Young Women and Breast Cancer: ‘You Think You're Healthy, and Then You're Not’

Stephanie Rico Masterson, a breast cancer survivor, lives a full life as a pediatric nurse and young mother. Not that long ago, she suddenly became part of a concerning trend without a clear cause – the increasing rates of breast cancer among younger women.

“I was diagnosed at the age of 28 with metastatic breast cancer,” recalls Ms. Masterson. “And it was, actually, a very exciting time in my life because I was newly married. My husband and I were just about to celebrate our one-year anniversary … but also I was feeling pain under my armpit and we realized that it was going longer than expected.

She remembers thinking that as a pediatric nurse she carries many trays. “So, we thought it was maybe that I'm carrying too-heavy trays and stuff like that. There's no way that this can be something because I'm so young,” she said. “And we were like -- let's go get it checked out. And that's when we seek medical advice, and then it went from there.”

She adds: “You think you're healthy, and then the next day you're not.”

Ms. Masterson and Starr Mautner, M.D., breast surgical oncologist at Baptist Health Miami Cancer Institute, are featured in Baptist HealthTalk’s latest podcast: From Diagnosis to Motherhood: A Young Woman's Journey Through Breast Cancer.

Podcast host Johanna Gomez asks Dr. Mautner to explain the alarming rise in breast cancer diagnoses among women younger than 50. For now, there is no clear cause – but a possible combination of factors.

“I noticed this in my own patient population,” explains Dr. Mautner. “I've been working at Baptist Health for the past 10 years and over that 10-year period of time, I am seeing increasing numbers of women under the age of 40 being diagnosed. It used to stand out when you would see a woman in your clinic under 40, and now it's almost on a daily basis. I'm seeing someone 45 or younger being diagnosed with breast cancer, and so it's just becoming much more common.”

The reason behind this trend is unclear and likely “multifactorial,” she said.

“We can't pinpoint one exact reason. It appears to be due to a multitude of factors, such as late childbearing, lack of exercise, increase in alcohol intake. Genetics definitely play a role, but I also see plenty of young healthy women that don't really have strong family histories of breast cancer that are also developing breast cancer in their 20s and 30s.”

The latest study released this month, which is Breast Cancer Awareness Month, comes from the American Cancer Society, which found that breast cancer rates among women younger than 50 years have increased 1.4 percent per year since 2012. Baptist Health South Florida supports annual mammograms for women at average risk starting at age 40. Talk to your doctor about your specific risk and what screening is right for you.

What should young women who feel a bump or pain in their breasts do if they’re not 40 or older to get a mammogram, Ms. Gomez asks Dr. Mautner?

“If you are feeling a change in your breasts, whether it's a consistent pain and you think something's not right or whether it's a lump, the first step is to go to your primary care physician or gynecologist and say: Listen, I think something's not right,” said Dr. Mautner. “And demand imaging. Just because you're under 40, it doesn't mean you cannot have a mammogram. It just means that it's not usually recommended as a routine screening test.”

Fertility must always be part of the conversation when a young woman is newly diagnosed, as was the case with Ms. Masterson. She had extensive treatment, including both chemotherapy and radiation.

“I've actually done it all,” she said “We went through IVF (vitro fertilization) first. Then I went through six rounds of aggressive chemotherapy. I had a liver ablation in between. I went through a double mastectomy with reconstruction, and 28 fractions of radiation.”

Dr. Mautner explains that Ms. Masterson underwent proton therapy radiation, which uses high-energy beams to destroy cancer cells while sparing healthy tissue.

“Specifically, proton therapy is a type of radiation which produces high-energy particles that are used to kill tumor cells,” Dr. Mautner said. “And in traditional radiation we use photons which can scatter, and while it kills the tumor cells, it can also damage healthy tissue. When you think of the breast, it's near the chest. So, you have the heart, you have the lungs, and you have a young woman who you need to radiate. But you really don't want to damage the heart and lungs because that can have effects like heart disease.”

Ms. Masterson is very grateful to everyone who took part in her treatment and overall care at Baptist Health Miami Cancer Institute.  “I am so grateful to say -- thankfully to all the incredible physicians at  Miami Cancer Institute -- that I am a mother. And now that I'm a mother, I just enjoy every second and every ounce of my child. Life is as beautiful, and I'm very, very, very grateful to say that. That's something that I give thanks for every single day.”