‘It Changed My Life’: Comedian Tig Notaro, 54, Says Her Stage 2 Breast Cancer Diagnosis Helped Her Get Over Her Unwillingness to ‘Ask for Help’

The award-winning comedian and actress, known for her dry wit and fearless honesty, had already built a career on turning discomfort into punchlines. From her acclaimed series “One Mississippi” to voiceover work on “Star Trek: Discovery Logs,” Notaro’s comedic lens was sharp.

In the summer of 2012, her life unraveled. Within weeks, she lost her mother, endured a painful breakup, battled pneumonia, and was diagnosed with stage 2 breast cancer.

Early-stage breast cancer refers to cancer that is typically smaller in size and confined to the breast and surrounding tissue. As is the case in most cancers, when the disease is caught in its earlier stages, there is a higher chance of a cure.

“[Breast cancer] cracked me open completely,” Notaro said, reflecting on the moment that shattered her self-reliant shell.

“I went from being somebody who held everything to myself. I was gonna do it on my own,” but that moment of vulnerability became an escape hatch to allowing close friends and family to help her through that trying time.

Just days after her diagnosis, Notaro was scheduled to perform a live comedy set. She considered canceling, but a persistent venue owner urged her to postpone instead. Ultimately, she chose to go on with radical candor.

“I walked out devastated, crying on the sidewalk,” Notaro explained in an interview with LA Ist.

“I got a text asking if we were doing the show [the next night], and I just wrote, Yes. I wanted to do standup one more time.”

That night, she opened with the now-famous line: “Hello, I have cancer.” Her voice trembled. She nearly cried. But the audience responded with a standing ovation, and Notaro’s vulnerability became a turning point in her career and healing.

Her treatment journey was anything but straightforward. Faced with surgical options, including breast reconstruction, Notaro felt overwhelmed by the permanence of the decisions ahead.

“In the course of about two weeks, I was expected to choose how I wanted my body to be for the rest of my life,” she told Patient Resource. She ultimately chose a double mastectomy.

A double mastectomy is a procedure in which both breasts are removed to get rid of cancer. The procedure may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.

“A double mastectomy typically takes about two hours for the cancer part of the operation, the removal of the tissue,” Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet. “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”

The diagnosis also disrupted another deeply personal dream: having children. Because her cancer was hormone-sensitive, fertility treatments like IVF posed risks.

“It was frustrating, to put it mildly,” she said. “I had been on such a route in life—I wanted kids. I just always assumed I would have my own children. So I was stunned.”

Endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.

WATCH: Hormone Therapy for Breast Cancer

“For women who have hormone-positive breast cancer, it means that they have a cancer that needs estrogen to grow,” Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, explains.

Hormone therapy is used for hormone receptor-positive cancers. These types of cancers are the most common types of breast cancer. Hormone receptor-positive means the cancer or tumor needs the hormones estrogen and/or progesterone to grow and flourish.

“Endocrine therapy has significant benefits in reducing the risk of breast cancer recurrence and improving breast cancer survival,” Dr. Eleonora Teplinsky, head of Breast Medical Oncology at Valley Health System, tells SurvivorNet. Hormone therapy blocks hormones that feed cancer cells.

Hormone therapy works by driving the estrogen levels down or blocking the estrogen’s ability to interact with the estrogen receptor on the cancer cell.

Tamoxifen is a type of hormone therapy drug used to treat breast cancer. It is also used to prevent breast cancer among women who are at high risk for breast cancer because of family history.

Other hormone therapies may include aromatase inhibitors. These drug treatments block the activity of the aromatase enzyme and, therefore, stop estrogen production. This helps slow down the growth of tumor cells sensitive to estrogen.

Despite the setback, Notaro and her wife, Stephanie, found a new path to parenthood. Today, they’re raising two sons together—and Notaro is cancer-free.

