Unexpected Diagnosis at 28: Aggressive Breast Cancer

At 28, life was good for Stephanie Rico Masterson. It was 2021, and the Miami native was enjoying her career as a pediatric nurse. She and her husband, Tom, were happily married, and the couple loved spending time together boating, cooking and playing with their dog. They couldn’t wait to have children.

Life had other plans, however.

(Watch now: At 28, life was good for Stephanie Rico Masterson. But then she was diagnosed with breast cancer – very unusual for a woman her age with no family history, says Starr Mautner, M.D. at Miami Cancer Institute. Video by Alex Calienes, Gort Productions.)

“I’ve always been pretty healthy,” Ms. Masterson said. “I love going for walks and I’ve always eaten healthy.” But when she experienced a pain under her armpit that wouldn’t go away after several weeks of Tylenol and Motrin, she called her doctor. Tests showed she had breast cancer.

Breast cancer up in younger women

The odds of a woman in her 20s being diagnosed with breast cancer — particularly when there is no history of cancer in the family as in the case of Ms. Masterson — are highly unusual, said breast surgical oncologist Starr Mautner, M.D., with Baptist Health Miami Cancer Institute. “When you’re looking at someone who is almost age 30, her risk of breast cancer should have been about one in 204, tor .5 percent,” she said.

Starr Mautner, M.D., surgical oncologist with Baptist Health Miami Cancer Institute

Unfortunately, said Dr. Mautner, there has been an upward trend in breast cancer incidence. Every year since 2012, there’s been about a 1 percent rise, and in women younger than 50, the number is 1.4 percent. Additionally, a study by the American Cancer Society showed that Asian American/Pacific Islander women under age 50 have experienced an increase in breast cancer of 50 percent since 2000.

While Ms. Masterson is unique because of her age at diagnosis, she is also rare because her cancer, known as invasive ductal carcinoma, was very aggressive and had already spread to her liver. Invasive ductal carcinoma begins in the milk ducts and can move into nearby tissues and beyond.

“Stephanie presented with de novo Stage 4 metastatic disease, which is relatively rare,” Dr. Mautner said. “Only about 8 to 10 percent of all breast cancers present this way. Her cancer was very aggressive and needed to be treated aggressively.”

Before Ms. Masterson began treatment, there was an important discussion that had to take place. “Everyone who knew me knew it was my dream to become a mother,” she said. “It was very traumatizing to have that taken away from me initially. As soon as I was diagnosed, we had no idea what the future might hold.” The couple opted to freeze her eggs so that she might be able to have children in the future.

Aggressive treatment

On Dec. 20, 2021, Ms. Masterson started chemotherapy, which was followed by a liver ablation, a minimally invasive technique that used heat to destroy the tumor in her liver. She received a combination of aggressive chemotherapy and immunotherapy and her scans showed an excellent response to treatment. Therefore, she was deemed a candidate to undergo surgery to remove the primary tumor in her breast. Although genetic testing revealed no known mutations that would put Ms. Masterson at increased risk for breast cancer in the unaffected breast, she opted for a bilateral (double) mastectomy.

“It’s a highly personalized decision,” said Dr. Mautner, who performed the surgery. “We couldn’t tell why she developed breast cancer at such a young age. Without removing the other breast, she was looking forward to a lifetime of screening of that breast with mammograms and MRIs. I’m sure she was concerned about developing another cancer in the future.”

After Ms. Masterson recovered from surgery, she underwent proton therapy treatment, a highly specialized radiation therapy that targets any remaining cancer cells while sparing nearby healthy tissues and organs. She remains on maintenance therapy, which includes an immunotherapy drug that helps the body’s immune system recognize and destroy cancer cells, and she’s also on endocrine therapy and ovarian suppression.

Throughout her journey, Ms. Masterson also took advantage of special services offered at the Institute, including physical therapy, massage therapy, acupuncture and online exercise classes.

Support all around

“I am cancer-free and I’m very grateful for all the physicians on my side,” Ms. Masterson said. “I feel amazing. And my family was my support system. My sister would bring my nieces over, and coming home to my husband every single day was the greatest gift I could ever ask for. It was really nice to have my parents and my grandparents, who are my heroes, just be there for me every step of the way.”

Also by her side, she said, were the Institute’s employees, who were compassionate and friendly. “I can’t say enough about them. Dr. Mautner is an amazing physician. She loves her patients. And Dr. Panoff is so down to earth and chill. Cancer doesn’t have a manual. I think it’s important for people who are going through cancer to listen to their doctors and trust the process. They’re in good hands at Miami Cancer Institute.”

“The best part of my job,” Dr. Mautner said, “is seeing my patients six months, one year, two years later and being able to tell them they’re doing great and that they’re cancer-free. It’s amazing to be able to celebrate with Stephanie. I see her living life to the fullest.”

A happy ending

Ms. Masterson’s experience has been so positive that she has joined the Institute at breast cancer awareness and fundraising events. But the best news is that earlier this year, she and her husband became parents to a baby girl, carried by a surrogate.

“It just brings me so much joy and happiness that I am a mother and that I’m able to enjoy and watch my daughter grow up,” she said.

“Stephanie makes me feel like the luckiest man in the world,” said Tom Masterson. “Having our child and at this point Steffi being cancer-free is absolutely a miracle,” said Dr. Masterson. “We’re incredibly fortunate, incredibly hopeful. We love being parents.

The Mastersons’ daughter is perfect, agreed Dr. Mautner. “I met her when she was only a few weeks old. She’s beautiful and Stephanie is an amazing mom.”

For younger women at average risk of breast cancer, Dr. Mautner and Ms. Masterson would like to remind them to stay healthy, perform monthly breast self-exams and see a physician at any sign of a problem.