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"Walking together in kindness" artwork produced for Gold Coast Health by Riki Salam, We are 27 Creative.
When 30-year-old Paola Kohl discovered a lump in her breast during a self-examination, she thought it was probably nothing.
As a healthy and active young woman, breast cancer was the furthest thing from her mind. However, while on holiday in Bali, a massage therapist encouraged her to have it checked.
“I realised I needed to make it a priority,” Paola said.
After returning home in January, she underwent an ultrasound. Although she was experiencing increasing pain that affected her sleep, surfing and gym routine, she was reassured by her General Practitionerthat it was likely nothing serious and advised repeating the scan in six months.
But the symptoms continued to worsen.
“In May, I noticed redness, dimpling and that my breasts were becoming asymmetrical,” she said.
“The small lump I felt initially wasn’t a small lump anymore. It had changed very quickly, and I felt like I needed to do something immediately.”
Paola presented to Robina Hospital's emergency department, where urgent tests and specialist appointments were arranged. Following a biopsy and further investigations, she was diagnosed with HER2-positive stage 3 breast cancer, which had spread to lymph nodes near her collarbone.
“It was incredibly overwhelming,” she said.
“But from the moment I arrived at the hospital, I felt like they took my case very seriously. I felt looked after and like I was in good hands.”
Paola began chemotherapy and targeted therapy at Gold Coast University Hospital in July. Her treatment protocol, known as TCHP, combines chemotherapy with HER2-targeted medicines and is administered every three weeks.
While treatment days are challenging, recovery can be equally difficult.
“About three days after treatment, the side effects really hit,” she said.
“The medication affects your body and your mind. I feel physically and mentally exhausted. After about 10 days, I slowly begin to feel better, but it's more like adapting to a new normal. I never really return to how I felt before treatment.”
Paola is preparing for a bilateral mastectomy later this year, followed by radiation therapy and ongoing targeted treatment.
“There’s definitely anxiety around the surgery,” she said.
“But I’m also excited because finishing chemotherapy is a major milestone and ringing the bell will be very special.”
Genetic testing later revealed Paola carries a BRCA1 gene mutation, which increases the risk of developing breast cancer despite no obvious family history.
Now, she is using her experience to encourage other women to be aware of changes in their bodies and seek medical advice if something doesn’t feel right.
“I want people to understand that young doesn’t mean immune,” she said.
“I thought I was too young to have breast cancer, but I’ve learned how important it is to know your body, do self-checks and follow up if something doesn’t feel right. Constant pain isn’t normal.”
While routine breast screening is not available for women under 40, women who notice changes can visit their GP for assessment and referral for diagnostic imaging such as a mammogram or ultrasound.
Paola’s diagnosis inspired her to launch Know Your Normal, a breast awareness campaign encouraging people to recognise breast changes and seek medical advice early.
“I wanted to turn my experience into something useful,” she said.
“I hope it helps start more conversations about knowing your normal and speaking up when something changes.”
October is Breast Cancer Awareness Month. For more information, visit BreastScreen Queensland.
You can follow Paola’s journey at @paola.kohl on Instagram.