“I’m happy, healthy, and cancer-free,” she said. “We laughed that one day we would just want to put ‘little pants on someone.’ Now we have two sons.”

Understanding Early-Stage Breast Cancer and What Comes Next

Early-stage breast cancer means the tumor is small and hasn’t spread to nearby lymph nodes. According to Dr. Comen, the first step is usually surgery to remove the cancer. This may involve a lumpectomy, where only the tumor and surrounding tissue are removed, often followed by radiation therapy to reduce the risk of recurrence.

However, treatment isn’t one-size-fits-all. Factors like age, tumor size, family history, and personal preference may influence whether radiation is needed or if a patient chooses a more aggressive approach, such as a mastectomy—removal of the entire breast. After surgery, a pathologist examines the tissue under a microscope to help determine the next steps in treatment.

WATCH: Understanding Early Stage Breast Cancer

Diagnostic testing plays a critical role in shaping your care plan. If a mammogram or clinical breast exam reveals something abnormal, your care team may recommend:

• Diagnostic mammogram and breast ultrasound to get a closer look at the breast and nearby lymph nodes
• MRI scans for additional imaging detail
• Biopsy of suspicious areas, including lymph nodes, to confirm cancer
• Tumor marker testing to identify hormone receptors and proteins that influence treatment options
• Additional imaging to check for any signs of metastatic disease

Once all this information is gathered, your cancer is staged—based on tumor size, lymph node involvement, and whether it has spread. Staging helps guide treatment decisions, while hormone receptor and protein marker tests reveal how the cancer behaves and which therapies may be most effective.

Your healthcare team will consider all of these factors—alongside your personal health, values, and goals—to create a treatment plan tailored to you.

IVF’s Role In Family Planning For Cancer Patients

Fertility struggles are a genuine concern among cancer patients, as certain cancer treatments can cause infertility. Fortunately, in many cases, efforts can be made before beginning treatment to help preserve fertility.

Even without a diagnosis, many couples, at one point or another, experience infertility. The Centers for Disease Control and Prevention (CDC) says within the U.S., “about one in five” married women between the ages of 15 and 49 with no prior births are unable to get pregnant after trying for a year. Additionally, “one in four” of women in this group struggle to get pregnant or carry the pregnancy to term.

WATCH: How does chemotherapy affect fertility?

Infertility can be a side effect of cancer treatment due to how it impacts the body. Various cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility. Before undergoing cancer treatment, patients should speak to their doctors about fertility preservation if they wish to have a family in the future.

Patients should also recognize that infertility is a problem that affects so many people hoping to be parents, and nothing to be ashamed of.

The American Psychological Association said in its Monitor on Psychology Magazine, “A diagnosis of infertility — the inability to get pregnant after a year or more of trying — can lead to depression, anxiety, and other psychological problems, trigger feelings of shame and failure to live up to traditional gender expectations, and strain relationships.”

Among men, infertility can “cut into a man’s feelings of masculinity” and “can lead to issues of shame and embarrassment,” psychologist William D. Petok told the outlet.

Cancer Treatment’s Impact on Fertility in Women

For women, some types of chemotherapy can destroy eggs in the ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the type of drug and your age, since your egg supply decreases with age.

“The risk is greater the older you are,” reproductive endocrinologist Dr. Jaime Knopman told SurvivorNet.

“If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply,” Dr. Knopman continued.

Radiation to the pelvis can also destroy eggs. It can damage the uterus, too.

Surgery on your ovaries or uterus can hurt fertility as well.

Meanwhile, endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.

If you are having a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you for sure whether you will be impacted. That’s why you should discuss your options for fertility preservation before starting treatment.

Research shows that women who have fertility preserved before breast cancer treatment are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.

Most women who preserve their fertility before cancer treatment do so by freezing their eggs or embryos.

After you finish your cancer treatment, a doctor who specializes in reproductive medicine can implant one or more embryos in your uterus or the uterus of a surrogate with the hope that it will result in pregnancy.

