Safe for the two of us

Kellie Dubravec was happy when she learned she was pregnant with her seventh child, but she became concerned when she felt a large lump in her breast. She didn’t have a family history of breast cancer, but she hadn’t been feeling well lately — she had lingering back and hip pain.

“I called right away and got an appointment with my OB/GYN. I’ve had four of my seven children at Trinity Health,” Kellie said. “I trust them completely.”

Maggie Forgue, DO, Trinity Health Medical Group, Obstetrics and Gynecology, Grand Rapids,  performed an exam and found the lump to be suspicious enough to order a diagnostic mammogram at the Trinity Health Grand Rapids Breast Center, even though Kellie was only 36 (40 is the typical age for a first mammogram). The center’s fellowship-trained, all-female breast oncology team — recognized as a certified as a center of excellence — have the expertise to evaluate her. 

The breast oncology team physicians are members of the Cancer Network of West Michigan, which is a collaboration between UM Health-West and Trinity Health Grand Rapids and Muskegon. This network offers patients access to leading specialists, clinical trials, and the latest cancer treatments.

Following her mammogram, Kellie was called to return the next day for a needle biopsy of her breast and lymph nodes.

“We know that mammograms are safe in pregnancy, and the additional information we received from Kellie's mammogram made us confident we needed to perform a biopsy,” said Jennifer Rollenhagen, MD, chair of Radiology and Breast Imaging medical director, Trinty Health Grand Rapids.

“I knew it was cancer,” Kellie said. “A lot of those first visits were about how to navigate the fact that I was pregnant. My objective was clear from the start: It was always about making treatment safe for the two of us.”

Kellie’s diagnosis

Breast surgeon Jamie Caughran, MD, ordered a PET scan to see if there was disease progression beyond Kellie’s lymph nodes. After expressing concern for her baby’s safety, Kellie learned that there was minimum risk to her child and that the scan would give a more complete diagnosis. 

“PET scans look for cancer throughout the body but do expose our patients to radiation. We knew that in Kellie’s case it was important to know if her cancer had spread. With her pregnancy, we were able to modify the protocol to ensure that Kellie and her baby were safe during the scan,” said Dr. Rollenhagen.

Radiology remained involved to help with imaging later in Kellie’s pregnancy as well as obtaining biopsies to monitor Kellie’s progress and inform treatment recommendations.

On her 37^th birthday, Kellie learned she had HER2-positive, stage 4 breast cancer. Surgery was not an option. The cancer had spread to her bones.

“Test results came back really fast,” Kellie shared. “It was overwhelming at the time, but I am grateful now. My husband and I were emotional at first, but we are both pretty faithful, steady people. So, we slowed down in order to think things through and to figure out the next step. It was a gift that we were able to remain calm.”

Cancer treatment on Kellie’s terms

Medical Oncologist Heidi Egloff, MD led Kellie’s care team at Trinity Health Lacks Cancer Center. A key member of that extraordinary team is Nurse Practitioner Alyssa Robinson. As devout Catholics, the Dubravecs explained that their goal was to deliver their baby safely and, if possible, to find a way to treat Kellie’s cancer. Dr. Egloff, Alyssa Robinson, and the entire team were on board with this decision.

Although Kellie sought a second opinion, she chose Trinity Health for her cancer treatment. She learned that not all hospitals and cancer centers are willing to treat a patient with breast cancer during pregnancy.

“I decided to choose Trinity Health because of how they respected my desire to continue with the pregnancy. They were all in. They never questioned me,” said Kellie.

“Dr. Egloff is very thorough and empathetic,” Kellie said. “I know how much she thinks about me and worked with everyone involved to get test results back as quickly as possible. I know she is invested in my case.”

“Pregnancy-associated breast cancer is uncommon,” said Dr. Egloff. “Most of those cases are early stage. This case of a stage 4 diagnosis while pregnant (HER-2 positive) is exceptionally rare.”

Kellie’s care required close collaboration across multiple specialties, including Medical Oncology, Radiology, Maternal-Fetal Medicine, Pharmacy, Lab Services, Nurse Navigation, and Palliative Care. Each decision was made with both Kellie’s health and her baby’s safety in mind.

Clinical Pharmacist Laura Green, PharmD, Hematology/Oncology, modified Kellie’s treatment plan with detailed attention to chemotherapy agents shown to be safe for pregnant patients and their babies.

Chemotherapy before childbirth

The next step was to decide when to begin chemotherapy. Kellie was eight weeks pregnant. The team consulted Maternal Fetal Specialist Thomas Balaskas, MD, and together they determined Kellie would begin chemo at 14 weeks, during her second trimester. 

