Two-Time 88-Year-Old Stage 4 Breast Cancer Survivor Says, ‘If You Want to Live, You Will Fight to Live’ – How Her Perspective On Life Changed Over the Years

“If you truly want to live, you will fight to live, and that’s one of the things it taught me,” she told WXII News.

Dr. Elizabeth Comen, a medical oncologist from the Memorial Sloan Cancer Center, explains that metastatic breast cancer means that the breast cancer is “living in another part of your body. That can be in the liver, the bone, the lungs, or potentially even the brain.”

Throughout Best’s cancer journey, she’s endured years of treatment, including a double mastectomy (removal of the breasts), and now she’s learned to manage stage 4 disease.

A double mastectomy is a procedure that removes both breasts. Some women choose to get a double mastectomy to reduce their risk of cancer, especially if they have a family history of cancer or possess the BRCA1 and BRCA2 gene mutation, which also increases their risk.

WATCH: Dr. Elisa Port explains what happens during a double mastectomy.

Deciding to undergo a mastectomy can be an emotional experience for many women facing breast cancer. While the surgery itself may only take a few hours, the changes can be difficult to adjust to mentally.

“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.”

For many women, the decision to undergo a mastectomy is deeply personal. The physical changes can be profound, and the mental adjustment can take time.

Admirably, when she talks about her journey, she focuses on the positive and an unyielding desire to live.

Each day since learning her cancer had advanced, Best says she makes a conscious choice to stay positive and practice self-care. She believes deeply in showing up for yourself, even on the days when it feels hardest.

“Go out and do something for yourself, put some lipstick on, step out the back door, get dressed up,” she says. “It is very important how we treat our bodies; we don’t have to treat them like they are something to put on a shelf.”

Best’s story is a reminder that medical timelines don’t always define survivorship. It’s defined by personal resilience and a spirit to focus on living.

Treatment Options for Advanced Breast Cancer

Metastatic breast cancer means cancer cells have spread from the breast to other parts of the body, which may include the bones, liver, lungs, brain, and beyond.

Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different body parts, where they grow as new tumors.

As the cancer spreads to other body parts, patients may experience additional symptoms depending on where the cancer has spread. Examples include:

• Bones: Severe bone pain or fractures
• Lungs: Difficulty breathing, chest pain, new cough
• Liver: Yellowing of the skin (jaundice), abdominal pain, nausea, and/or vomiting
• Brain: Headaches, memory loss, changes in vision, seizures

WATCH: Treatment options for metastatic breast cancer.

Although stage 4 breast cancer is not curable, several treatment options exist that can extend the life of patients. Treatment options depend on the stage, type of primary breast cancer, and whether hormone receptors are positive.

Treatment can include a combination of:

• Chemotherapy: Oral or IV medications that are toxic to tumor cells
• Hormonal therapies: Drugs that lower estrogen levels or block estrogen receptors from allowing the cancer cells to grow
• Targeted therapies: Drugs that target your tumor’s specific gene mutations
• Immunotherapy: Medications that stimulate your immune system to recognize and attack cancer cells
• Radiation: The use of high-energy rays to kill tumor cells and shrink tumors
• Surgery: To remove a cancerous tumor or lymph nodes (uncommon with stage IV; more common in stages I, II, and III)
• Clinical trials: Studies of new medications, treatments, and other therapies offer hope for better outcomes.

Discovering the Latest Treatments for Advanced Breast Cancer

Late-stage breast cancer is not one disease, but many different diseases, so the options available to different patients vary a great deal. Which treatment doctors recommend will depend on several factors, such as a woman’s overall health, genetics, the biology of the tumor, and more.

Some of the newer treatments for advanced breast cancer include imlunestrant. This treatment, which received approval from the U.S. Food and Drug Administration, is the second oral selective estrogen receptor degrader (SERD) for adults with estrogen-receptor–positive (ER+), HER2-negative, ESR1-mutated advanced or metastatic breast cancer whose disease has progressed after at least one line of endocrine therapy.

WATCH: New Hope For 70% Of Advanced Breast Cancer Patients

During clinical trials, imlunestrant demonstrated a meaningful improvement in progression-free survival (PFS) as a stand-alone therapy in patients with an ESR1 mutation versus the standard of care endocrine therapy, reducing the risk of disease progression or death by 38%.

