BrittLee Bowman had a huge decision to make as she lined up at an elite cyclocross race. Cyclocross is a sport that throws obstacles at you, from sand pits to staircases to knee high barriers. And this one, alongside the Hudson River in Queens, N.Y. was no different.
Bowman pedaled. People cheered. And if you saw her that day... you probably had no idea what she was wrestling with. That decision she had to make: Do I have both my breasts removed?
It all started with a tiny lump. "Sometime in October I just you know was touching my boob and felt a lump," she says. "It was about the size of a pea."
She immediately called her mom, Sara Bowman. Her mom says she was probably more concerned than her daughter, but she didn't let on.
Bowman made an appointment with her doctor. And the doctor thought it was best to do an ultrasound. And the ultrasound showed another lump. Two total. And that led to a biopsy. And the biopsy led to waiting.
"I'm telling you," she says. "In my mind, I did not have cancer."
So Bowman went on with her life. She was out shopping when she got the call.
"You have breast cancer," she says the doctor told her. "And I was like, 'Wait. What!?'"
The doctor clarified her statement, telling Bowman the result came back positive. She had stage one multifocal invasive ductal carcinoma, ductal carcinoma in situ, and lobular carcinoma in situ all in her left breast. Her right was unaffected. She called her mom.
"I don't even remember what I said," Sara Bowman says. "I was just trembling."
For BrittLee, the cancer diagnosis just didn't make sense.
"You can exercise everyday of the week for an hour-and-a-half — except on Sundays, you need a rest day. Be pescatarian for six years. Eat lots of fruits and vegetables all the time. Drink green juice all the time. You know, you can be pretty healthy and live an active lifestyle and still get cancer," she says. "It sucks."
Bowman started researching her particular cancer: medical journals and anything she could get her hands on. Meanwhile, there were more tests. Her doctor gave her options: lumpectomy, single mastectomy, or double mastectomy.
"So basically, if I chose double mastectomy and then take care of everything right now then I hopefully will not have a recurrence of this cancer," she says.
Thirty-four and single, she wanted the option to have kids. Some treatments impact fertility. Then there were a host of other concerns, including how it could impact her athletic career, and also, how she looked at her body.
"I've always been a very comfortable person with my body... And I know that a lot of women struggle with their bodies and don't love them," she says. "And so I had this fear that the surgery would change that about me. It wasn't totally the fear of it changing my body, it's like more about like the fear of it changing how I felt about my body."
She continued to research and read. But sometimes journals feel impersonal.
So she looked up #doublemastectomy on Instagram. "And they're posting everything. They're showing: This is what it looks like right after surgery. This is what it looks like when you have a bad reconstruction that you're sad about and that makes you want to get surgery again. This is what it looks like when you're happy that your surgery went well. This is what it looks like when you have radiation. And so just finding that on Instagram was actually really helpful for me to see other women my general age going through this experience."
She soon had her surgery date. But still hadn't decided which surgery to get.
"It was the thing I thought about every moment."
All that was going through her head when she entered that cyclocross race in Queens.
That day, Bowman powered through the course, battling for second place with rider Rachel Rubino. The two are competitors and also friends.
"Hey, I've been thinking about you so much all week, Rubino told her as they raced. "I love you so much."
By the last lap, Rubino was in second and Bowman had third place wrapped up. They'd get to stand on the podium together. It meant a lot for Bowman. But it meant a lot for Rubino, too.
"A lot of people in my family have had cancer," Rubino says. "My mom passed away of breast cancer when I was 22. So for me it hits this really deep place. You know? It's like being a woman and being an athlete. This can happen to any of us."
Days after the race, Bowman made her decision. She'd have surgery to remove both her breasts. On the day of the appointment she went to the hospital with family and a friend.
"It was just a long wait a long wait in there ..." says Sarah Bowman.
Finally, it was time.
"So they they placed the I.V. in my arm while I was in the holding area with my family," says Bowman. "And they walked me down a hallway. And there was an elevator. And I was with the nurse. And I had to say bye to my family. So I go into this elevator. The doors close. And I was like in the elevator with the nurse and I was just crying. ... It's just scary. You know you don't want to have to do that, but you're trying to fix the problem."
She walked into the operating room in her gown, past a table of surgical tools. She climbed onto the table. And she stared into silver lamp lights.
Three weeks after her surgery, she was still healing and feeling hopeful about racing again.
"I got on my bike on a 28-degree day here in New York City. And I rode laps in Central Park," she says.
Athletes are like that: Tough. But Bowman is quick point out that she only had stage one. She's young. There's a lot of women dealing with far worse. That said, there's still radiation ahead, healing from reconstructive surgery, and five to 10 years of tamoxifen to ward off a recurrence.
"I'm like did I survive yet? I don't know. Do I still have cancer? I'm a little unclear on that right now. Maybe I do still have cancer? Or maybe maybe it was all cut out of me? I'm not quite sure," she says.
You can see the wear on Bowman's face, but also the resolve. She'll wake up. Roll out of bed. Do her treatment. Get on with her life. Copyright 2019 NPR. To see more, visit https://www.npr.org.