Fresh out of college, Annie Gerlicher noticed a tiny lump on her chest. “It was only about the size of a pea,” she explains, noting that the lump was so high up on her chest, she didn’t even realize it was considered breast tissue.
Life on pause
Deep in the midst of preparing for Physician’s Assistant (PA) school interviews, she dismissed it as nothing. “The thought didn’t even cross my mind that it could be breast cancer,” she notes.
Annie was diagnosed with Stage 3C invasive ductal carcinoma, the most common type of breast cancer, a few months later. She had just celebrated her 23rd birthday and was preparing for graduate school. A future full of bright, young dreams dimmed to reveal months of relentless chemotherapy, radiation and a double mastectomy.
Breast cancer is a staggering diagnosis at any age. While the median age of diagnosis is 62, the disease does not discriminate. Annie is a part of the small but loud percentage of women diagnosed under age 40.
The experience can be especially devastating for young women, as the physical and mental toll of the disease is amplified on young bodies. Fertility issues, psychological issues and body image issues create lasting challenges beyond the battle for remission. Women at the cusp of potential suddenly find themselves grasping for good health.
Sadly, many breast cancer diagnoses in young women are late-stage. It is doubly tragic: not only does the disease tend to thrive in young bodies, it is also rare enough that doctors are hesitant to test for it. By the time it is found, it has to be tackled with incredible force for even the healthiest young adults to survive. Survival rates are lower in young women with breast cancer: Of the nearly 13,000 women diagnosed under age 40 every year, over 1,000 succumb to the disease.
A renewed crusade
For many women — including Annie — the toughest part of the experience is the physical changes they go through at such a young age. “It’s not easy to have a double mastectomy or to have hormone therapy injections every single month,” Annie expresses. She recalls simply “existing” through all of the pain and struggle of her breast cancer journey, noting that she felt — and still often feels — “very empty.”
Now on the road to recovery, Annie will start as a PA student at Midwestern University in Glendale, Arizona in June 2018. While her mission is to become a PA in Oncology and help others through their own diagnoses, Annie also intends to raise awareness for breast cancer in young women. She encourages other young women to pay attention to their bodies even though they want to assume they’re perfectly healthy. “Never be afraid to bring something up to your doctor, and don’t forget to check yourself every month,” she states.
Her own advocate
For Brianna Armour, it wasn’t a lump, but some redness and a woman’s intuition that brought her to her doctor. The month before her 26th birthday, she noticed discoloration on her chest and made an appointment. Her gynecologist dismissed the redness as a possible bruising, but Brianna pushed for a mammogram. Her request was denied. “I didn’t fit the demographic,” she explains. “I was told the insurance wouldn’t cover it and there wasn’t a real need for it. I wasn’t happy with that.” After consulting a different doctor, she had her mammogram approved — but had to pay for it out of pocket.
A few weeks and a biopsy later, Brianna was diagnosed with Stage 1B breast cancer. She underwent aggressive hormone therapy, radiation and a lumpectomy before being declared in remission about a year later. Now, almost two years cancer-free, she still faces harsh side effects with the breast cancer drugs that she must remain on for years to come.
Like Annie, Brianna discloses that the entire experience has changed her — and aged her.
“Being told that you’re in remission is great, but your life doesn’t just go back to normal. I have two lives now — pre-cancer and post-cancer,” she says. “I feel like I’ve aged internally so much.” She notes that although she hasn’t even turned 30, she feels as if she’s lived multiple lives, “and not in a good way.” The psychological effects of dealing with her disease have left her with troubles as well. “I’m angry and I don’t know why, I’m crying and I don’t know why,” Brianna asserts, “and every check-up, I’m wondering if this will be the time they tell me ‘it’s back.’”
Throughout her breast cancer journey, Brianna has had her world turned upside down, but has also found new purpose. A young mother and former corporate worker, beating cancer inspired her to pursue her lifelong dream of becoming a doctor. She is currently a pre-med student at New York University and also works as an EMT and medical scribe.
Brianna stresses that although people may think that when you’re young, cancer is easy to “bounce back” from, it is an incredibly difficult ailment to grapple with. “My health has declined so much and will never be the same,” she notes. “My immune system is shot for the rest of my life. It’s really rough.” Like other survivors who are mothers, she also deals with the guilt of not getting to be the parent she wants to be because of her diagnosis.
An indiscriminate disease
Only a handful of studies show it, but research shows that metastatic breast cancer at the time of initial diagnosis is rising in women under the age of 40. Solid research is sparse on the demographic because of its rarity, and young breast cancer patients are often underrepresented in studies on the disease. Brianna asserts that the disease is more prevalent in her peers than people realize. “We’re starting to see that this isn’t the same demographic anymore,” she states. “This isn’t just older middle-aged women facing this, it’s women of all ages, all socioeconomic statuses, all ethnicities getting this.” Most importantly, she maintains, there needs to be a bigger push for early preventive screening in young women.
There are countless challenges with asking an entire demographic to remain vigilant for a disease that is still considered rare. Yet, Brianna and Annie both agree that women should still be self-checking their breasts often and paying attention to their health. They declare that the worst thing women can do is assume it can’t or won’t happen to them. “You’re never too young,” states Annie, who had no family history of the disease. She recommends that women who do have a family history get genetically tested for the BRCA gene. Brianna voices that sometimes, you won’t always have clear signs that something’s wrong, “but if you feel that something is ‘off,’ don’t ignore it.”
Like her fellow breast cancer survivor, Brianna agrees that it’s a “better safe than sorry” situation.
“If it’s nothing, it’s nothing — it may cost you time and money to get it looked at, but it could cost you everything if you don’t,” concludes Brianna. “I want more people to become aware. I don’t want them to become aware when it’s too late.”