Hope for Breast Cancer Patients Desiring Motherhood: Dana Koman's Journey

In 2015, 29-year-old Dana Koman was excited about the future. She’d been married for two years, her career in the marine industry was going strong and she and her husband, Greg, were preparing for a move from Massachusetts to Florida. Then she felt a lump in her breast.

Told she was too young to have breast cancer, her request for a mammogram was turned down — twice.

But Ms. Koman’s instincts told her not to give up. Shortly after arriving in Florida, she found a clinic willing to perform a mammogram. When she received the news that her test came back negative, she called her mother, who had recently been diagnosed with breast cancer herself. Her mother’s advice was unexpected.

“She asked me if I had seen a breast specialist or had been to a clinic that specializes in breast cancer. I didn’t even know there was such a thing,” Ms. Koman says. “I’d just gone to a random clinic. She pushed me to get a second opinion.”

A Diagnosis of Breast Cancer

That’s when Ms. Koman met breast surgeon Starr Mautner, M.D., with Baptist Health Miami Cancer Institute. Dr. Mautner examined her, took one look at the images she brought from the outside mammography office and immediately ordered a biopsy. It was cancer — invasive ductal carcinoma stage 2b.

“Dr. Mautner was the first doctor who took me seriously,” says Ms. Koman, who was 30 at the time of her diagnosis. “I think if I hadn’t been so proactive, I would be dead or very sick or I would have had to have much more radical treatment than I had.”

In 2015, it was rather unusual for young women to be diagnosed with breast cancer. But in the last decade there has been a significant rise in breast cancer incidence in women in their 20s, 30s and early 40s. Today at Miami Cancer Institute, 13 percent of all new breast cancer diagnoses occur in women under age 45. Because of the increase, the Institute has developed the Young Breast Cancer Program to help streamline care and address the unique needs of younger women.

The Fertility Talk

Although that program didn’t exist when Ms. Koman was diagnosed, Dr. Mautner initiated a crucial conversation about fertility preservation. It was a topic that Ms. Koman, understandably focused on surviving cancer, hadn’t previously considered.

“Initially, it wasn’t clear if I’d need chemotherapy, but based on my pathology, Dr. Mautner recommended it,” Ms. Koman says. “At the time, we weren’t certain we wanted children, but when I learned the gravity of chemotherapy and what it does to fertility, it put it in a different perspective. I wanted to be able to make the decision to have children down the road. Dr. Mautner opened my eyes to the options.”

Ms. Koman was referred to a fertility specialist, and after a bilateral mastectomy but before beginning chemotherapy, she underwent egg harvesting and the couple’s embryos were frozen for future use.

“Dana’s cancer had spread to her lymph nodes, so chemotherapy was necessary,” Dr. Mautner says. She was also put on tamoxifen, a hormone therapy that reduces the risk of recurrence. Tamoxifen works by blocking estrogen production, which can fuel some types of cancer growth. Because of its toxicity, however, women are advised not to get pregnant while taking the drug.

A Growing, Healthy Family

When Ms. Koman and her husband decided they were ready to become parents, she went off the medication. Their son, Huck, was born in June of 2021. A month later, Ms. Koman went back on tamoxifen for two more years. Then they repeated the process and their daughter, June, was born in April of 2024.

“It’s like a tornado every day. They are into everything,” says Ms. Koman, who is now 40 and lives in Massachusetts with her family. “But it is the best chaos you could have. Huck is very creative and very curious. June has a smile that lights up the room. They are healthy and happy kids.”

If there’s one thing that Dr. Mautner loves about her patients who go on to have children, it’s the holiday cards they send year after year. “She has beautiful kids,” she says of Ms. Koman. “She credits me for saving her life, because she had been told it was nothing. But the fact is, we’re not only saving lives, we’re also creating lives because she is a survivor who was able to go on after treatment and have kids. That is very rewarding.”

Visit BaptistHealth.net/Mammo to learn more or schedule your breast cancer screening this Breast Cancer Awareness Month.