In the spring of 2018, Sabrina Levine had her annual gynecological check-up, breast exam and mammogram. The results showed no cause for concern — another routine visit.
Last March 6, however, after a bout with the flu left her with what she thought were swollen glands, she visited her primary care physician. When he felt the two golf ball-sized lumps under her left arm, he wasted no time ordering the imaging and biopsies that three days later would confirm his suspicion: Levine had invasive ductile carcinoma.
“My first thought was of my kids — what was going to happen to them?” the Wantagh mother of two girls recalled. The news was so unexpected that Levine collapsed as she left the office. “I just cried and cried,” she said.
The biopsies showed 20 enlarged lymph nodes, 15 of them malignant.
Levine, 42, was never much given to crying before she received the devastating diagnosis. Her husband Mike, 41, is a Freeport police officer, a volunteer firefighter and a senior airman in the U.S. Air Force Reserve. Risk has been a factor during most of their 22-year marriage.
Because Levine is screened regularly, doctors caught the tumors relatively early, so her oncologists decided to treat them with chemotherapy, hoping to reduce their size and save her breasts. But three months of aggressive chemo had no impact. “It didn’t reduce the size of the tumors even a little,” Levine said. At that point, surgery was her only option.
She had a double radical mastectomy in July, as well as lumpectomies to remove the cancerous nodes. Radiation and more rounds of chemo followed. Levine had a total of three surgeries and two rounds of chemotherapy, and is finishing a course of radiation. One of the drugs she received was so toxic that nurses had to wear hazardous material suits to administer it. “I saw them coming into my room in hazmat suits and thought, ‘They’re going to put that stuff in me?’” she recounted. The injection site on her arm also required special protection, in case any of the medication dripped out. “They said it would have eaten away my skin,” she said.
Levine’s physical response to chemo was mixed. “Some days, I was so sick I just lay on the bathroom floor and wanted to give up, just stop everything,” she said. “It destroys your white blood cells and your bone marrow, and it burns. I never felt so much pain, and I did natural childbirth.”
All through her treatment, Levine wondered, “Why me?” she said. “I don’t have the genetic marker; I have no family history. Why did this happen to me?”
Because she lacked the BRCA mutation — the so-called breast cancer gene — and had no history or obvious lifestyle factors, her oncologist speculated that environmental factors might be at work.
The Levines, high school sweethearts who celebrated their 22nd wedding anniversary last week, have lived on Hunt Road in Wantagh, about five blocks north of the Southern State Parkway, since they relocated from Oceanside in 2008. Sabrina is a stay-at-home mom, caring for their daughters, Riley, 15, and Emma, 13.
Until Sabrina’s diagnosis, neither she nor Mike was aware of any local environmental issues. Even now, both are careful to acknowledge the complex nature of cancer and the difficulty of drawing a straight line from her illness to any external causes. They cannot answer Sabrina’s question “Why me?”
They have also learned more about the environmental factors the oncologist alluded to, such as the Bethpage plume. The plume is a section of contamination running south from the former weapons facility in Bethpage jointly operated by Grumman Corp. and the U.S. Navy starting in 1944. It is currently roughly four miles long and two miles wide, reaches a depth of 900 feet and is thought to contain at least two dozen pollutants, some of which are known or suspected human carcinogens.
“When we moved into our house in 2008, our house wasn’t on the plume,” Mike said. “We didn’t even know anything about it. I’m not sure we’d even heard of it.” But by last year, the plume had moved far enough south that their home now sat squarely atop it. And as they learned about the plume, they began to wonder about the incidences of cancer they saw among their neighbors, including brain, kidney, lung, ovarian and prostate cancers.
According to the New York State Cancer registry, which lists incidences by zip code, the number of breast cancer cases in Wantagh has exceeded the numbers expected by epidemiologists by as much as 49 percent. The data is collated in five-year increments, and a new study is expected soon.
The number of breast cancer cases in Nassau County as a whole grew by 25 percent between1976 and 2016, to 145 cases per 100,000 women, up from 115.5 — 13.4 percent higher than the national average of 127.8 cases per 100,000.
For now, the Levines’ main concerns are to continue Sabrina’s treatments and to do as much as they can to ensure their daughters’ health. “They can’t be tested for the gene until they’re 16,” Mike said, so Riley, a sophomore at MacArthur High School, will be tested next year. Emma will have to wait another two years.
Sabrina will undergo her last radiation treatment on Friday, three days before her husband is scheduled to leave on his first overseas deployment. He is not permitted to say where he will be, but he expects to be away until Christmas. The couple are prepared for communications to be sporadic at best. “We’ve put old photos and notes around the house for the girls to find,” Mike said.
They continue to be concerned about the groundwater beneath them, especially in light of recent news reports that paint a much more comprehensive and sobering picture of the possible pollutants in the aquifers as a result of the plume. Homes in both Wantagh and Seaford draw their water from surface-drilled wells.
“We can filter the water,” Mike said. “But we still have to bathe in it and wash our clothes with it.”
His wife is looking forward to celebrating her first year cancer-free on March 6. After that, she plans to take things a day at a time. She will be on hormone therapy for the foreseeable future, which brings its own set of side effects. “I’ll have hot flashes and early menopause,” she said.
“Breast cancer never really goes away,” Sabrina continued. “I’ll never be the same person I was, no matter how long I’m clean.” She spoke of the constant awareness that the disease can return, and of the physical toll it has already taken.
“I lost my hair. I lost my breasts,” she said. My skin looks different. I’m not the same person. I don’t feel the same. I don’t look the same.”
Nonetheless, she emphasized the importance of staying positive. “I don’t really have a specific approach,” she said. “It’s just to stay positive.”
She also emphasized the importance of screening and early detection. Her own regular attention to her health enabled her doctors to catch her cancer relatively early and treat it aggressively.
“Go for screening,” she said. “If you feel anything, any lump. If you have any feeling that something’s not right, go to the doctor right away. It’s easy to put it off and say it’s nothing. Just go.”