If you freeze eggs only before treatment, a fertility specialist can use sperm and your eggs to create embryos in vitro and transfer them to your uterus or a surrogate later on.

When freezing eggs or embryos is not an option, doctors may try these approaches:

• Ovarian tissue freezing is an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment right away and don’t have time to harvest eggs.
• Ovarian suppression prevents the eggs from maturing, so they cannot be damaged during treatment.
• Ovarian transposition, for women getting radiation to the pelvis, moves the ovaries out of the line of treatment.

In addition to preserving eggs or embryos, research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to safely pause endocrine therapy (ET) to try to get pregnant, and they did not have worse short-term recurrence rates than people who did not stop endocrine treatment.

When to Screen for Breast Cancer

The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.

The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.

WATCH: Mammograms are still the best tool for detecting breast cancer.

Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.

Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.

Regular Self-Exams Are Helpful In Between Mammograms

A self-breast exam is an easy way to monitor your breasts for abnormalities. It involves feeling the breast for swelling, bulging, or changes in the shape of the breast or nipple.

WATCH: How to perform a self-exam.

Checking for signs of redness, rashes, or discharge is also part of this exam. If anything is found that is concerning, you should contact your doctor. It’s important to note that self-exams should be done with regular mammograms.

How AI Is Enhancing Mammograms When Screening For Breast Cancer

The artificial intelligence program that has received approval from the Food and Drug Administration (FDA), called Clairity Breast, may change the way doctors assess breast cancer risk from screening mammograms.

While not a replacement for traditional mammography, this AI-powered tool can enhance current screening practices and improve early detection efforts, according to Dr. Mary Newell, a breast imaging specialist at Winship Cancer Institute of Emory University.

“This new approach can enhance the current standard of care,” Dr. Newell tells SurvivorNet.

Clairity Breast analyzes subtle patterns in screening mammograms linked to future breast cancer risk, generating a validated five-year risk score. This score is seamlessly integrated into clinical systems, enabling more personalized follow-up care.

“We can identify patients who are at elevated risk and offer supplemental screening to them with breast MRI or other technologies as a way to increase the likelihood of early detection. It does not replace mammography, and in fact, relies on mammographic images to allow the risk assessment,” she adds.

How to do a self-breast exam.

Currently, women at average risk are advised to begin yearly mammograms at age 40. While Clairity Breast does not change these guidelines, Dr. Newell noted that it could help identify patients who may need earlier screening or additional imaging methods.

“It may allow us to identify patients who should start screening at an earlier age if they are shown to be at elevated risk,” she said. “It can also allow us to identify patients who may benefit from supplemental screening technologies, in addition to their yearly mammogram, after the age of 40.”

Unlike AI programs designed to detect cancer directly from images, Clairity Breast functions as a risk assessment tool. It does not interpret mammograms for cancer detection but instead works alongside traditional methods to pinpoint patients who may be at higher risk.

“Other AI tools are being developed that provide assistance with interpretation, helping to detect a cancer that may already be present,” Dr. Newell explained. “But most of the literature to date suggests that AI tools work best when deployed in conjunction with interpretation by a breast radiologist.”

Clairity Breast represents a promising step in breast cancer prevention, offering a new layer of analysis that helps doctors identify high-risk patients early and refine screening approaches — all while keeping mammography at the core of detection.

How is 3D mammography different?

“Now, advancements in AI and computer vision can uncover hidden clues in mammograms — invisible to the human eye — to help predict future risk,” said Dr. Lehman, founder of Clairity and breast imaging specialist at Mass General Brigham, in a press release.

Dr. Amani Jambhekar, a board-certified surgeon specializing in breast cancer and melanoma at CHRISTUS Health, says this new technology can make mammograms even more valuable.

“It may be a more individualized way of calculating breast cancer risk, which we need, as existing risk calculators do not identify everyone who is high risk. As a surgical oncologist, I am excited to learn more about this platform when it launches,” Dr. Jambhekar tells SurvivorNet.

