Saenz was on vacation to celebrate her 38th birthday in September 2019 when she got the call: The almond-sized lump in her left breast was cancer. She had an instant of “oh, crap” shock and a few tears before her Air Force training kicked in.

“Then it was like, all right, suck it up,” she says. “We’ve got to fight this thing. The military gives you the mindset to focus on what’s in front of you, get your feelings out of it, get the information you can, and push forward. That’s what I did.”

Saenz grew up in a military family and served 15 years on active duty with the Air Force. She learned Korean to intercept and translate top-secret communications, then served two years in South Korea. She later retrained to be a respiratory therapist at a military medical center in Nevada.

She intended to stay in the military until she retired, but a sexual assault while on active duty brought her service to an abrupt end.

What stayed was the trauma.

Saenz returned to San Antonio, where she grew up, and was working through her post-traumatic stress when cancer changed her priorities.

Her doctor felt the tumor in a routine wellness check. Saenz didn’t worry at first, because she had a similar lump in her right breast about a year earlier. That one turned out to be a harmless pouch of fluid.

A mammogram, then an ultrasound and finally a biopsy confirmed this one was cancer. At first, her Texas doctors thought a lumpectomy would be enough to remove the tumor. Then the tumor tripled in size and grew a satellite nodule in just six weeks. Saenz needed chemotherapy to shrink the tumor and then a mastectomy to remove all the tissue in her left breast.

She buzzed her long, wavy brown hair military-short and wore an “F— Cancer” T-shirt to her chemotherapy treatments.

Halfway through her six chemo cycles, in March 2020, COVID-19 was declared a pandemic.

Many surgical procedures were banned in Texas to free up hospital resources, making it even harder for Saenz to find the type of surgery and team she needed.

She was looking for two women surgeons who could do her mastectomy and start her reconstruction at the same time.

“I always ask for female providers, especially when it came to breast cancer and being exposed all the time,” she says. “It’s a sensitive area and a sensitive topic for me.”

She wanted to find a team with expertise in the latest surgical techniques. She hoped to keep her nipple and an envelope of skin for a more natural look after reconstruction. And she needed to find a hospital that took her VA medical insurance.

The first place that checked all her boxes was OHSU. Three of four plastic surgeons, two primary cancer surgeons, and most of the nurses and other specialists on OHSU’s breast cancer team are women. Dr. Naik is an expert in skin- and nipple-sparing surgery, and Dr. Hansen is highly skilled in creating a natural appearance.

Oregon’s relatively low rates of COVID-19 at the time and OHSU’s safety precautions also put her at ease.

“We coordinate your surgical care and work closely as a team,” Dr. Hansen says. “We wouldn’t dream of doing it any other way.”

The team understood and respected her request for all-women providers and was careful to ensure that men didn’t come into her room unexpectedly. That can be tricky at an academic health center, where trainees play integral roles.

“It’s awkward for me to have to tell a student who’s trying to be a doctor why I’m so uncomfortable every time,” she says. “But they tried to make sure that didn’t happen. I didn’t have that in other places.”