Breast cancer accounts for 26 percent of all cancer in females ages 15-39 years old and 39 percent of all cancer in 35-to-39-year-olds.
It’s always shocking to hear you have cancer, but especially if you’re a young mother with no family history of cancer.
Jennifer Overstreet of Rockland was diagnosed with Stage IV breast cancer last year at age 23, making her one of about 11,000 women under age 40 who develop breast cancer each year.
“I was shocked and felt like all my energy just fell to the floor,” she said. “I kept thinking, ‘I have to take care of my daughter. I don’t want to die.’”
Overstreet, now cancer-free and scheduled for reconstructive surgery next month, is typical of many young women with breast cancer. She received a diagnosis when the cancer was advanced.
“Younger women are much more likely to present with more advanced cancer than older women,” said Dr. Ann Partridge, director of the Program for Young Women with Breast Cancer at the Dana-Farber Cancer Institute in Boston. “Younger women are more likely to get more aggressive tumors, and older women to get the wimpier ones.”
The explanations for these distinctions remain unknown, but treatment, survival and quality of life are improving for young women. Clinicians and researchers increasingly focus on the unique medical and personal needs of young women, and resources are expanding for education and support.
“I think there has been incredible progress made,” said Marcia Stein, 47, chief executive officer of The Young Survival Coalition, who had breast cancer 13 years ago. “When I first got diagnosed, it was one size fits all. There were no support groups for young women, and everyone took the same chemotherapy whether you were 34 or 70. Now they tailor treatment to your specific type of cancer, and they consider issues facing young women, like fertility.”
In the majority of cases, breast cancer develops when women are in their fifties and older, after they have completed their family and are established in their career. But younger women face distinctively different challenges: they can find their plans for children and a career derailed and threatened. They often know no other young women with the disease, increasing feelings of isolation.
“It’s life altering at any age to have cancer, but it’s really life altering for someone in their 20s and 30s,” said Stein of Cambridge, who was diagnosed in 1996 at age 34. “They’re on the cusp of their lives and dealing with incredibly complex issues.”
Both Stein and Overstreet had cancers that occurred without any known cause, which is true for about 90 percent of young women. Only about 10 percent of young women have a close relative with breast cancer or a genetic mutation that increase susceptibility.
In many respects, Stein was lucky since she felt a lump and her doctor diagnosed it immediately, when it was still a small Stage 1 cancer and removable by a lumpectomy.
In contrast, Overstreet received a diagnosis last year after her tumor had grown large and spread to her rib bone. She had first seen a doctor in 2007 for a small lump just before her wedding. The doctor told her she was unlikely to have cancer because she was so young, but advised her to come back for tests after her honeymoon and she subsequently repeated the advice in letters.
“I didn’t worry about it because I was so young and I got caught up with things in my life, so I didn’t go back,” Overstreet said. “But then it got big and painful.”
Anecdotally, there are plenty of situations like Overstreet’s, where either the woman or the physician downplays the lump, believing it to be either normal glandular tissue, a cyst, or a benign fibromatoma.
“Statistically, the lump is probably nothing, but it can be catastrophic,” Partridge said. “There isn’t data, but anecdotally, I see patients at least once a month who saw someone else who didn’t think it could be breast cancer and they sat on it. The important thing for a physician is to follow a woman closely or further evaluate them. You never let something go and say it is nothing.”
Fortunately, Overstreet now is cancer-free, after a year of difficult treatments. From August through December, she had chemotherapy to shrink the tumor. Then, she had a double mastectomy and removal of a piece of her rib in January, followed by radiation from February through April. Her ovaries were removed in July, and she will have reconstructive surgery next month.
“She’s doing well,” said Dr. Julie White, a surgeon with Signature Healthcare Brockton Hospital who diagnosed Overstreet’s cancer, planned her treatment and continues to monitor her. “People think the worst when they get the diagnosis, but most do fairly well. It can be a long battle, but the survival rates are much higher than people imagine.”
The average five-year survival rate is 82 percent for women under 40 and 87-89 percent for women older than that, Partridge said. The rates are not broken down, though, by type of cancer.
Overstreet has received enormous support from her husband, Matt, and his mother, who opened her Whitman home to the couple and took care of their daughter, then age 3, during the months of treatment. As she bravely endured sickness from chemotherapy and pain from surgery, she also found comfort and stress relief in reiki. Now certified in reiki, she hopes to help others.
And Overstreet said she thinks about what she is gaining, rather than what she has lost.
“I’m excited for my reconstruction,” said Overstreet.
“At least I get to pick out a new set of boobs and I’ll get a tummy tuck, because they take the fat from my stomach. I think I’m going to feel reborn.”
The cancer, despite the damage to her body, has made her feel stronger.
“It gave me more respect for myself,” she said. “It made me think that if I can get through this, I can do anything. I hope it doesn’t come back, but if it does, I think I’m going to be fine.”
The Patriot Ledger