In the fall of 2014, Christina Best began her much-anticipated job as an English teacher at the rural northeastern North Carolina high school she had attended only four years earlier.
“I loved my students. I even had siblings of the students I went to school with in my classroom,” Best, who was 24 at the time, told Healthline.
While her enthusiasm for teaching was great, the joys of the job were hampered by a nagging and sometimes severe pain in her chest.
In spring 2016, a biopsy confirmed the pain was caused by a cancerous tumor. Her doctors eventually diagnosed it as stage 2A breast cancer.
“I was stunned,” Best said. “It was a total surprise. I just didn’t know that women that age got breast cancer. My grandmother had it. I always thought it happened to older women.”
Best took an extended leave from her job to undergo treatment.
She has endured chemotherapy, surgery, hormone treatments, radiation and other treatments.
It’s been traumatic, but Best has gotten through it with her positive attitude intact.
She’s now in remission, but her life and career trajectory have changed since her diagnosis.
She returned to the classroom for a while, but she now works on the corporate side of education helping colleges and universities put their courses online.
Best moved to Los Angeles recently and has pursued other interests, including photography, acting, and singing.
And she does whatever she can to explain breast cancer risks.
“I’m passionate about inclusivity and considering all genders/nonbinary people as well as prevention/early detection,” she said.
Best volunteers for Teen Cancer America, a nonprofit organization founded by Roger Daltrey and Pete Townshend of the rock band The Who that supports teens and young adults with cancer.
Best says that young adults with breast cancer often find themselves outside looking in, with pediatric patients and older adult patients getting most of the attention in terms of resources and research.
“It’s not that scientists don’t care, but the focus has been polarized in these two groups, and for those in the middle it has been hard,” she said.
“I’m not sure why I got it, but there are a lot of people where I come from in North Carolina who have breast cancer,” Best added. “And the numbers of young women nationwide who are being diagnosed is increasing.”
Young adult breast cancer on the rise
A new study published in the journal Radiology confirms Best’s assertion.
The study shows that breast cancer death rates have, in fact, increased in people under age 40. This reverses a trend in breast cancer mortality rate decreases over the past decade.
Statistics have shown a steady decline in overall breast cancer mortality rates in the United States since 1989, the researchers explain.
From 1989 to 2017, breast cancer mortality rates for all people in the United States decreased by 40 percent, which was attributed to improved treatment and increased mammography screening rates in the 1980s.
In the new study, researchers determined U.S. trends in female breast cancer mortality rates by 10-year age subgroups based on recent data from the National Center for Health Statistics.
Underlying breast cancer incidence rates have increased in people younger than 40 years old. Distant-stage breast cancer rates have also increased by more than 4 percent a year since 2000 in people ages 20 to 39 years, the study reported
Breast cancer mortality rates continued to fall among ages 40 to 79, but they increased in those age 40 and younger.
The increase was nearly 3 percent a year in ages 20 to 29.
Researchers conducted a retrospective analysis of breast cancer mortality rates using data from the NCHS and from the National Cancer Institute’s Surveillance, Epidemiology and End Results program.
Researchers did not include data on how breast cancer impacts other genders.
While breast cancer is still less common in younger people, the rates are rising, the study reports.
The call for more research
The study’s authors expressed hope that the findings would raise awareness of breast cancer in younger people and lead to more research into the causes behind the change.
“It’s clear that mortality rates in women under age 40 are no longer decreasing,” R. Edward Hendrick, PhD, the study’s lead author and a clinical professor in the department of radiology at the University of Colorado School of Medicine in Aurora, said in a press statement.
“I estimate that in two to three years, the mortality rate will be increasing significantly in these women,” he added.
“Our hope is that these findings focus more attention and research on breast cancer in younger women and what is behind this rapid increase in late-stage cancers,” Hendrick said.
Breast cancer is the most common non-skin cancer and the second most common cause of cancer deaths in women in the United States, accounting for 30 percent of all cancers.
Although most invasive breast cancers occur in women age 40 and older, about 5 percent of cases happen in women younger than 40 years old.
Dr. Anne Wallace, director of the Comprehensive Breast Health Center and a professor of surgery at UC San Diego Health, told Healthline that even people in their 20s must be diligent.
“Pay attention to your body. If you discover something new in your breast, and it is not gone in couple weeks, pursue it with your doctor and make sure the answer sits well with you,” Wallace said. “If you don’t have a good feeling about it, push forward and ask your doctor to order an ultrasound.”
She added there are no valid reasons to delay medical appointments.
“Don’t wait until school is out. We see this a lot,” Wallace noted. “If you are studying for the bar exam, don’t wait until after you take the exam.”
She encouraged people to be aware of family history. “We’ve had young patients, they knew their father had cancer, but no one tested for the gene. You should know the history of both parents. Pediatricians and primary care doctors should have all this on file,” Wallace said
Why death rates are increasing
Dr. Patricia A. Ganz, director of the Cancer Prevention & Control Research at the Jonsson Comprehensive Cancer Center at the University of California Los Angeles, said there are likely multiple reasons for the increase in breast cancer death rates among people in their 20s.
“It’s complicated,” Ganz told Healthline. “We know, for example, that delayed childbearing is a risk factor for breast cancer.”
Ganz added that there is also data showing that alcohol and tobacco are risk factors for breast cancer.
“Tobacco use rates have declined, but women still smoke. Some of them do it to stay thin,” she said. “That, too, is a risk factor.”
A mastectomy at age 18
Emily Sowski, 27, a pharmaceutical representative who lives in Santa Monica, California, underwent a prophylactic mastectomy at age 18 immediately after testing positive for the BRCA2 gene.
That means she had a mutation in one of her breast cancer genes and was at higher risk of developing breast or ovarian cancer.
Sowski agreed to have her breast removed and then underwent a second surgery for the reconstruction.
“I was a teenager, and to be honest I was so young and naïve, I didn’t fully understand what it meant to cut my body and remove the features I was born with and what makes me a woman,” she told Healthline. “If I did that now, those factors would play a bigger part.”
Her mantra now is simple.
“Know your family’s history. It could save your life,” she said. “If I didn’t know about this gene, the chances would’ve been about 80 percent that I’d get cancer.”
“Now that I’ve had the double mastectomy, the chances are very small,” she noted.
Putting feelings into songs
Meanwhile, Best embraces her life and shares her story to increase awareness among her fellow young adults with breast cancer.
She’s now an artist in Teen Cancer America’s “Play it Back” music program and has become a prolific singer-songwriter.
“Breast cancer can be devastating both physically and emotionally,” she said. “I think about the toll that losing my breasts had on my femininity. But people are getting more informed.”
With more research, Best said, “perhaps someone like me will not have to get rid of her breasts. I wish I had that option. It is such a game-changer, such a big change to your body.”
Simon Davies, executive director of Teen Cancer America, told Healthline that “Christina is an extraordinary young woman. She’s been brave enough to share her story and advocate for Teen Cancer America in many ways that will both educate health professionals and empower young people with cancer.”
“She embodies the ethos of Teen Cancer America, and we are indebted to her,” Davies said.
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