SARAH FULFORD: A modern day previvor

Laura Young
ECB Publishing, Inc.

In 2021, breast cancer became the most common cancer worldwide. Women who discover that their family history, personal medical history or genetics heightens their risk of developing breast cancer can find their life's path increasingly fraught with more-than-routine screenings filled with deep anxiety, waiting for test results.
Like many women around the world, when Sarah Fulford of Monticello learned in 2007 that her mom had breast cancer, her life changed in an instant.
“Not only did I have to watch my mother go through the toughest journey of her life,” says Fulford, “I had to come to terms with how this would affect my life as well.”
At age 31, the risk factors were starting to build up for Fulford. Her paternal grandmother had also had breast cancer, and she learned that her own breast density increased her risk. She started having screenings early, and the more frequent mammograms and MRIs that her doctors recommended repeatedly revealed worrisome cysts, which led to frequent biopsies and one lumpectomy of a cyst cluster. Genetic testing, though inconclusively in the “gray zone,” added to the worry that breast cancer was on her horizon.
Fulford had become a “previvor.” A previvor is someone with a predisposition to cancer but who hasn't yet had the disease. Breast cancer previvors have basically three options to manage their risk: monitoring their condition, taking a hormone-lowering medication or undergoing a preventative double mastectomy.
“So, here I was,” recalls Fulford, “rotating from mammograms to MRIs every six months, dealing with my own breast issues, biopsies, results, scares and worries and prayers. My surgeon told me I could have a mastectomy at any time, and that I easily qualified for it.”
Fulford faced a monumental decision about how to manage her risk. She chose to continue with monitoring for 12 long years, all the while going back and forth in her mind about the surgical option. Then, in the summer of 2018, when a radiologist mistakenly identified an old spot as new cancer, she realized she had enough of the stress and trauma of monitoring.
“I knew in my heart; I was ready to move forward with my surgery,” says Fulford. “We met with my surgeon again, talked things over and set the date for Jan. 25, 2019.”
As a farmer's wife, Fulford needed to plan for the surgery and recovery to happen during the brief time of year that falls between harvest and planting. Then, unexpectedly in October, her husband Ernest had a serious farm accident. A 15-foot fall from a semi-trailer while harvesting peanuts left him with complicated injuries: a crushed wrist, damaged rotator cuff, eye trauma, a concussion and partial amnesia. He embarked on a series of surgeries that would overlap with his wife's own mastectomy date. She didn't feel she could cancel her surgery; so she pressed on, with faith that it would all work out.
To ease the anxiety leading up to the big day, Fulford joined The Prophylactic Mastectomy Group on Facebook.
“It helped me so much! I met so many brave, incredible women who helped me along the way. Even though so many people were praying for me, I still couldn't shake my nerves. I was a wreck until the morning of. Then the Lord put a peace over me that I cannot describe. I felt each prayer, and I was ready to do this.”
Fulford's successful surgery for a double mastectomy with no reconstruction lasted two and a half hours. She was able to receive visitors during the first, difficult night afterwards, and the following afternoon she went home.
“My next days were full of resting, getting my drains stripped and watching my family and friends step up and take care of my every need,” remembers Fulford. Meals arrived daily, friends brought gifts to help with recovery and someone anonymously paid the kids' school tuition for the month.
“People showed us the love of Christ by their actions,” says Fulford.
She found the physical pain very manageable, but the roller coaster of emotions was more difficult than she expected.
“I couldn't bear to look at my chest. I had to grieve my boobs. Getting a shower took every ounce of energy I had. I felt as if I would never be myself again. I craved normalcy badly, but it felt like I would never achieve it.”
Fulford thanks her husband for stripping her drains twice a day, bathing her, telling her how great her wounds looked when she wasn't able to look at them, and encouraging her through it all. When he needed his fourth post-injury surgery just two weeks after her double mastectomy, she didn't know how they would handle it. Thankfully, Clay, the oldest of the six children in their combined families, was able to drive them to Shands Hospital in Gainesville. When they returned, the two youngest children, still at home, took charge.
“I couldn't take care of Ernest, being down myself,” says Fulford. “So challenging! Our 12-year-old daughter Megan really stepped up to the plate and took care of her mom and dad with such grace. She had to fix meals, tidy the house and make sure her little brother was cared for. Our 10-year-old son Noah helped out as well. He never left my side except to go to school. He fetched water, medicine and blankets. He held my hand every time I experienced pain. I feel so blessed to have them.”
Nearly three years have passed since Fulford had the prophylactic double mastectomy to reduce her risk for breast cancer. No longer in a high-risk group, she now has a zero to two percent chance of developing the disease. The difference is huge for her.
“Sometimes I can't believe it has been that long, and other days it feels like it was just the other week. It's been such a time of growth, strength and realizing I'm a proud, beautiful warrior. God has grown me in ways I could not have imagined. My faith has increased, and He told me early on that He would use me to share my story. When we go through something very challenging in life, it helps to know someone who has experienced firsthand what you are about to endure. I share with women what I went through and answer any questions they may have.”
Fulford frequently gets asked why she chose not to have reconstruction. She explains that following a mastectomy, a woman has a number of options about her appearance. She can present herself as flat, simply wear a store-bought padded bra, be fitted for custom prosthetic breasts, have reconstruction with implants or have reconstruction with fat from another part of her body.
“In the beginning, I fully planned to get implants,” says Fulford. “I just didn't feel like I could wake up and be completely flat. Then a friend of mine had to explant due to being severely ill from her implants. She almost died twice because of immune issues. I decided right then and there that the risk just wasn't worth it.”
Because she has chosen not to have reconstruction, Fulford says, “It's up to me to have boobs today or not.”
She has zero regrets about the choices she has made. She has found her new normal and is living life to the fullest. Fulford's conversations with women on this journey always conclude with several reminders:
“First, you can do this! Even when it seems impossible, you can do it with God's help. Second, boobs do not define who you are. You are beautiful with or without boobs. Each scar tells your story and makes you a beautiful warrior. Lastly, nothing is wasted. God has and will continue to use every hard thing we face for good. What seems overwhelming now will be your testimony later.”