They bonded over having breast cancer under 40. Now they're helping prevention in others

Before Lauren Dages met Markeeta Morrow, she knew no one other than herself who had breast cancer at the young age of 31.

So when Dages and Morrow met, they bonded instantly. Not only did they share a health history of triple-negative breast cancer, which tends to be harder to treat than other forms of the disease, they also both had infants under the age of 1. Now, the two are banding together to reach out to other young women and warn them that even those younger than 40 can find themselves facing a breast cancer diagnosis.

While breast cancer in women this young remains quite rare, experts worry that the number of breast cancer cases among women younger than 50 is on the rise. Ending a longstanding debate over when women should start having mammograms, the U.S Preventive Services Task Force in May joined many other organizations in recommending that women of average risk begin screening at 40. Previously, the group advised women to start at 50, but evidence that breast cancer is increasing in women in their 40s helped prompt the change.

Estimates suggest that between 4% to 7% of women in the United States who are diagnosed with breast cancer are under the age of 40, however, so doctors urge that women do regular breast exams to detect any changes. Women at age 30 have a 0.5% chance, or 1 in 204, of being diagnosed with breast cancer compared to about a 1.6% or 1 in 65 chance one decade later, according to the National Cancer Institute.

At their initial meeting last fall, Dages and Morrow could not stop talking.

“It was like we were the best friends because we had just so much in common,” Morrow said.

Added Dages: “Our lives line up a lot.”

They learned that they had even more in common than having been diagnosed in mid-2021 with triple-negative breast cancer, which unlike other forms of breast cancer typically does not respond to hormone or targeted therapy. Both had boys born on July 22, 2020.

Dages and Morrow are not necessarily unique in their struggle with breast cancer at such a young age.

In her role as medical director of the breast care program at Community Health Network in Indianapolis, Dr. Erin Zusan sees more young women being diagnosed with the disease. Lifestyle changes such as increased alcohol consumption and obesity contribute, along with better imaging to detect cases earlier, Zusan said.

That earlier detection can be critical.

“The sooner we find things, the more treatable it is,” said Zusan, whose health system strives to see newly diagnosed patients within 48 hours.

Now Dages and Morrow are spokeswomen for Community's Commit to One campaign, which urges women to do one self-breast exam one day each month.

If women detect any change, they should watch it for a week or two or through one menstrual cycle and if something continues to feel off, contact a health provider, Zusan said. Young women may shy away from reaching out, afraid that they’re overreacting, she added. That should not detract them.

"You’re not wasting our time. We would rather give you good news and explain what they’re feeling if it’s not cancer,” she said. “We don’t want to ignore something that someone feels is a change from their normal.”

Dages' diagnosis

Three years before her breast cancer diagnosis in May of 2021, Dages had her first mammogram after noticing some dark red-brown nipple discharge.

The mammogram found nothing and her doctor attributed the discharge to birth control. He told her she had nothing to worry about because she was healthy and young with no family cancer history. In retrospect, she said, she wished the doctor had recommended she return for annual follow-up exams. Instead, she did her own self-exams.

When she first noticed something off a little more than half a year after her son was born, she wasn’t too concerned, given that prior experience.

“I do think it gave me a little bit of too much confidence at first, me assuming it has something to do with my breastfeeding because who else in their late 20s has had a mammogram and been told you were completely fine?” she said.

In the spring of 2021, she noticed her milk volume had decreased in the breast with the lump. The lump, a rosy hard stone, seemed to go away when her milk let down and then return. But after she stopped breastfeeding, the lump remained.

On the one hand, Dages feared that something was amiss. On the other, she remembered her earlier experience, how doctors had dismissed her fears, and she worried that she was “the girl that cried tumor.”

The fear preyed on her mind enough that she mentioned it to one of the clients in her hair salon, a nurse practitioner. The woman felt the lump through her shirt and recommended another mammogram.

The mammogram technician did two rounds and then asked her to stay for an ultrasound. Only after the ultrasound, when the technician said a doctor would come in to speak with her, did Dages realize this could be serious. The doctor told her they would need to do a same-day biopsy. As she was waiting for the biopsy, she called her husband and burst into tears and said, “This is bad. This is bad.”

A few days later, her worst fears were confirmed.

Morrow’s diagnosis

Morrow’s diagnosis came a few months later in August 2021. She, too, noticed a new lump. She had already made an appointment to see her primary care doctor when her best friend, a nurse, met her for dinner. Morrow, who lives on the far east side, mentioned the lump and right then and there in the restaurant, the friend stuck her hand down her shirt. See the doctor, she said.

