Stacey Managh was at home on a Saturday night, attempting to pop a pimple on her chest, when she realised there was a lump in her breast. 

She quickly reached for her other breast to see if it felt the same. 

It didn’t.

That’s when the Auckland high school teacher, who was 25 at the time, had a flash vision into the future like the ones in an episode of That’s So Raven.

“I saw myself standing in front of the classroom telling the class I was going away for a while.

“It only lasted a second before it went away and I told myself to stop being so dramatic,” she laughs.

Stacey remembers that fleeting vision because that’s exactly how it played out. 

Less than a week later, she was sitting in a surgeon’s office with her sister, nodding along blankly as she learned she had a rare form of breast cancer usually found in women over 60 years old. 

“It was surreal. I’m a healthy young person with no history of breast cancer and suddenly I have this type of cancer that only makes up 1-3% of all breast cancers,” she says.

The lump Stacey found that night was a 3.5cm tumour and its size is what saved her life. 

“Because I had this rare type of cancer, the tumour was made up of all of this mucus which is why it was so big and that’s why I found it. If it was another form of cancer, maybe I wouldn’t have,” Stacey says.

Why breast cancer is more likely to kill young women

Nearly 400 women are diagnosed with breast cancer under the age of 45 each year in New Zealand. 

The scary thing is, by the time these young women are diagnosed, half of them have grade 3 tumours - a more aggressive form of cancer that is harder to treat. This is nearly double the rate of older women.

Women under 40 are also 64% more likely to die of breast cancer within 10 years of diagnosis compared to older women. 

Under 35-year-olds have the worst survival rates.

Chief executive of Breast Cancer Foundation NZ Ah–Leen Rayner says it’s not known why breast cancer is often more aggressive among younger women. And a big reason for this is the lack of research into breast cancer among that group. 

“There is a big gap in our knowledge that we are trying to overcome,” Rayner says. 

“We've recently funded a four-year study called the Helena McAlpine Young Women’s Breast Cancer Study. It's essentially the first of its type in New Zealand to focus on women that have been diagnosed with breast cancer under the age of 45.”

What we do know is like all cancers, the earlier you detect breast cancer the higher your chances of survival. 

“Unfortunately with the way that our screening works, younger women often take longer to be diagnosed because routine mammograms are only funded from the age of 45,” Rayner says.

This is because mammograms aren’t reliable at detecting breast cancer in younger women because their breast tissue is too dense to see cancers clearly. 

But even with small, early cancers, young women are still more likely to die. 

That is why Rayner says it is crucial young women aren’t locked out of clinical trials because of their age and they have access to funded drugs that are proven to prevent cancer from returning. 

It’s also why all young people with breasts need to self-check. 

How do you self-check your boobs?

Self-checking is the most effective way to screen for breast cancer among young people. 

Stacey says it’s a mystery as to why people aren’t taught how to do this from a young age. 

Here is the Breast Cancer Foundation’s guide to breast checking:

  1. The best time to do a self-check is usually the week after your period when your breasts aren’t as tender or lumpy. If you don’t have your period regularly, just make sure you are checking your breasts roughly around the same time each month - the first day of the month, for example. Pre Check is an app you can use to remind you to check your boobs each month.
  2. Boobs are naturally a bit lumpy so it can be hard to know what you are looking for. Rayner says the best thing to do is to get to know “your normal” so that you can tell if something has changed over time. This includes the feel of your breasts but also the look of them as well. Look out for any change in their size, colour, or skin textures.
  3. Checking your breasts in the shower can be the easiest way because water and soap can make it more comfortable to slide your hand over them. Start by raising one arm over your head and use your three middle fingers to press into your breast, feeling for any changes. Start softly at first and then you can press more firmly. Check the entire breast area from your collarbone to under your breast, and from the side of your breast up into your armpit. Then do the same on the other side. 
  4. If you have larger breasts, it is recommended you do your breast check lying down so your breast tissue is flatter. Bend one arm and place it behind your head on a flat pillow. Using your other hand, check all over your breast on that side, including the nipple, up to the collarbone, and under your arm. Swap the pillow to your other shoulder and repeat on the other side.
  5. If you find something that feels unusual, call your GP as soon as you can and get an appointment to have it professionally checked. 

Going into surgery without a guarantee

Three weeks after discovering the lump in her breast, Stacey was taking photos of her boobs in the mirror on the morning of her surgery. 

“I didn’t know if I was going to be able to keep my nipple or how much they would have to take out. They couldn’t give me any guarantees. 

“So I was going into surgery not knowing what I would come out with,” she says.

When Stacey woke up from her surgery and saw that she still had her nipple and could recognise her boobs as her own, she burst into tears. 

“I cried for a long time because, fuck, I was 25. I was not ready for that. I’m still so emotionally connected to my body, I haven’t [had] kids, I haven’t breastfed. I wasn’t ready.”

‘I wasn’t myself after surgery’

Stacey is now 28 and three years cancer-free. 

But even though the cancer didn’t return after her surgery, she says the mental toll from the whole experience still lingers. 

“I felt really detached from my body and who I was.

“Doctors had their hands on my chest all the time. I would be naked in front of strangers every week so I would try to disassociate from my body so I could numb myself from feeling so exposed.”

For a long time when Stacey went out in public, she would keep her distance from people because she was afraid people would knock into her.

“I’ve had experiences of being assaulted in the past, strangers trying to feel you up. I was so protective of my boobs at that point because they hurt so much. I didn’t want to look nice or wear what I usually wear because I didn’t want to attract any attention. 

“I didn’t even want to be hugged. It was a massive shift in my personality,” she says.

As time passed, Stacey started wearing what makes her feel good and is back teaching and doing exercise. 

“Slowly, I feel like I am getting myself back, but it took a really long time,” she says.

“I hope that by sharing my story, other women will be inspired to have those really hard, but extremely important conversations with women in their lives, young and old.

“I want people to think ‘If it could happen to her, then it could happen to me.’”

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