breast tissue doesn’t always start in the breast) and then a Salingo-Oophorectomy to get rid of all body parts that fall in the “familial” category to minimize any recurrence of cancer in like organs.

So, do you think you have a family history of Breast Cancer?  If so, here’s some facts I’ve learned over the years of hereditary Breast Cancer:

I’m a huge believer that Knowledge is Power.  

Having Cancer and thinking you’re going to die really forces one to face their own mortality.

Life is a gift. 

It was given to you and it can be taken away from you.

What will you do with your gift of life?

Will you embrace your talents and others and leave an impact on those you touch?

Feel free and reach out if you have questions, and I’ll be happy to answer them. Know that my data and research is likely old, as it’s been over 21 years. However, I hope you have the drive and passion to fight (or help others to do so).

Here’s to all the Cancer Warriors out there!

You can learn more about hereditary Breast Cancer and Breast Cancer in general via:

Kristin Culpepper - Supportive Sister of Cancer Patient

Consultant, Pepper Foster Consulting, Portland Office

My name is Kristin Culpepper and my hope is that once you’ve finished reading this, then you will have made a commitment (1) for yourself and (2) for a loved one. But first, I’m going to tell you what happened in September of 2018.

My older sister, Monika—we call her Mo—called me. She started to tell me she found a lump in her breast...and that yes, it was cancerous. She downplayed it, like, “Well they are going to do a lumpectomy and test for malignancy. But it’s probably nothing.”

A few weeks after that, I got another call. Mo told me that the cancer was Stage IV, terminal, as it had metastasized throughout her bone. Treatable to a degree, but not curable. When I answered the call, I was outside my house on the sidewalk. I yelled. I cursed at the phone (and probably indirectly to the people walking by). I didn’t cry yet because I was in shock.

I asked her how did this happen, why did it happen, and how come this wasn’t noticed earlier? I knew she was getting regular mammograms since she turned 40, which is the usually recommended healthcare schedule for women. We have no history of breast cancer in our family. She eats healthy and gets regular exercise. One month later I flew to TN to visit with her and the family before she started chemo. One year later I flew back to TN to help out while she underwent a hysterectomy and Ovariectomy.

Mo, now 50, has triple positive Stage IV cancer and requires treatment every 3 weeks indefinitely. She has two ‘tweenage’ daughters, three dogs, one horse, some cows, and innumerable cats living on a farm in East Tennessee. Her husband and her friends have formed an invaluable support system. Mo’s staring cancer in the face every day. She still works full-time and stays occupied raising school-aged children during the COVID-19 pandemic, juggling online and in-person instruction. It serves as a good distraction.

Here’s what I’ve learned when it comes to breast cancer detection and I want to share it with you because it affects us all.

Mo told me that, although she was getting regular mammograms, she has dense breast tissue. This is the first time that I’ve heard this term.  According to the Mayo Clinic, dense breast tissue is “normal and common,” and about half of the population of women, who are currently undergoing mammograms, have it. HALF.  So what’s the problem? Dense breast tissue makes it more difficult to interpret a mammogram since cancer and dense breast tissue both appear white on the image. Very dense breasts may increase the risk that cancer won’t be detected on a mammogram, which is the first and often only-used screening method for women.

Despite concerns about detecting cancer in dense tissue, mammograms are still the go-to screening tools used in clinics today. Digital mammograms have now replaced film mammograms. The resolution on digital file allows for more detailed analysis, but it’s still not good enough. I asked my doctor if there are other screening tools that can be used in the place of mammograms. My doctor said there are, but that the medical profession as a whole still uses mammograms as the only screening tool, even in the case of dense breast tissue. (1) Why is that? These additional tests carry additional risks, and according to the research literature, no additional testing method has been proven to reduce the risk of identifying breast cancer.

What implications does this have again? 1 in 8 women will develop invasive breast cancer in their lifetime. [Count the number of people in the room around you.] Here’s the main point: Mo’s cancer wasn’t discovered by a mammogram or by a doctor. My sister found the lump herself. Self-exam is independent of what type of tissue you have and whether imaging can detect something or not. Now, I’ve shared my experience with you and my new understanding that mammograms have limitations. This has the potential to lead to horrible results if the technology is the sole form of proactive breast cancer screening used.

For some of you, my story may sound very familiar or it may sound foreign. For those where it sounds familiar, I’m so sorry. I empathize with you. This is where I ask each of you to remain diligent about your own self-exams… and for the men, to please, please, please approach the topic of self-exams with someone you love. I offer that you use my story as an icebreaker. Let the other person know that you wanted to share it with them.

To summarize:

  1. Dense breast tissue is normal and common.
  2. Mammograms are used to increase the detection rate of breast cancer in all women, annually past the age of 40.
  3. The paradox: Dense breast tissue interferes with the ability of mammograms to detect cancer masses. Both appear white.
  4. Supplemental tests are available, but they come with their own pros and cons. And you have to ask for them through your health provider.
  5. Please do self-exams. Please share my story with a female in your life.

Thank you.


