When holidaying in Thailand in 2006, cancer was the furthest thing from 29-year-old Sarah Powell's mind. However, once she felt a lump in her armpit while showering, that all changed.
"The lump was weird, hard and small, I immediately had a bad feeling," Sarah told Mamamia.
"Although I thought I was probably overreacting because I was only 29, for the rest of my holiday it was on the back of my mind."
Sarah's instincts were correct. Upon visiting her GP after returning to Australia, Sarah underwent an ultrasound and biopsy which confirmed she had an aggressive form of triple negative breast cancer.
These are the five things she wants you to know.
1. More than 3,500 Australian women under 50 are diagnosed with breast cancer every year.
Although Sarah's then-husband was supportive throughout her cancer treatment, before her diagnosis, due to Sarah's age, he wasn’t concerned that the lump would be anything sinister.
"I was alone when I found out I had cancer, my husband didn’t come to the appointment because he didn’t think it was anything, he thought I was too young," Sarah said.
"When I was told, I was in complete shock. People talk about fight, flight, or freeze, I was in freeze mode."
While around 80 per cent of all breast cancers in Australia occur in women over the age of 50, according to data from the Australian Institute of Health and Welfare, over 3,500 women under the age of 50, like Sarah, are diagnosed with breast cancer every year.
2. The impact on your mental health can be the hardest part.
Throughout Sarah's treatment, the now 47-year-old said she coped well, but once her final session of radiation ended, she broke down.
"I walked out and sat in my car crying. It was a really strange feeling because, while you’re in treatment, you feel like you have people around you doing everything they can to help. But when it had finished, I just wondered, 'what happens next? Who is helping? Who is going to stop this cancer from coming back?' It all hit me afterwards."
The fear of recurrence has remained with Sarah, and still impacts her 18 years on.
"Despite doing what I can to reduce the risk of cancer and being one of the lucky ones who hasn’t had it recur, I still have quite bad anxiety around recurrence," she said.
"I worry all the time. Whenever I feel a pain I think, is it back?"
However, with Sarah’s knowledge comes power.
"I am trying to implement strategies like positive self-talk to help reduce my anxiety. I am learning to talk myself down," she said.
3. Know your family history.
Sarah discovered she was pregnant with her first child only a few weeks after completing radiation — a big surprise for her and her husband.
"I was told I might not be able to get pregnant after my treatment, and had undergone one round of IVF beforehand. In the end, I didn’t need it," she said.
Throughout the pregnancy, Sarah was asked if she had a family history of cancer. Although she had none, Sarah later became aware of a link between her family ancestry and the BRCA mutation — an abbreviation for 'BReast CAncer gene', which has been found to impact a person's chances of developing breast cancer.
"When my baby was six months old, I was reading about the BRCA mutations and that there was a higher prevalence of this amongst those with an Ashkenazi Jewish background, which was where my family was from."
Based on this, Sarah decided to have genetic testing which revealed that she carried the BRCA 1 mutation. Sarah then underwent a mastectomy and hysterectomy.
4. Cancer can affect your parenting.
Sarah, now a mum of two — Mikayla, 16 and Jackson, 11 — said that there's an increased chance that her children may also develop cancer if they inherit this from her, meaning they may need to undergo high-risk screening in their twenties and also be tested for the BRCA gene mutation.
"This is always at the back of my mind," she shared.
For Sarah, it has remained important to educate both her teen and tween about her breast cancer history and the BRCA genetic mutation in an age-appropriate way.
"It’s a difficult one, as teenagers can already have a lot of worry and challenges, and I don’t want to scare [my daughter]. However as she gets older, I’ll need to balance that with ensuring she is educated on the importance of regularly checking her breasts," she said.
5. Know your body and "know your normal".
While Sarah shared she wasn't in a routine of checking her breasts when she discovered the lump in her armpit, she now advocates for this as a part of her role as CEO of cancer charity, Inherited Cancers Australia.
"At Inherited Cancers Australia, we talk about the importance of incorporating a regular self-breast check into your routine from a young age, say your twenties. If you put a good routine in place at a young age, it’s already second nature to you," Sarah said.
While most breast changes are not caused by breast cancer, it's important to become familiar with the shape, feel and look of your breasts, and always check any changes you detect with your doctor.
"You are looking for something that wasn’t there a week ago and is still there in a week's time. Once you know your baseline or your normal, it’s easier to spot when something changes, and not just in your breasts. Know your normal."
Seeking advice from your health practitioner and a second opinion if you're not satisfied is also important, Sarah believes.
"I am very pro-second opinion. There have been so many advances with screening and treatment but critical to this is having the right care."
This information is general in nature and does not replace the advice of a healthcare professional. As with any medical condition, always seek health advice from a qualified healthcare professional.
Feature Image: Supplied.