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Lillie D. Shockney, RN, BS, MAS

Lillie D. Shockney served as administrative director of breast center from 1997 to November 2018 and director of cancer survivorship programs from 2011 to November 2018, at which time she retired from her hospital leadership roles. She continues to serve on the faculty in the Johns Hopkins University School of Medicine and also as the co-developer of Work Stride - Managing Cancer at Work, an employee benefit developed for Hopkins employees that now is being utilized by businesses and corporations nationally. 

Her name is well known in the cancer field, especially in navigation, survivorship, patient-centered care, preservation of quality of life, end-of-life planning and care, improving the cancer patient's experience, breast cancer, and clinical outcomes. She clinically specializes in breast cancer care. Her public speaking, literary work, and notable roles she has held over the last 40+ years are well known to many.

  • University Distinguished Service Professor of Breast Cancer (2016-present)
  • Former Administrative Director, Johns Hopkins Breast Center (1997-2018)
  • Former Director, Johns Hopkins Cancer Survivorship Programs (2011-2018)
  • Professor of Surgery, Johns Hopkins University School of Medicine (2016-present)
  • Co-Developer and medical advisory of Work Stride: Johns Hopkins Managing Cancer at Work Program (2012-present)
  • Co-founder, the Academy of Oncology Nurse & Patient Navigators (AONN+) (2009- present)
  • Co-founder, the Association of Chronic & Complex care Nurse Navigators (ACCCNN) 2021-present
  • Former Program Director of AONN+ (2009-2019)
  • Editor-in-chief of the Journal of Oncology Navigation and Survivorship (2012-2023)
  • Author of 30 books and > 350 articles on various cancer topics and 20 book chapters
  • National and international public speaker (1997- present)

A two-time breast cancer survivor, originally diagnosed in her 30s, Lillie has worked tirelessly to improve the care of breast cancer patients around the world. She has worked at Johns Hopkins since 1983. Lillie takes great pride in the Academy of Oncology Nurse & Patient Navigators (AONN+) which has more than 9,000 members. She has served as a consultant for breast cancer for national ABC News and Good Morning America, and has been also consulted regularly by the Today Show and CNN. Lillie serves on 28 medical advisory boards currently.  

In 2008, The President of The Johns Hopkins University and their Board of Trustees appointed her to a Distinguished Service Faculty Chair. This is the first and only time in the history of the institution that a hospital nurse has been appointed to a distinguished service designation. She continued to climb the academic ladder and in 2016 was promoted to full professor and is the only nurse at Johns Hopkins to have a primary faculty appointment in the School of Medicine and the only nurse in the country to have reached the highest academic faculty ranking and be appointed to a faculty chair as a University Distinguished Service Professor of Breast Cancer at Johns Hopkins University School of Medicine

In 2009 she co-founded the Academy of Oncology Nurse & Patient Navigators, a national professional organization for those working in the navigation space with oncology patients.

In 2012, she and a colleague created an employee benefit called Work Stride- Managing Cancer at Work. Though originally developed for Johns Hopkins employees, its success resulted in it being offered nationally to other businesses and corporations across the country. She continues her work as a medical advisor within Johns Hopkins Healthcare Solutions to enhance the program and continue to support its growth.

In 2021/2022, she co-founded the Association of Chronic & Complex Care Nurse Navigators, a national professional organization for those working in the navigation space with chronic illness and complex care patients. 

She has authored 30 books and more than 350 articles on breast cancer, oncology navigation, survivorship, patient advocacy, communicating bad news, end of life, and most recently, chronic illness and complex care. 

She has received 62 awards—55 national, 6 state, and 1 international award including being inducted into the Maryland Women Hall of Fame, Women in Business Healthcare Trailblazer Award, Johnson & Johnson's Most Amazing Nurse in America award, National Komen for the Cure's Professor of Survivorship award, and several national life time achievement awards. Her research area of focus is preservation of quality of life for patients with metastatic breast cancer. 