For women with a common type of advanced breast cancer — hormone receptor-positive (HR+), HER2-negative (HER2-), a new drug combination — camizestrant plus a CDK4/6 inhibitor reduced the risk of disease progression or death by 56% in patients with HR+ breast cancer and an emerging ESR1 mutation.

Better Understanding Breast Cancer Surgery

Dr. Ann Partridge, an oncologist at Dana-Farber Cancer Institute, says there are a number of factors to weigh when considering a mastectomy, chief among them is whether breast-conserving surgery (or lumpectomy) is possible. Your doctor will look at the size and features of your tumor as well as your family history in order to make a recommendation.

“When I talk to a woman who comes to me and she has breast cancer, I evaluate what the standard options for treatment for her are, which typically include cutting out the cancer– which is either a lumpectomy if you can get it all with just a little scooping around of the area that’s abnormal or a mastectomy for some women meaning taking the full breast because sometimes these lesions can be very extensive in the breast,” Dr. Partridge explains.

If you’ve had a mastectomy, breast reconstruction is one of the major issues to consider. There are several options available. The reconstruction process can happen at the time of the surgery to remove the breast or later on in the case of implants. Some women opt for no reconstruction, but decide later on that they want reconstruction to restore a sense of self, or simply get back to the way they used to look.

WATCH: Breast Reconstruction: Regaining Your Sense of Self

“Breast reconstruction is about restoring both a woman’s form and her sense of self,” explains Dr. Andrea Pusic, Chief of Plastic and Reconstructive Surgery at Brigham and Women’s Hospital. It’s a deeply personal decision, and today’s surgical options can create breasts that look natural and real.

Immediate reconstruction can produce better results than delayed reconstruction, resulting in fewer surgeries. However, it may require a more extended initial hospitalization and recovery time. This long surgery may also have a higher risk of complications, such as infections, than two separate surgeries.

It may be worth noting that “Delayed reconstruction has fewer complications than immediate reconstruction,” Dr. Terry Myckatyn, a plastic surgeon specializing in breast reconstruction, told SurvivorNet.

When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). During reconstruction, one can also take one’s own tissue (usually from the belly area) and transfer it to the breast area.

After breast cancer surgery, women diagnosed with early-stage breast cancer may also need chemotherapy, radiation, or hormone therapy.

Dr. Myckatyn emphasizes that the process is collaborative: “It’s a shared decision-making process between the patient and the physician. The patient needs to advocate for herself and make her goals clear. The physician needs to provide clear, logical, evidence-based explanations for their recommendations.”

WATCH: How some women may keep their breast size and shape in cancer surgery.

Plastic surgeons typically reconstruct breasts using either implants or tissue taken from another part of the body—such as the back, abdomen, or inner thigh. This tissue-based approach, known as a flap procedure, often produces breasts that look and feel more natural than implants and can change with your body over time, for example, with weight gain or loss.

However, flap procedures involve more extensive surgery, longer recovery, and additional scarring—both at the breast and at the donor site. They may also weaken muscles where tissue is taken, and not all patients are candidates. Women who smoke or have certain health conditions, such as poorly controlled diabetes, circulation problems, or connective tissue disorders, may not be eligible.

Implant-based reconstruction usually requires fewer surgeries, smaller incisions, and less scarring, allowing for a quicker return to daily life. The trade-off is that implants don’t adapt to body changes, which can make them look less natural over time. Implants also carry risks of leakage or rupture, which would require replacement.

Every surgical option comes with risks. Understanding those risks—and weighing them against your personal goals—is essential before making a decision.

Another aspect of breast cancer surgery involves the possibility of sparing the nipple.

WATCH: Understanding Nipple-Sparing Mastectomies

During a nipple-sparing mastectomy, doctors use special techniques to remove a woman’s breast, leaving the skin and the nipple intact. The idea is to maintain, as close as possible anyway, the natural look of the breast. After a mastectomy, a plastic surgeon will use either an implant or the woman’s own tissue to recreate the breast. When a woman’s own tissue is used, doctors typically take it from fat in the patient’s lower abdomen.

“Nipple-sparing mastectomy, or nipple-preserving mastectomy, differentiates itself from the traditional mastectomy where the nipple was not saved,” Dr. Irene Wapnir, a surgical oncologist and breast surgeon at Stanford University Medical Center, explains to SurvivorNet.

“It’s the ideal procedure for those women who choose to have prophylactic mastectomy who don’t yet have breast cancer, who will choose that route because they have a strong family history of breast cancer, or if they’ve been tested and are a carrier of a mutation, a gene mutation, that predisposes them to a much higher risk of developing breast cancer,” Dr. Wapnir explains.

