MARYSVILLE — In the month of October, thousands of Americans choose to support Breast Cancer Awareness Month in different ways. In Snohomish County, that includes the thousands who have been diagnosed with the life-threatening illness. According to the American Cancer Society, an estimated 230,480 new cases of invasive breast cancer were diagnosed among women in the United States in 2011.

One of the women diagnosed was Wanzellia Clark, a sixth-grade science teacher at Marysville Middle School.

“I went to the doctor in 2011 because I had a pain in my elbow,” said Clark. “It was strange because my mother had colon cancer and one of her symptoms was transferred pain. Her arm was always hurting.”

The pain in Clark’s elbow turned out to be the least of her worries after her doctor issued a mammogram, which came back with unusual results.

“They compared the mammogram from 2009 to the one from 2011. I had missed my annual exam in 2010,” said Clark. “I could see it. I said, ‘Well, what’s that right there?’ It just wasn’t right.”

After a needle biopsy confirmed what Clark and her physician already feared, Clark was in shock.

“The biopsy came back showing it was cancer. I could already see it very clearly on the mammogram, but you are just hoping that’s not what it is,” she said.

Clark was diagnosed with stage II triple negative breast cancer, an aggressive subtype of the illness. According to the Triple Negative Breast Cancer Foundation, subtypes of breast cancer are generally diagnosed based upon the presence or lack of three receptors known to fuel most breast cancers: estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2). The most successful treatments for breast cancer target these receptors. None of these receptors are found in women, such as Clark, with triple negative breast cancer. A triple negative breast cancer diagnosis means the tumor is estrogen receptor-negative, progesterone receptor-negative and HER2-negative.

The disease produced a lump the size of a jelly bean in Clark’s breast and had already spread to her lymph nodes and grown to half its original size there when it was discovered.

“If I had waited one more year before getting a mammogram, it would have been very likely terminal,” said Clark.

Once she was diagnosed, Clark’s life changed drastically. She underwent a lumpectomy, chemotherapy and radiation.

“All of my hair fell out right before Christmas and that was really upsetting,” she said. “I had hair down past the middle of my back, almost to my rear end. I had it cut first and sent to Locks of Love. I knew it was going to fall out anyway and I figure someone should be able to use it.”

The timing of the diagnosis was particularly stressful for Clark, who had just adopted her 3-year-old daughter Jayden in June of 2011 — her cancer would be discovered only two months later.

Each member of Clark’s family supported her in their own way. Her 17-year-old son Alexander, a student at Marysville-Pilchuck currently enrolled in the Running Start program, gave her a sticker that said, “Cancer Sucks” and her 28-year-old daughter Annamaria helped to care for Jayden. Her father was the one who shaved her head before Christmas.

“My dad, daughter and son were so supportive,” said Clark. “I was so sick I couldn’t get off the couch some days. I lost close to 30 pounds, no food was staying down. You feel really depleted, because you can’t take any healthy vitamins because the whole process is trying to destroy the cancer.”

Clark’s family wasn’t the only source of comfort during her treatment. The staff at Marysville Middle School threw a hat and scarf party for her and arranged meals to be brought to her house each day of the week, and her students made a point to help her through it.

“My students were so wonderful,” she said. “I had posters all over my room. They would write me notes and letters. It made a big difference.”

It was clear that her family and co-workers were doing their best to help her through the struggle, but she also sought the encouragement of those who had already survived the disease. “Shirley was very supportive. It was helpful to talk to someone who has already been through it,” she said.

Shirley Dickerman, a school counselor at Marysville Middle School, is a breast cancer survivor. She was diagnosed with breast cancer on May 5, 2002.

“It’s still hard to talk about it, even though it’s been 10 years,” she said. She was living in Nevada at the time, and her family lived in the Seattle area. “Nothing even showed up in the mammogram. They sent a sample to Salt Lake City and then they called me on the phone. The doctor wasn’t telling me it was cancer, he just wanted me to come into the office,” said Dickerman. “I went after work and then he told me. I was in shock.”

The next several months were wrought with pain — both physical and emotional.

“They ran all these tests that no one should have to go through,” she said. “The doctor told me they would begin with a partial lumpectomy, to do the least amount that they can.”

But the lumpectomy did not successfully remove all of the cancer.

“I went back a few days later and he said, ‘I’m sorry but we didn’t get clean margins. We have to do a mastectomy.’”

Dickerman moved from Nevada to Washington to be closer to her family following her surgery. “It happened so fast and it was so much at once. A new job, a new place to live and cancer.”

The emotional toll was significant. “The following fall after my surgery, I could tell I was getting depressed. I cried and cried. I wasn’t dealing with the loss of a body part,” she said. It took some time, but she managed to pull herself up out of that emotional state. “I was finally accepting that I couldn’t deal with it on my own.”

This year, Dickerman, has undergone two reconstructive surgeries at the University of Washington medical center to rebuild the breast that she lost.

“You don’t have to have silicone implants. You can do an implant of fat from the abdomen that will reshape the breast mound,” she said. “They include the veins to give the breast a blood supply so that it is more natural. It’s a very extensive surgery.”

For her and many other breast cancer survivors, not being able to feel feminine was one of the worst long-term impacts of the surgery.

“I’m very happy with doing this. It really did change me, it freed me up to be a whole woman. I mean, I didn’t go all Dolly Parton,” she laughed. “But it freed me up to wear clothes that I couldn’t wear before. My doctor gave me my body back.”

For both Clark and Dickerman, the support that they received from other breast cancer survivors is important for them to pass on to others who are going through the same terrible process.

“It is scary if you don’t know anyone who has gone through it,” said Dickerman. “I thought I was a strong person. I am a strong person. But it’s okay to be sad. It’s okay to cry. It’s okay to grieve. If you need support there is plenty of support out there and plenty of people who will help.”

Clark agreed and urges women of all ages to make sure that they take care of their bodies.

“Remember to get your mammogram,” she said. “That’s a big one. If I had skipped another year, I would have been terminal.”

Marysville services providing free or low-cost breast health screenings and mammograms include Planned Parenthood and Sea Mar Community Health Center.