My Daughter, the Learning Opportunity

One of the phrases used by many people during the pandemic to describe young people is that they feel invincible, that their youthful confidence gives them a sense that COVID-19 is something only other people get. As we now know that confidence has turned out to be more like blissful ignorance, because the virus has hit younger people hard in the last wave.

That same blissful ignorance of the fact that young women get breast cancer made my daughter, Adrienne, brush off her concern when she first felt the lump during a shower check in November of 2018. After all, she was 27, and although one in eight women will be diagnosed with breast cancer during their lifetime, she had never heard or seen any stories of cases from women in their 20s. As time passed, however, the lump not only remained but grew bigger, and Adrienne decided it was something that needed to be checked out. In February of 2019 she went to her doctor to express her concerns.

Adrienne’s doctor is in her 50s and has been practicing medicine for over 20 years in a large city. She is respectful of my daughter’s body awareness and when Adrienne said there was a lump, she asked her to get into a gown so she could do an exam. Her dismissal of Adrienne’s original concern was evident in her face when she felt what Adrienne had felt in the shower, and with surprise on her face and in her tone, she said, “Oh, that’s definitely a lump.” And in the next sentence she began to list off all the things it could be that weren’t cancer.

Next step was an ultrasound. The ultrasound technician was also in her 50s and got the same surprised look on her face when she saw the spot in the images that appeared on her screen. As she was taking measurements, she began talking to Adrienne about all the possible benign things the lump could be.Adrienne walked out of that appointment knowing the lump in her breast had been confirmed but confident that it wasn’t anything she needed to be worried about.

Based on the ultrasound results, Adrienne’s doctor referred her to a surgeon who ordered a biopsy. The technician froze the area and guided by ultrasound, inserted the needle into Adrienne’s breast to take a sample as they had a conversation about all the benign possibilities. When the biopsy needle encountered something solid, the technician eliminated a cyst as an option but spoke at length about fibroadenomas, which are a solid benign mass found in women’s breasts. It was only after this appointment that Adrienne looped me in about what was going on, I think because her 100% certainty that it was not cancer dropped to 99% when the biopsy needle didn’t poke into a sac of fluid.

When Adrienne walked into the surgeon’s office, she carried with her youthful confidence in her invincibility, that blissful ignorance reinforced by the fact that all the medical professionals she had dealt with up to then had spoken to her about all the possible reasons for the lump other than the worst-case scenario.

So, when the surgeon looked at her and said that it was a “little bit of cancer,” her shock was magnified a hundredfold. He gently shared with her what the next steps would be, and as Adrienne left his office, his receptionist asked if she could give her a hug. Both of these people are in their 50s and had never seen a case of a woman in her 20s with breast cancer.

Many people ask me how Adrienne found out she had cancer, and I tell them she found the lump in a shower self-exam and made the choice to check it out. Because she made that choice, despite everything she “knew” about breast cancer, it was caught early enough that it had only metastasized to her lymph nodes. This is not the situation in too many cases. Younger women who have breast cancer may ignore the warning signs—such as a breast lump or unusual discharge—because they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes. And some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a "wait and see" approach.

I will be forever grateful to Adrienne’s doctor that she opted to investigate right away. And I think her doctor, her ultrasound and biopsy technicians (who were part of her surgical prep team) and her surgeon owe her a debt of gratitude, as well. Now, when a 20-something woman comes into their sphere they no longer live in blissful ignorance that it can’t be breast cancer, because they met my daughter. I hope that her diagnosis is being shared with the young women they know and that by bursting that innocence bubble my child having had cancer may save lives.

Keeping my fingers crossed.

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