Battling breast cancer made her stronger

By Katherine Zoepf

updated 8:37 a.m. ET Oct. 5, 2009

When Michelle Eskengren-Brown was in the shower one evening in March 2008, she noticed a large lump on the underside of her right breast. It was odd, she thought, but she wasn’t especially concerned. At 38, Eskengren-Brown, a former model from Sweden who had become a successful New York City casting director and the mother of two young sons, was in sturdy good health. Breast cancer was so far from her mind that she waited almost a week before consulting her doctor.

Her physician examined the lump “and said it was way too big to be anything,” Eskengren-Brown recalls. “She told me it was probably because I drank too much coffee” — usually three cups a day — “which I thought was hysterical. But of course I was very accepting. ‘Yes! I drink too much coffee! Get me out of here!’” Still, she says, her doctor added, “You know what? Just go and have a mammogram and get it over with, just to feel comfortable that it was nothing.”

And so, on April 3, 2008, a reluctant Eskengren- Brown found herself sitting in a mammography office following her screening, waiting for her name to be called so that she could receive her results and leave. “They called names and names and names.... I was sitting there thinking, Oh my God, I have to get back to the office! What is going on here? It was irritating.”

Finally, her turn came, “and they said, ‘You have to come back into the room and do more pictures.’ And I’m like, ‘No, I’m not doing that.’ And they said, ‘You have to.’ So they did mammos, and then they did a sonogram, and then all the doctors kept coming in. And then this one girl handed me a box of tissues, and I was like, ‘What? What do you want me to do with these tissues?’”

Though the doctors told Eskengren-Brown that the lump in her breast looked suspicious and warranted a biopsy, she didn’t reach for the Kleenex. Instead, she headed back to her office and promptly resumed work after telling her husband the news. Today, she thinks her intense focus was not so much an extraordinary ability to compartmentalize, but simply disbelief that what she’d learned at the mammography office could be true.

Eskengren-Brown “I didn't care what [the doctors] did to me; I just wanted my kids to be OK,” says Eskengren-Brown, with (from left) Markus, Ray and Alex.

The doctors’ assessment was confirmed by a biopsy several days later: infiltrating (or invasive) ductal carcinoma, a cancer that forms in the ducts that carry milk to the nipple. Ductal carcinoma is the most common form of breast cancer, making up about 70 percent to 80 percent of all breast cancers. The infiltrating form can quickly spread to other parts of the body, so doctors recommend surgery.

Despite the diagnosis, Eskengren-Brown was still so deep in denial that when meeting her surgeon for the first time, she says, “I still was very optimistic that it was nothing. Finally the surgeon said, ‘Michelle, I’m a breast cancer surgeon. What do you think you’re doing here?’ And I said, ‘I don’t know. Maybe you’re checking my results?’”

As a woman in her 30s, Eskengren-Brown had only a 1-in-233 chance of having breast cancer, according to data from the National Cancer Institute; for women in their 20s, the chances are far lower. But breast cancers in younger women are often faster-growing and thus more aggressive, says Kathie-Ann P. Joseph, medical director of Women at Risk at Columbia University Medical Center. Detection in young women is relatively tricky, says Julia A. Smith, director of the breast cancer screening program at the New York University Cancer Institute. Premenopausal women have denser breasts, with a higher percentage of glandular tissue than fat, she explains; the X-rays of mammography don’t penetrate dense tissue, making the images there less clear. MRIs can be an additional test to help the screening process in high-risk patients, Joseph says, but these scans aren’t considered an alternative to mammograms on their own; their extreme sensitivity can result in a high rate of false positives.

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Upon learning that she had breast cancer, Eskengren-Brown says, “I just shut down.” For months, she says, she went into a kind of emotional cocoon, numb to the world. Her husband, Ray, a photographers’ representative, and a handful of close friends shuttled her to and from doctors’ offices and helped her determine her course of treatment; her friend Faith Kates Kogan, president of the Next Model Agency and of the board of directors of the Ovarian Cancer Research Fund, provided introductions to sought-after local cancer specialists.

At one point, Eskengren-Brown’s husband asked her doctor what she would recommend if Eskengren-Brown were her own daughter. “A mastectomy” was the answer, and so, less than three weeks after her mammogram, Eskengren-Brown went to Mount Sinai Medical Center to have her right breast removed. Two months after that, she underwent the first of four chemotherapy sessions, each three weeks apart, to reduce the chance of the disease affecting her other breast.

"I didn’t even look the doctors in the eye. I couldn’t,” Eskengren-Brown says. “That was my way of dealing.” A self-described “control freak,” she was used to being on top of all the details of a bustling New York life. “But then I discovered that there are two types of cancer patients,” she says. “There’s the one that takes control and needs to talk to the doctors and understand — they want to see pictures, and they want to know what they’re doing in their breast. And then there’s the person that shuts down, and that’s me.”

Eskengren-Brown Before beginning chemotherapy, Eskengren-Brown, seen here with a friend from Paris, began cutting her long, brown hair in radically different ways and bleached it blonde, aiming to make the side effects less alarming to her children.

Eskengren-Brown focused her energy on her work — she scheduled castings around her chemotherapy sessions and says that she completed her biggest job yet, an advertising campaign for Elizabeth Arden, while she was undergoing treatment. Eskengren-Brown’s two boys — Markus, then three years old, and Alex, then five — never knew their mother was sick or struggling in any way, never even heard the word “cancer,” a fact their mother reveals with pride.

“I didn’t care what [the doctors] did to me; I just wanted my kids to be OK. There are times when you’re so tired, you’re so sore, and you’ve got pouches of blood you have to drain,” Eskengren-Brown says, referring to the drains that are installed after a mastectomy to prevent buildup of fluids where the tissue was removed. “But you still have to be a mom. You still have to put them to bed and cuddle them. So I think that was the hardest thing. I could deal with a lot of stuff, but I could not deal with the idea that they’d be affected.”

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