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31 July 2013

With Breast Cancer Discovered at Age 26, a Young Woman Confronts Her Mortality

Kathryn Petrides
A new study published in the Journal of the American Medical Association (JAMA, Feb. 27, 2013) suggests that advanced breast cancer is showing up more frequently in younger women between the ages of 25 and 39. Over 30 years ago, roughly 1.5 young women in 100,000 were diagnosed with metastatic breast cancer. Three decades later, that rate had almost doubled to 2.9 women per 100,000.
With Breast Cancer Discovered at Age 26, a Young Woman Confronts Her Mortality
by Kathryn Petrides, The Washington Post, 13 May 2013

It was on the weekend of my 25th birthday that my boyfriend alerted me to a lump in my left breast. At first dismissive of his concern, I eventually promised to see my gynecologist. I was due for my annual exam anyway.

About three weeks later, I walked away from the doctor visit confident and reassured. My gynecologist conducted a breast exam, made note of the lump’s size and sent me on my way. She didn’t order a mammogram or an ultrasound or suggest a follow-up appointment.

“She said considering my age and family history, it’s probably just a cyst or a fibro-something and to keep an eye on it,” I reported back to my boyfriend.
So, I continued with my normal life in Washington, where I’ve lived since 2005.

Fast-forward to July 2012, more than six months after the discovery of the lump. I had been accepted into a program to teach English in Leon, Spain. I gave notice to my employer here, completed the paperwork for my visa and booked my plane ticket. Dreaming about tapas and siestas, I’d forgotten about the mass in my breast. My boyfriend hadn’t, and he urged me to follow up on it.

Deep down, something told me he was right. You can probably guess what happened next.

I have cancer, an aggressive kind that has already spread to my lymph nodes. In official “cancer talk,” I have grade three invasive ductal carcinoma that is estrogen-, progesterone- and HER2Neu-positive. I chose to participate in a clinical trial that entailed neoadjuvant chemotherapy — a fancy way of saying chemotherapy before surgery — so I will never have an official staging because they cannot know with certainty how many of my lymph nodes contained cancer cells.

Since my diagnosis, I have received 16 chemotherapy treatments and undergone a nipple-sparing double mastectomy. Currently, I am wrapping up 28 radiation treatments. In addition, I continue to receive Herceptin via IV every three weeks, as well as hormone therapy that consists of ovarian suppression drugs and tamoxifen.

Given the aggressiveness of my disease and its treatment, people often become upset when they learn how long it took my cancer to be diagnosed. Many express anger at the practice where I had my breast exams. A few people have even suggested that I look into legal action.

I choose not to walk down that path, though. Sure, sometimes I allow the thought to creep into my head. What if it had been caught earlier? Would it still be in my lymph nodes? Would my prognosis be better? As soon as they pop up, I try to kick these thoughts to the curb. I will never know the answers, and blaming someone won’t change my current reality. I choose to focus my energy on a path toward healing, not fault.

Besides, part of me understands. Given my lack of a strong family history of breast cancer and my age, I am an outlier, to say the least, from the normal breast cancer patient.

In a lifetime, the overall risk of a woman’s developing breast cancer is one in eight. But try looking up statistics for having breast cancer at age 24, when my lump was already there, and you won’t find any. Even the risk calculators you get at the doctor’s office begin at age 30.


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