Coping With Your New Body After Cancer Treatment

After breast cancer surgery, patients often struggle with the changes to their bodies that others can see, whether those changes are temporary or permanent, like hair loss and weight gain. However, survivors also struggle with changes that may not be as obvious — such as infertility — and these can create body image issues and make survivors feel vulnerable.

One way to prepare yourself for possible body changes during cancer treatment is to understand that changes are possible but also, frequently, temporary. This can also help build up your self-confidence. Your support group, filled with loved ones, can help you during this stage of your journey as well.

Psychologist Dr. Marianna Strongin shares with SurvivorNet some additional tips cancer warriors can explore to help manage the emotional toll body changes can have during treatment.

Dr. Strongin encourages survivors to take ownership of the part (or parts) of their body impacted mainly by cancer treatment. She says that although they may represent “fear and pain,” they also represent “strength and courage.”

“Research has found that when looking in the mirror, we are more likely to focus on the parts of our body we are dissatisfied with, which causes us to have a negative self-view and lower self-esteem. Therefore, I would like you first to spend time gazing at the parts of your body you love, give them time, honor them, and then thank them,” Dr. Strongin said.

Dr. Strongin then suggests focusing on the part or parts of your body affected by the cancer or its treatment. She recommends creating a regular practice of accepting your body image because it helps you accept your cancer journey emotionally and physically.

“As you allow yourself to spend more time looking at all of you, you will begin having a new relationship with your body. It may not happen immediately, but with time, you can begin honoring and thanking your new body,” Dr. Strongin added.

What If You Have the BRCA Gene Mutation?

We briefly discussed that some women choose to get a preventative mastectomy if they are at higher risk of breast and ovarian cancer. One way to know if you’re at higher risk is if genetic testing reveals 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.

What to Consider When Weighing Preventive Mastectomy?

A prophylactic, or preventative, mastectomy is an operation where the breast tissue is removed to prevent cancer from developing in the future.

“Risk-reducing mastectomies are an operation where we take women at, usually, very high risk for getting breast cancer, for genetic mutation carriers, who are the ones at the highest risk; there’s unfortunately only one way to actually prevent breast cancer,” Dr. Port tells SurvivorNet.

WATCH: What to Consider When Thinking About a Mastectomy

“Women who are found to test positive for a genetic mutation really have two options,” Dr. Port explains. “One is what’s called high-risk surveillance, which means we check them every six months or so, mammograms, MRIs, with the hope that if God forbid, they develop breast cancer, we pick it up early. But that’s not prevention; it’s early detection.

“Early detection is a goal; it’s not a guarantee. For the woman who wants to be more proactive about actually preventing breast cancer, or as we say, reducing her risk, unfortunately, the only way to do that is to remove the actual tissue at risk, and that is the breast tissue,” she adds.

Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.

The benefits of a prophylactic or preventative surgery are:

• Significant reduction in cancer risk (from 80-90% to 1-2%)
• Nipples can often be spared
• Women can get reconstruction at the same time

Breast Cancer Symptoms & Self-Exams

Women are encouraged to do regular self-exams to become familiar with how their breasts feel normally, so when something unusual, like a lump, does form, it can be easily detected. A self-exam includes pressing your fingertips along your breast in a circular motion.

For some women, that means going to their doctor and walking through what a self-breast exam looks like, so they know what normal breast tissue feels like, so if they do feel something abnormal, whether it’s a lump or discharge from the nipple, they know what to ask and what to look for.

Below are common symptoms to look out for:

• New lump in the breast or underarm (armpit)
• Any change in the size or shape of the breast
• Swelling of all or part of the breast
• Skin dimpling or peeling
• Breast or nipple pain
• Nipple turning inward
• Redness or scaliness of the breast or nipple skin
• Nipple discharge (not associated with breastfeeding

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: When you’re getting a mammogram, ask about dense breasts.

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.

Questions For Your Doctor

• What stage is my cancer, and how does that affect my treatment plan?
• What are the recommended chemotherapy options for triple-negative breast cancer, and what side effects should I expect?
• Are there any clinical trials or emerging treatments I should consider?
• How will treatment affect my fertility, physical activity, or ability to work?
• What follow-up care and monitoring will I need

Learn more about SurvivorNet's rigorous medical review process.

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