Woman, 22, Shocked by Diagnosis After Finding Lump

At age 22, Nuttavadee Tungkongnuch was living a hectic life like most people in their early twenties, going to school full-time, working a full-time teaching placement, and working part-time in a coffee shop.

"I had no time to take care of myself when I was so busy trying to graduate school and start working a full-time job," Tungkongnuch, now 24, told Newsweek.

It was during this busy time, in June 2022, that she noticed a lump in her right breast, getting bigger and growing fast.

"I did not think anything of it and didn't want to get it checked out because my main focus has always been finishing school and making my family from Thailand proud," she said. "I also wasn't worried because every time I went to the doctors for something, there was never anything wrong with me. Before I got diagnosed I swear I lived my life like I was a cat with nine lives."

While at an initial appointment Tungkongnuch, from Vancouver, Washington, was assured by doctors that it was probably nothing due to her age and lack of symptoms. Another doctor was sure the ultrasound would not show anything up due to her age and apparent health.

"This was the second doctor that told me this so I thought it couldn't be cancer, right?" said Tungkongnuch, "However, this doctor must have seen something that made her doubt things because she sent me for a biopsy. I felt scared, worried, and vulnerable."

Crying in the Avocado Aisle

A week later, on July 20, 2022, Tungkongnuch received a call while grocery shopping.

"I had a weird feeling when I got the call because usually I would receive any test results on an app. The nurse said my name gently, and paused. 'I don't have it right?' I said, and she replied, 'I'm so sorry.'

"I felt so blindsided. I felt sad, I felt lied to by all the doctors that said it was probably nothing. My whole life turned upside down that day. I started crying in the avocado aisle, I just couldn't believe it."

Tungkongnuch was diagnosed with triple positive breast cancer, a very fast growing and aggressive type of cancer, consisting of all three types of cell surface receptors used to classify breast cancer: estrogen, progesterone, and human epithelial growth factor receptor 2 (HER2).

Around 10 percent of all breast cancers are hormone receptor-positive as well as HER2 positive, according to Medical News Today. The treatment methods for triple positive breast cancer may include a combination of treatments to shrink or destroy the tumor, and surgery to remove as much of the cancer as possible.

'I Couldn't Believe That I Had To Go Through All Of This At This Age'

"Everything moved very quickly from the day I received that call," said Tungkongnuch, "I had my MRI scan two days later to see if the cancer had spread. My PET scan was two days after that, and I had my port surgery the following week to make the chemotherapy easier to administer. Two days after that I had my lymph node biopsy, my echocardiogram the week after, and I started my chemotherapy the month after that."

The 22-year-old's life consisted of four doctors' appointments a week, 117 in total, and 18 chemotherapy treatments.

Women have a 34 percent higher risk of severe side effects from cancer treatments such as chemotherapy, according to the National Cancer Institute (NIH).

"I ended up getting every single reaction you can have to the first round of chemotherapy," she said.

Some of these included high fevers, bone pain, hair loss, bowel problems, low energy, and a reduction in vision, leading Tungkongnuch to need new glasses.

"My skin on my hands and fingers would peel off," she said, "and my doctors said that only one percent of people get that side effect. Water tasted like metal to me. The chemo messed up all my tastebuds, so I lost my appetite. I couldn't find any comfort in food."

Chemotherapy also potentially affected her ability to have children.

"I had no choice," she said. "Everything happened so fast that I didn't even get to save my eggs for future kids because the doctors said I needed to start chemo within the next month and that saving my eggs the procedure would take too long. It was also very expensive because insurance doesn't cover it. By the end of chemo, I didn't feel like myself. I felt like I lost myself through this process and I am now learning how to get myself back."

As well as the side effects from chemotherapy, Tungkongnuch had to deal with the three types of surgery: port surgery, mastectomy, and reconstructive DIEP flap surgery, an intense physical and psychological struggle.

"I felt like I lost a part of myself and my femininity after my mastectomy," said Tungkongnuch, "I didn't feel beautiful. I hated looking in the mirror. I couldn't believe that I had to go through all of this at this age."

