When Samantha Ciaccia, now 38, was traveling around the world in May 2022, she noticed bloody discharge from her nipples. The fitness entrepreneur and former emergency medicine physician assistant knew this was a serious symptom not to be ignored. But the doctors she saw in Croatia initially dismissed her concerns. As things got worse she sought a second opinion in Croatia and got a breast cancer diagnosis—via an email subject line—in October 2022. Her experience led her to start a business focused on helping others get back into fitness after breast cancer treatment. Here’s her story, as told to health journalist Caitlin Carlson.
About 10 years into practicing medicine in New York City, I started getting burnt out. I had been training clients on the side as a certified strength and conditioning specialist (CSCS), and I decided to take the risk and go all in. I also established a course for consumers as well as other movement professionals focused on preventing injuries I would see in the ER. I flew to Europe in 2022, intending to travel the world while working on my business remotely.
Things were going really well, but a few months later, in May 2022, I noticed my left nipple was bleeding. Based on my medical experience, I was worried about cancer, and it was nerve-racking, so I decided to go to the doctor in Croatia and get it checked out. They did a cytology smear, which screens for cancer by looking at bodily tissue, cells, or fluid—in my case, the nipple discharge—under a microscope. They weren’t concerned, though. I was 34 at the time and didn’t have a worrisome medical history, so they thought the likelihood of it being cancer was very, very low.
So I continued on with my travels. But the discharge never stopped. A client suggested I see her doctor, also located in Croatia, for a second opinion. This time, they did an ultrasound followed by a galactogram (a special type of X-ray), and what they saw looked very concerning. I had my first biopsy, but it took a month for my results to come back. At this point I was vacationing on a Nile River cruise in Egypt when I got an email with the subject line “DCIS,” which stands for ductal carcinoma in situ. I didn’t even have to open the email—as soon as I saw the subject line, I was like, Oh my gosh. But I was literally in the middle of the river. There was nothing I could do at that moment, so I just went about my vacation. I had some work to do in Jordan for my business, so I was like, Let me just get this work done. I was supposed to go to Dubai for another business trip, but instead I rerouted and returned to New York because at this point the Croatian doctors wanted to do a double mastectomy without any further testing.