Her primary care doctor sent her for a mammogram and while she was there, they did an ultrasound as well. The next day she came back for a biopsy.

That weekend Morrow went to Puerto Rico. Unlike Dages, she had few fears. She had had a tough life already, she figured. What else could go wrong? That Monday her doctor called her at work, answering that question.

Morrow told her boss she was going home.

“And I just got up and left and I went home and of course cried and boohoo about it,” she said. “But I think I'm like one of those people where I'm just like, OK, this is where we're at, right? So now what do we do?”

Her nurse friend connected her with doctors at Community Health Network and just as they had with Dages, they sat down and charted a treatment path.

The treatment

At the time of diagnosis, Dages had a tumor that measured 5.5 centimeters, Morrow had one 3.6 centimeters in size. Both were diagnosed with a highly aggressive form of triple-negative breast cancer.

Morrow had two teen boys already and was not thinking about having children in the future. Dages and her husband, however, had just started their family. Before she had surgery or chemotherapy, Dages had her eggs retrieved. Time was of such the essence that the staff came on a Sunday to make sure she had her best shot at freezing her hopes of a larger family.

Then came four months of chemotherapy, followed by a double mastectomy and radiation because while the tumor shrank, it did not respond completely to the chemotherapy. Throughout, Dages seemed to suffer any side effect possible, no matter how rare. To this day, her son calls the bedroom she and her husband share “Mommy’s room” because she spent so many days confined to it.

Morrow’s treatment consisted of six months of chemotherapy and a double mastectomy. During that time, Morrow had COVID-19 twice. At one point, she recalled, she lay on a pallet in her son's room because she was too weak to pick him up. Her ex-husband came over to stay with her on days she had chemo to help with the baby and her older sons did what they could. But Morrow didn’t want to burden them.

As Dages and Morrow recount their journeys, they bond over the bad times – such as losing their hair and eyebrows, experiencing what chemo can do to nails and skin, and the “red devil,” a particularly nasty chemotherapy that left them sick for days. And, they both felt like outliers at the treatment center, surrounded by people far older than them.

Often Morrow sensed others in the treatment center assumed she was there as a caregiver for an older relative. She approached each session with a positive attitude, dressing in all pink and providing her friend who accompanied her with a matching pink T-shirt, as she put it, looking like “Pepto Bismol twins.”

“I should have known you during my treatment,” Dages said, saying perhaps their friendship would have made her a little less bitter about all she faced.

But she followed that up, wondering if she would have ever approached Morrow if she had seen her at the treatment center. Instead, she might have thought, I’m not talking to her. She’s having too good of a time.

Now that they have put cancer behind them for the most part, they can reminisce about the lighter side of their cancer journey, sharing anecdotes about choosing implants with their male partners. Morrow recalls how involved in the decision her boyfriend was, to the point where, she jokes, one might think they were going in him not her. Dages said her husband, when asked which one he preferred, cautiously answered, whichever one made her happy.

More health news: Should I drink that Diet Coke? What WHO says about the potential health risks of aspartame

The recovery

The two might never have met if not for the Community Health Network marketing team, which was planning a campaign to encourage young women to do breast self-exams.

Corporate Communications Director Kris Kirschner knew Dages while her colleague Communications Manager Bobbie Brooks had met Morrow. They realized the two women would be the perfect spokespeople for Community’s Commit to One campaign for women under 40 who fall outside the mammogram guidelines.

“Their stories are so similar, it’s unreal,” Kirschner said. “It seemed so unusual, being as young as they were, wouldn’t it be nice for them to connect.”

Before her diagnosis, Dages said, she like many of the women the campaign is trying to reach had never thought that she might have breast cancer, given her age. All her life, she had learned that women who have no family history of breast cancer, have no need to worry before the age of 40.

“I think we get overly confident about that,” Dages said. “No one is too young for cancer.”

Young people who have cancer wind up with different concerns than those who are diagnosed later in life. Dages had always hoped to have multiple children, but until she hits the five-year survivor mark those plans are on hold. She’s optimistic but also wary.

More health news: What's to blame for certain cancer outcomes? New studies confirm: sex matters

Now Dages offers a discount at her Atelier Salon for people going through cancer treatment. She helped style the hair of one woman who had a bald spot left from radiation therapy. For another woman going through chemo, Dages created a new look with a pixie cut and highlights.

Morrow is just relishing the sense that life has returned to a semblance of normal.

“I will say this when you're in it. It feels like it's going really, really slow,” she said. “But…it's only been two years and look where we're at. Like we're laughing about it and our hair is growing back and we're just living life and flourishing.”

Contact the reporter at shari.rudavsky@indystar.com or at 317-444-6354.