A key part of youth is to consider yourself indestructible however, five percent of breast cancer cases occur in women under 40 years old, according to the Cleveland Clinic.

"Everyone told me that I was lucky I was diagnosed so young, but I would have 100 percent preferred to have gone through this later," Tungkongnuch said. "I would have preferred to have been diagnosed at 40, when I had already lived some sort of life, had kids, worked for a while."

While young women may think they're not at risk of getting breast cancer, and it is rare, triple positive breast cancer is the most common cancer among women ages 15 to 39. "Certain kinds of breast cancer are on the rise among young women," says Yale Medicine, adding: "More than half of the time, women detect breast cancers themselves when they notice an unusual breast change."

Tungkongnuch found little comfort in breast cancer support groups as she was always the youngest person there.

"I am very lucky to have such wonderful friends, family and an amazing community," she said, "I was extremely worried about my hospital bills, house bills and everything else because I was quitting my barista job at the time and there was so much uncertainty.

"Before I got diagnosed I refused to get a biopsy because it would cost me a couple thousand dollars to get that done. My mom insisted that I got the biopsy though, so it would make us feel more at ease. I would cry because I had no clue how I was going to pay for all of my hospital bills. My best friends then set up a GoFundMe for me and I didn't think much of it. By the third day of it being up, I reached my goal that my friends set up. I was completely shocked."

How To Do A Breast Self-Exam

A self-exam is an effective preventative early detection tool that can help catch breast cancer in it's earlier stages.

"Knowing how your breasts normally look and feel, also called breast self-awareness, will help you identify any changes or abnormalities in your breasts, such as a new lump or skin changes," the National Breast Cancer Foundation (NBCF) says. "Any changes in your breasts discovered during a breast self-exam should be reported to your healthcare provider right away."

The NBCF guidance explains that one of the ways you can check your breasts is in the shower.

"With the pads/flats of your 3 middle fingers, check the entire breast and armpit area, pressing down with light, medium, and firm pressure. Check both breasts each month, feeling for any new lumps, thickenings, hardened knots, or any other breast changes."

It's important to remember that a mammogram can usually pick up a tumor before they can be felt so if you are over the age of 40 or have a family history of breast cancer or any of the other risk factors, schedule regular mammograms with your doctor.

The Road To Recovery

On December 9, 2022, Tungkongnuch finished her sixth and last round of chemotherapy and was finally able to ring the hospital bell to signal that she is cancer-free.

"I felt all of the emotions," she said. "I felt sad that it took over a year to get to this point. I truly didn't see the end of the tunnel when I first got diagnosed. It really was a marathon. I felt happy that I didn't have to do this again. I felt worried that I would have to be back there if it came back someday. I felt a bit sad also because I would miss all of my wonderful nurses. But overall I felt so proud and happy that I made it out alive. It made me appreciate my life a lot."

Another milestone came recently when Tungkongnuch celebrated her 24^th birthday.

"I celebrated it with all of my close friends. It was so much fun. I felt free and it was the first time I have done anything like that since chemo. I was on a lot of restrictions before and now I am a lot more independent and free.

"My life feels like it is slowly going back to normal, whatever that is. However it doesn't dismiss how hard remission is and the fear of the cancer potentially coming back in the future since there are chances of that because I kept my left breast because I want to experience breastfeeding one day."

Despite the traumatic, life-changing experience, Tungkongnuch said she did learn some important lessons.

"I learned to slow my life down, that I didn't need to have everything all together at a young age, and that life really is unpredictable. Sadly, I am not a cat with nine lives."

She also said to anyone who might be going through the same thing that there is light at the end of the tunnel.

"Life is a marathon, not a race. Take it easy, be patient, rest up, and it will all be OK. Your life will not be the same, but it really is about your mindset. I didn't believe I would get this far and here we are.

"I am now teaching my own first grade classroom next door to my best friend! I want to go skydiving, I want to have all the fun in the world because I want to say I lived my life to the fullest."