“During our consultation, I explained to Ms. Dubravec that ‘Our primary goal is to get you and your baby through the pregnancy safely and that we have a high probability of achieving that goal,’” said Dr. Balaskas.

It was then that Kellie experienced a “big burst of hope.”

“I realized it would be okay, because when I asked Dr. Balaskas how many women he had treated who had cancer, he said, ‘Too many to tell’.”

Kellie was preparing her children to see her sick from the chemo, but amazingly, she had very few symptoms other than fatigue.

She is overwhelmingly grateful for the convenient, comprehensive cancer care she received at Lacks Cancer Center — and that the care was all in one place. Kellie’s Nurse Navigatorand Palliative Care specialists were also involved to help support with complex care coordination and symptom management.

“Once we got started, the nurses and the staff at the infusion center made it easy to be there. They cared about me. They helped me come to the acceptance phase of the diagnosis. Everything went smoothly,” Kellie shared.

Welcoming Gianna

Kellie gave birth to her daughter Gianna (named after Saint Gianna), on Oct. 15, 2025. The Dubravecs were inspired by Saint Gianna during their cancer journey. 

 

“The birth center team was amazing and respectful of all we went through,” Kellie said. “Gianna is thriving and healthy.”

“Kellie had chemotherapy, delivered a healthy baby girl, and is doing quite well,” said Dr. Egloff. “Several months after treatment, a follow up scan showed a miraculously positive response to treatment.”

Treatment following childbirth

After childbirth, Kellie began HER2-directed therapy — targeted chemotherapy that could not safely be given during pregnancy. It is designed to attack only the cancer cells.

“Kellie will be on long-term treatment (targeted chemotherapy, antibodies, and anti-hormonal treatments) to control the cancer,” said Dr. Egloff. “Historically, treatment has been indefinite, however, there are cases of exceptional responses to HER-2 treatments in stage IV breast cancer.” 

“So far, I’ve had no side effects,” Kellie shared. “I’m doing great. I feel better now than I did before my diagnosis. I’m thankful every day for that.” 

“Kellie knows treatment is not expected to be curative. However, in a small percentage of HER-2 positive patients, there are exceptional responses where patients have no evidence of disease on scans years after starting treatment,” said Dr. Egloff.

And what about treatments on the horizon?

Dr. Egloff shared: “The treatment Kellie is currently receiving is a newer treatment with excellent success rates. There are ongoing clinical trials in breast cancer to identify newer and individualized treatments for patients. In the past few years, we have seen many new drug approvals in breast cancer that have led to improved prognoses and often more tolerable treatments. There is a clinical trial currently ongoing (STOP-HER2) at another institution that is evaluating the safety of stopping treatment in exceptional responders.”

“Now I’m looking at four to five, and maybe even more years,” Kellie said. 

Kellie’s wisdom

Today, Kellie focuses on living in the present and protecting her joy. She prioritizes self-care by employing a dietician, an acupuncturist, and a counselor. She also leans on her family and church community for support. “Don’t be afraid to ask for help,” she said. 

Here are Kellie’s insights for others facing cancer: 

• “It’s okay to feel scared. Ask questions and take time to understand all your options. And try to slow down. You are alive right now. Be calm.”
• “It’s possible to fight for your life and protect your unborn child. Women have done it before.”
• “Having so many children, I’m used to repeatedly placing my trust in God. When this disease appeared, God had been preparing me to continue to trust Him.”
• “I feel I’m going through cancer in order to share my story and help others. And by doing so, it helps me too.”
• “I’m hoping for a miracle, but I don’t expect it.”
• “I’ve found peace by being grateful. I’m thankful for this day.”
• “People with stage 4 cancer don’t wake up like everyone else. It was awful to wake up every day wondering: How many more days will I have? or How old will this child be when I die? These were intrusive, negative thoughts. I didn’t want that. I wanted joy.”
• “No one is guaranteed tomorrow. With stage 4, thoughts of death are more concrete. What I came to realize is that God wants us to live in the present moment — not the past or the future. Once I began to focus on my day, it changed everything for me. My joy has returned.” The Trinity Health team is ready to walk with you every step of the way of your breast care or cancer care journey. 

Learn more about comprehensive cancer care in West Michigan and request a second opinion appointment with a Trinity Health oncologist. 

Photos: 

The entire Dubravec family at Gianna’s christening: Kellie and husband Nate, Gabriel (10), Michael (9), John (7), Margaret (5), Philomena (4), Emil (2), Gianna

Kellie with Gianna and daughter Margaret