New Duke Health program supports young breast cancer patients as diagnoses climb

When Duke Health nurse Kimberly Ross learned her father tested positive for genetic mutations tied to higher breast cancer risk, she immediately formed a plan.

The first step was to get tested herself.

“He ended up being positive for a BRCA2 and PMS2 mutation,” Ross said. “I got my results in June 2021, and I was found to have the same mutation.”

Ross was 35 at the time. She told WRAL that because she specialized in cancer care, she understood what those mutations could mean.

“From the beginning, I already knew that I wanted to do a double mastectomy. I wanted to do anything possible to reduce my risk,” Ross said.

Carrying the BRCA2 gene can increase a person’s risk of developing breast cancer, along with ovarian, prostate and pancreatic cancers.

Ross’ treatment plan involved having breast MRIs and mammograms ahead of surgery in March 2022.

Her scans hadn’t shown anything concerning, until a breast MRI shortly before her surgery.

“That is when we found the small tumor in my right breast,” Ross said.

Ross' doctor at the time, Dr. Jennifer Plichta, had warned Ross it was possible one of the scans would spot signs of breast cancer in its early stages due to her inherited gene. Even still, Ross said nothing could have truly prepared her for that moment.

“When I actually saw it – shock,” Ross recalled. “I knew it was a possibility, that’s why we do all of the imaging. But when they came and told me there was something and they were going to send me for an ultrasound, I was just in complete shock.”

The discovery of her breast cancer came about two weeks before her surgery date.

Ross also underwent four cycles of chemotherapy and had breast reconstruction surgery in August 2022.

“It was very surreal in the timing of how it all played out, and I’m very thankful that it played out in that way,” Ross said. “If I never had the testing, who is to say what that trajectory would have looked like.”

Ross became part of an alarming statistic of more young patients being diagnosed with cancer.

Statistics from the American Cancer Society show that in 2022, cancer incidence rates for women younger than 50 surpassed men for the first time ever. The report found young women are 82% more likely to develop cancers.

The issue is one Dr. Rani Bansal with the Duke Cancer Institute told WRAL she has seen firsthand in patients.

“I remember within the first few months of me starting here at Duke, I saw a 21-year-old patient with breast cancer. I had never seen someone that young before,” Bansal said.

Bansal said the shift in who breast cancer is impacting requires clinicians to recognize age may not be as large of a contributing factor as it once was.

“I think a lot of times younger patients are seen in urgent care or in the emergency department or by another provider and it’s thought, ‘Oh that can’t be breast cancer. It’s probably a cyst or an infection,” said Bansal. “I think sometimes that’s why younger patients are delayed in terms of their diagnosis or seeking care, and get diagnosed at a later stage, because there’s such a delay in figuring out what’s going on.”

The physician explained more research is needed to understand what’s causing the increase.

“This is a different patient population. They have different needs than our patients who are older and are going through breast cancer,” she said.

The idea to find a better way to help young patients led Bansal to create the BEYOND BC program through Duke Health.

“That stands for boost and empower young onset network at Duke for breast cancer,” Bansal explained. “The goal is to focus on patients under the age of 40 with the diagnosis of breast cancer – localized or metastatic.”

The physician said the program will utilize existing programs at Duke, such as nurse navigators, but tailor how they are used specifically for the needs of younger patients.

“There's also going to be a research component. We're also looking at following the patients in terms of their outcomes, how they do over time, and for clinical trials as well,” Bansal said.

She continued, “It’s very different treating breast cancer in a 30-year-old than someone in their 70s, and I think we just need more information on that. That’s what this program will help us get as well.”

The program will also help connect patients with each other. Bansal added additional support will help patients better navigate life challenges that come with a young diagnosis, such as fertility questions and disruptions to career growth.

Ross said her own experience has already helped better shape the way she connects with and cares for patients.

“I can definitely empathize with patients in a very different way,” Ross said. “The side effects that you feel from chemotherapy, how you feel recovering from surgery, how it affects your normal life; it can be very difficult.”

The nurse told WRAL she is excited to see the program officially launch so that more patients can benefit from specialized care.

“When you're going through chemotherapy, or you're having breast reconstructive surgery or a mastectomy, your life kind of halts to a sense,” Ross added. “I think having a clinic where different support services are able to help you to navigate that, I think that will be huge.”

Bansal said the goal is to launch the program this November.

WRAL dives deeper into increasing cancer diagnoses among young patients in the documentary Diagnosis Young: The New Face of Cancer in NC.