Kristi Egland knows the particulars of breast cancer through both her years of research and through personal experience.
She is breast cancer survivor. She learned she had the disease in June 2007.
"My husband and I moved to Sioux Falls in 2004, and I became pregnant with our second child.
Egland and her husband, Tom, are the parents of two children, a 6-year-old daughter, Claire, and a 3-year-old son, Clark.
"And when I was done nursing Clark, I noticed that my right breast didn't dry up," Egland said.
She was 37 years old.
"I was before the age of regular mammograms, and I was not high risk," Egland said. "There is no breast cancer in my family. But I noticed there was a lump, and that wasn't right."
She called her doctor, and a mammogram was scheduled. The test detected a large tumor in her breast. "I also had lymph node involvement," Egland said.
She underwent a double mastectomy and had her axillary lymph nodes removed from her right side, near where the tumor was located.
She underwent eight rounds of chemotherapy. "The cancer I had was very aggressive, and so if it is going to recur, it would probably recur sooner than later," Egland said. "My oncologist said that in approximately three years, it would probably come back."
The aggressive nature of her cancer isn't what compelled Egland to have a double mastectomy.
"I didn't want to have to deal with this again 10 years from now," she said. "And, I think the bottom line is I was afraid I would find cancer in my left side 10 years later, and I didn't want to deal with it. I think it's wise to have a double mastectomy, and then not have to worry about it, not have to think about it again."
Reconstruction following a double mastectomy, Egland added, "is more balanced. Seriously, being a woman, and being in my 30s, it just made sense."
Before her surgery, Egland requested that doctors save both her cancerous and non-cancerous breast tissue.
"Part of me getting control of my life was getting control over the tumor, and for diagnostic purposes, they (doctors) don't use the whole tumor; they only need a small section of it, and a lot of it goes into what's called surgical waste," she said. "And I couldn't bear the thought of that.
"I had them paraffin-imbed all of the leftover tumor, and then, since I had a double mastectomy, I obviously had normal tissue, and I also had that frozen," Egland said. "I don't want people to think that I'm using my sample and it's tilting the data. I basically use my tissue as a control."
The decision to save her tissue wasn't difficult to make. Egland knew at the time that it would be of great value.
"Normal breast tissue is very hard to get," she said. "It's very valuable, it's an important gift to science. If we're looking at the presence of a protein in normal tissue versus one with cancer, I can use normal tissue of mine and compare it with cancer."
The rural nature of South Dakota, with its few cancer research facilities, allows scientists like Egland to obtain the needed amount of breast cancer samples for research.
"Patient samples are invaluable to research," she said. "Here at Sanford, we can access them. We can get what we need. At places, say, like in San Diego, where you have many universities, the hospitals are overwhelmed with requests for tissue. Here, it's just a matter of getting the word out."
Egland said her experience with breast cancer taught her the many challenges women face, particularly young mothers who are battling the disease.
"The hardest thing about the cancer was 'the mom factor.' There are so many things that people can do for you – they can cook for you, they can wash your laundry … but nobody can take the place of holding your children," she said. "With Clark, it was hard because I went from nursing him, and then I stopped, and then I had surgery and I couldn't hold him tight to my chest anymore."
Egland also couldn't pick up her son for six weeks after her double mastectomy.
"What do you do with a 1-year-old? You pick them up, you change his diaper, you put him back down, you carry him from room to room and I couldn't do that," she said. "The bonding with Clark went to Paul. It was tough being a mom and watching that. He got what he needed – the amount of 'skin time' is what I call it – but it's tough. You go from being so bonded to watching him bond with his dad."
She also had to endure the exhausting effects of chemotherapy, that at times, Egland said, virtually makes one's body shut off. "My kids could be screaming, and running through the house, and I would just pass out in the easy chair with my feet up. I had no control."
Her ability to defy breast cancer through proper treatment, Egland said, has made her a better researcher.
"Part of that is because I know what questions patients are asking, and I know what science can answer," she said. "With the research that I'm doing in my lab, I'm trying to focus more on translational projects – ideas that we discover in the lab that I can apply directly to patients."