RELATED: When Should I Get a Mammogram?

False Positives & the Dreaded ‘Callback’

If you went in for your mammogram and received a call from the doctor’s office to say more images, including MRI or ultrasound, may be required if the initial pictures aren’t clear, while worrisome, this scenario could mean a number of things. For instance, dense breasts, which we discuss elsewhere in this section, can make it hard to distinguish between fatty tissue and a tumor.

Here is how the numbers on screenings break down, according to Dr. Lehman: Of the approximately 10 percent of women who get called back, the vast majority will be absolutely fine after more imaging. Only 20 percent of those will need a biopsy, and in the end, just five percent of that group will be found to have cancer.

Here are some tips to help ensure you get the most accurate test possible:

• Go to a large and experienced center that has a good record and reputation.
• Don’t wear deodorant on the day of your mammography. It can contribute to inaccuracies.
• Keep in mind that certain factors, like dense breasts, tattoos, and breast implants, may also result in errors.

Learning More About Genetic Testing

Genetic testing for cancer is typically conducted in a medical setting, such as a primary care office or an OB-GYN clinic. However, some tests are now available for direct purchase, allowing individuals to explore their genetic risk independently.

Initially, genetic testing was recommended for a limited group of individuals based on specific risk factors, including a strong family history of breast cancer, personal cancer history, or certain ethnic backgrounds.

WATCH: Helping you understand genetic testing.

“It started out with a very narrow field of women and men who were recommended to have it based on certain risk factors, family history of breast cancer, or other cancers, and also ethnic backgrounds,” explains Dr. Port.

Guidelines from the National Comprehensive Cancer Network (NCCN) suggest that genetic testing should be prioritized for patients at higher risk for hereditary breast cancer. This includes individuals diagnosed with breast cancer before the age of 45, those with a strong familial history of the disease, and individuals of Ashkenazi Jewish descent.

Meanwhile, the American Society of Breast Surgeons (ASBrS) takes a broader approach, recommending genetic testing for all patients diagnosed with breast cancer.

These evolving recommendations reflect a growing emphasis on personalized medicine, ensuring that individuals at risk receive appropriate screening and guidance to manage their health proactively.

What If You Have the BRCA Gene Mutation?

Discovering a genetic mutation can be unsettling, but there are several options available to manage cancer risk effectively. These include enhanced screenings for early detection, prophylactic (risk-reducing) surgery to remove high-risk tissue, and chemoprevention—the use of medications designed to lower the chances of developing cancer.

Interestingly, for individuals diagnosed with ovarian cancer, carrying a BRCA mutation may provide a treatment advantage when paired with a class of drugs known as PARP inhibitors. Approved by the FDA starting in 2014, these targeted therapies have transformed the landscape of ovarian cancer treatment.

WATCH: Understanding the BRCA Gene Mutation

PARP inhibitors function by blocking the protein PARP, which normally repairs damaged DNA. By preventing this repair process, the inhibitors selectively destroy cancerous cells while sparing healthy ones, making them a powerful treatment tool.

“The PARP inhibitor prevents the repair of the [damaged] single-strand DNA break, and your BRCA mutation prevents the repair of the double-strand DNA break,” explains Dr. Rebecca Arend, Associate Scientist at the University of Alabama, Birmingham, in an interview with SurvivorNet.

This combination of genetic insight and advanced medical therapies highlights how precision medicine continues to evolve, offering more effective, tailored approaches to cancer prevention and treatment.

Questions To Ask Your Doctor

If you have a breast cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet suggests the following questions to kickstart your conversation with your doctor.

• Do I have dense breasts?
• Do I need to undergo additional or more sensitive screening?
• How is my risk level being assessed?
• Will insurance cover additional screening if needed?

Learn more about SurvivorNet's rigorous medical review process.

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