Choosing Motherhood Amidst Stage 4 Breast Cancer

For many, a diagnosis of stage 4 metastatic breast cancer can feel like a closing chapter. But for Casey Liening, diagnosed at age 32 after a grueling two-year battle to have her symptoms taken seriously by medical professionals, the diagnosis was the beginning of a relentless mission. Now thriving with no evidence of active disease (NED), she is redefining what it means to live with MBC, proving that while the disease is incurable, it is not an end to one’s dreams.

In a candid interview with CURE conducted during the 49^th annual Miami Breast Cancer Conference, Liening explored the complexities of advocacy, the stigma of stage 4 and the deeply personal hurdles she faced while building a family.

The Power — and Price — of Advocacy

Liening’s decision to share her journey publicly was driven by a desire to ensure no other woman would face the diagnostic delays she did. By being vocal, she said aims to empower others to "be their own advocate" and "know their normal." However, she acknowledged that public disclosure is a double-edged sword. While it serves to inspire, Casey notes that for many, the stigma surrounding a diagnosis makes privacy a necessity.

"I want people to see someone living a normal life with a diagnosis such as mine," she explained. Yet, she admitted that her transparency led to one of the most difficult chapters of her life: the struggle to become a mother.

A Dream Deferred, Then Won

The reality of MBC often complicates family planning. Because Liening cannot carry a child, she and her husband turned to adoption. After a year of bonding with a specific child and receiving the full support of her medical team, the couple was met with a devastating blow: They were denied the adoption because of Casey’s diagnosis.

"Initially, being denied because of my diagnosis was almost harder than getting the diagnosis itself," she reflected. "It was like saying one of your lifelong dreams of being a mother is not going to be as easy now."

The denial was a direct result of her public advocacy and her refusal to hide her health status. It forced her to question whether her transparency was a mistake. However, Liening’s characteristic resilience took over. The couple took their case to a judge, who eventually overturned the agency's decision. Today, she is a mother, a victory she credits to the same tenacity that helped her navigate her cancer treatment.

Redefining the Narrative

Casey’s story is a testament to the fact that science and hope are shifting the MBC landscape. By balancing a full-time career and motherhood while managing a chronic terminal illness, she serves as a living rebuttal to the "death sentence" narrative.

Her message to the CURE community is clear: life with MBC is not just about survival; it’s about the right to pursue the same milestones as anyone else. Whether it’s career goals or parenthood, Casey proves that a diagnosis does not define a person’s capacity to love, work, or lead a fulfilling life.

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