A documentary was made about three key components of her life's work over a 5 year period and completed in 2022. It launched to audiences nationally and internationally in 2023 and is calle

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Closeup Female Body, Woman Having Pain In Chest

Sore Breasts

My menstrual cycles are regular, but my breasts get really sore for about 10 days before. Lately I've noticed that when my breasts are sore, the lymph node under one of my arms swells up. Is this any cause for concern? I'm 22 years old.

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Q: My menstrual cycles are regular, but my breasts get really sore for about 10 days before. Lately I've noticed that when my breasts are sore, the lymph node under one of my arms swells up. Is this any cause for concern? I'm 22 years old.


Breast pain is one of the most common breast-related symptoms women experience. It's called mastalgia in medicalese, and was first described in the medical literature as early as 1829.

Lymph nodes can swell in response to changes in the breast. Women associate lymph node swelling with cancer, however, the lymphatic system gets "turned on" whenever there is a hormonal change. Lymph nodes are also designed primarily to fight off infection. It sounds like what you're experiencing is cyclic mastalgia, or breast pain related to your menstrual cycle. One large US study found that 69 percent of women attending an ob-gyn clinic experienced regular premenstrual breast pain. It's not considered cyclical mastalgia, however, unless the pain occurs for at least seven days a month, as you say yours does, and is quite severe, as it sound like yours is.

I can understand your distress, since many studies find that the pain from cyclic mastalgia can interfere with sleep, work, school, social functioning, physical activity, even sexual activity. That's a lot to have to deal with for 10 days a month!

Despite numerous studies, no one really knows for sure what causes cyclical mastalgia, although there are several suspects. Have you ever been evaluated for fibrocystic breasts? Pain and tenderness are common symptoms of this condition, although the most common are breast lumps (don't worry, it's not related to cancer). There's some evidence that fibrocystic breasts might be related to cyclic mastalgia.

It makes sense to think that hormones are behind the regular pain, particularly since your pain is linked to your menstrual cycle, but no one has yet been able to demonstrate that connection conclusively. Some studies find hormone deficiencies or excesses may play a role, including high levels of prolactin, a hormone associated with breast feeding. Another possible cause: diet. Try cutting back on dietary fat and caffeine and see if that helps.

One thing you probably don't have to worry about is breast cancer. The link between cyclical mastalgia and breast cancer is very tenuous. And given your age, it's highly unlikely this will be a concern.

However, one thing concerns me about your problem. Studies find that cyclic mastalgia typically occurs in women in their 30s or 40s; you're still in your 20s. I'm also concerned about the pain you say you feel in the lymph node under your arm.

So I think it's important that you see your health care provider for a complete physical examination. At that time, you can also talk about what you can do to relieve the pain. Possible options include:

  • A more supportive bra (an estimated 70 percent of women wear bras that don't fit right). Try wearing it at night, as well.
  • Relaxation techniques. One study of women with breast pain who listed to a tape of progressive muscle relaxation for four weeks found 61 percent experienced a substantial or complete relief of the pain, compared to 25 percent of a control group who didn't listen to the tape.
  • Evening primrose oil. A few small studies find some benefit from taking recommended doses of this supplement. Evening primrose oil is an excellent source of anti-inflammatory omega-3 fatty acids, which may be the reason for its benefits.
  • Pain relievers. Aspirin, ibuprofen, and even topical analgesics that you rub on the breast may help with the pain.
  • Medications. If none of these non-prescription remedies help, talk to your healthcare provider about prescription drugs. Most are hormonal remedies, such as oral contraceptives. Only one drug has been approved specifically for the treatment of mastalgia. Called danazol (Danocrine), it's a form of the male hormone testosterone. Overall, 59 to 92 percent of women treated with this drug find relief from their pain, but they also experience significant side effects, so I only recommend this as a last resort.

Finally, I urge you not to worry. I'm sure between you and your health care professional, you will find out the cause of your breast and lymph node pain, and come up with a treatment that works for you.

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