I Got Breast Cancer Twice Before I Turned 40 — The Signs Many Women Miss
I didn't have any common risk factors or a family history.
Photo Courtesy of Author, pixelshot, Candice Estep | Canva, I was a busy mom of four kids and working from home part-time. Breast cancer was never on my radar. I didn’t have any of the common risk factors, including a family history of the disease. However, before I turned forty, I battled the disease — twice.
I was thirty-five the first time I found a mass in my breast during a self-exam. My doctor ordered my first mammogram and an ultrasound. Neither showed anything of concern.
However, I felt a growing sense of dread and decided to get a second opinion. The breast surgeon I saw agreed to do a biopsy. Three weeks later, I was diagnosed with stage 0 breast cancer. After my mastectomy, pathology unveiled that I actually had stage 1 breast cancer.
I was considered cancer-free for three-and-a-half years before another mass appeared, this time in my chest wall. Even though I was considered NED (no evidence of disease) after the tumor was removed, my medical team and I decided we should proceed with chemotherapy, radiation, and a year of HER2-targeted therapy infusions.
The reality is that one in eight women will be diagnosed with breast cancer in their lifetime. Nine percent of those diagnosed are young women under age 45. Unless breast cancer runs strong in your family, you are probably like I was: living life without considering that breast cancer is lurking in the shadows.
Besides a breast mass, I didn’t have any signs of breast cancer. The scary reality is that breast cancer often doesn’t show up by announcing its arrival with red-flag symptoms. If you’re someone who is under the age of 45, here’s what you need to know about breast cancer signs.
Here are 5 things to know about breast cancer — and the breast cancer signs not to miss:
1. Breast cancer rarely has symptoms, especially in earlier stages
Breast cancer is a tricky beast. Early-or-mid-stage breast cancer isn’t going to show up in routine blood work. Unless you are paying close attention to your breast health or your cancer is caught on a routine mammogram (which many younger women do not get) or clinical breast exam, it may not be caught.
The CDC wants us to watch for a "new lump in the breast or underarm," "thickening or swelling" anywhere in the breast area, "irritation or dimpling of the breast skin," and "redness or flaky skin" anywhere on the breast — including the nipple. Nipple inversion, nipple pain, discharge, size or shape breast changes, breast pain, or redness and warmth are all other possible symptoms. These require medical attention.
2. Breast cancer can be found in myriad ways
Just this past year, The U.S. Preventative Services Task Force, which is made up of medical experts, suggested that women who are 40 to 49, need to speak with their healthcare provider to get a personalized mammogram recommendation. The recommendation for women 50 to 74 years old who are "at average risk for breast cancer" is to "get a mammogram every two years."
Unfortunately, the current recommendations seem to ignore the fact that a percentage of women under age 40 are getting breast cancer, keeping in mind that most women who develop breast cancer do not have genetic mutation predisposing them to higher breast cancer risk.
Besides mammograms, self-breast exams, clinical breast exams, and ultrasounds can help detect breast cancer.
3. Find out your family history
When possible, find out your biological family’s medical history. If your family’s breast cancer history is close enough to you (sister, mother, aunt, grandmother), you can consider asking for genetic testing and earlier (than average) mammograms. Though 5 to 10 percent of breast cancer cases are caused by genetic mutations, the risk for those individuals is high.
For example, those who have either — or both — the BRCA1 and BRCA1 genetic mutations "can have up to a 72 percent risk of being diagnosed with breast cancer during their lifetimes." Knowing your risk can help you make decisions about your health. Some women choose to be more closely monitored by a breast specialist. Others might choose to have preventative mastectomies — and other surgeries.
4. Do monthly self-breast exams
I found my breast cancer both times by doing monthly self-breast exams. A comprehensive self-exam involves both looking and feeling. You’re checking for any of the issues listed above, including nipple inversion, redness and warmth, and a new lump. You should be feeling and looking from your collarbone to your armpits, to under your breasts, to everything in between.
If you feel or see anything of concern, immediately schedule an appointment with your doctor. Don’t wait and see, and don’t search the internet and try to self-diagnose and reassure. Time can certainly be of the essence when it comes to breast cancer.
5. Know your breast density
Forty percent of women have dense breast tissue, making imaging harder for radiologists to read. I was told that because my breast tissue was so dense, looking for any abnormalities on my 2D (standard) mammogram was "like looking for a snowflake in a snowstorm." This may explain why my cancer wasn’t caught on mammography. This doesn’t mean that if you have dense breast tissue, you should skip your mammogram. Instead, consider your options.
Talk to your healthcare provider about a 3D mammogram, breast ultrasounds, and MRIs. These can give the radiologist a clearer, more accurate picture of your breasts. Suspicious areas may lead your physician to recommend a biopsy.
Certainly, anything dealing with your health, and especially hearing the word "cancer," can terrify any woman. However, the more you proactively arm yourself with information and steps, the better off you will be. I wasn’t powerless in my health journey, and neither are you.
Rachel Garlinghouse is a writer residing in the St. Louis area. She is a two-time breast cancer survivor and type 1 diabetic who has committed much of her time to helping women advocate for their physical and mental health needs. She has nearly one thousand articles to her name and has appeared on CNN, MSNBC, NPR, CBS, and GMA.