  1. https://www.mayoclinic.org/tests-procedures/mammogram/in-depth/dense-breast-tissue/art-20123968

Paru Mahesh - Granddaughter of Cancer Patient and Supportive Friend

Managing Consultant, Pepper Foster Consulting, Portland Office

My grandmother, Subbamma was diagnosed with breast cancer in her late 50s. She was from a tiny village in India. I was very young and a child at the time and new my grandmother to be very sick.

I’m not sure how she was diagnosed, and the cancer stage, but she had to travel 500KMs to the big city, Chennai, India (it was called Madras) to get treatment. This was the only cancer hospital in that area in the 1980s. She had mastectomy and radiation. The cancer institute provided her with train tickets for her and companion every 3 months to travel to Chennai and for ongoing treatment. 

She fought this battle for 5 years and passed away peacefully at home surrounded by almost the whole village. Things have changed so much since then... different countries, different times, and lots of advances in diagnosis and treatment. 

Fast forward to 2014: My best friend went through a similar journey in the San Francisco Bay Area. I went with her for some of her chemo treatments, she was philosophical about life and had a lot of self-confidence. I seldom saw any fear.  She is a strong woman and dealt with the disease with tenacity and grace. What an amazing role model.

I happy to share my friend is cancer-free now and leading a healthy life. Treatments have come a long way. 

With a family history of breast cancer, I get mammograms every year. Please consider the same.

Michelle Macy - Child/Niece of Cancer Warriors

Avid Cancer fundraiser via University of Minnesota Masonic Cancer Center

Managing Consultant, Pepper Foster Consulting, Portland Office

Michelle recalls being on the Nike Campus a few years back as an employee and reflecting on her family and cancer history and shared that it was impossible to not be faced with MEET CANCER and LiveStrong.

Meet Cancer – My strong take no bull from anyone grandmother, Evelyn Pfarr, was diagnosed in her late 60’s with breast cancer.  She came from that good strong German stock.  Tall with long arms that could wrap you in a hug so strong and protective, you felt nothing could touch you as long as you stayed right there in that embrace.   But that embrace couldn’t protect her from breast cancer.  Not one to give in, she moved forward with a stiff upper lip.  “Get over it” was a favorite motto.   She fought a good fight, but cancer won the battle.

Meet Cancer – My aunt, Pat Pfarr Brown,  is diagnosed at 49 with breast cancer.  It is unbearable.  Her and my mother are like peas in a pod.  They talk without saying words and end up in tears from laughter because they are lost in some memory.    She is a true red-head in the family.  It is at this moment, that I know she will lose her fiery red hair.  I was older now to understand the impact of this on a person’s identity.  By this point, I have grown my signature long mantle of red hair.   In an embrace I whisper, for you, I will cut it so that you can still have a wig of red hair.  She declines and carries herself with grace, poise, and determination in her battle with breast cancer.  Another reminder of the strength of the women in my family.  She fought a phenomenal fight.  She is still here with us today celebrating, laughing, and helping share those stories of her and my mother.

Meet Cancer -  My aunt, Mary Pfarr Brian, is diagnosed at 39 with breast cancer.  The genetic link in the family seems to be clear.  Again the Pfarr women come together to laugh, cry and support each other in the battle.  It is like watching great warriors of Athena suiting up, standing their ground and saying “NOT TODAY and NOT THIS TIME!”  Together they bond over something no family should bond over – Cancer.   They connect through shared experiences of radiation, chemotherapy, lumpectomies, and mastectomies.   Cancer may take pieces like hair, breasts, and peck at your pride and identity, but the Pfarr women will not yield.   Mary wins her battle with cancer.  Cancer = 1,  Pfarr women = 2 a morbid score, but one where we were in the lead.

Meet Cancer – My mother, Kathleen Pfarr Macy (thank goodness she wasn’t into hyphenating her name), is diagnosed at 59.  She visits in July 2007 to help me train for my first English Channel.  After a training session, she sat me down and said “I have cancer.”  I can attest this is the worst sentence I’ve heard in my life to this point.  I cry.  She cries.  She wraps me in that long strong armed embrace that she has inherited from her mother.  It has to be safe in this place.  She has to be okay.  She receives a great prognosis and is able to join me on my first English Channel crossing and my introduction into my new passion of marathon swimming.  A gift that I will never take for granted.  She returned home to begin her battle with cancer. 

Almost 2 years later, she received the all clear and said “I’ll be here for a long time just to annoy you.”  Another win for the Pfarr women (Cancer = 1, Pfarr women = 3).  I was preparing for my 2nd English Channel crossing and in my 3rd  year of raising funds for MacySwim for a Cure.  She taught me that my swimming provided me with a gift to give back and join the war against cancer.   She states “I bet you could raise $10,000 for breast cancer research.”  I don’t think she has set the sights high enough and I say let’s make it $50,000.  “Ok Michelle.  $50,000 it is.”  Now my mom passed unexpectedly 6 weeks after receiving her all clear, which provided me with the worst sentence I’ve ever heard in my life “Oh honey, your mom died.”  It still brings me to tears to think about that day and those words. 

Life is not about fairness.  Life is life.  It is how you choose to get up every day and face it.  And I choose to continue the fight that was started long before the Pfarr women.  I know that with perseverance and determination this war with cancer can be won.  Every day strides are being made.  It is only a matter of time.

I welcome you to consider joining me in my fight against breast cancer.

Thank you for your continued support and encouragement.

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