Amelia Hill was three months shy of her 23rd birthday when she noticed something strange happening to her body. The skin on her right breast began to peel and scab. Her nipple would bleed and get stuck to her bra or shirt. She discovered a small lump under her right arm.
At first, Hill didn’t think much about it. She was preparing to graduate from N.C. State University in the spring of 2014, and she hoped to attend law school. She swabbed her skin with Neosporin and slept in bigger shirts.
But eventually, unable to ignore the symptoms any longer, Hill saw a doctor at UNC REX Hospital in Raleigh.
“The first thing she said was, ‘This can’t be cancer. You’re way too young,’ ” Hill recalled.
It was cancer. Hill was diagnosed last January.
A woman’s risk of breast cancer increases with age. Most breast cancer cases affect women who are 50 or older, according to the Centers for Disease Control and Prevention. But it’s not unheard of for a woman in her early 20s to be diagnosed. About 11 percent of new breast cancer cases in the United States involve women younger than 45.
Dr. Rachel Jendro, a breast surgical oncologist at Rex who led Hill’s treatment plan, said she has treated three 23-year-old patients this year.
Hill had Paget disease of the breast, a rare form of cancer that affects the skin and nipple. She had a 2-centimeter mass under her right nipple.
Jendro said it’s heartbreaking to tell a young woman she has breast cancer. They have so much life ahead of them – getting married, having children, pursuing their dreams.
The most important message, Jendro said: “You’re not going to die from this.”
Hill had watched what lung cancer did to her grandfather during her senior year of high school in High Point. He was diagnosed in October 2008 and died two months later.
When Hill was diagnosed, she immediately worried about losing her long hair. Then other fears surfaced. Would the treatments to combat cancer wreak havoc on her reproductive system, making it impossible for her to have children?
“For me personally, it hurt my feelings,” Hill said. “That’s what I really wanted in life. It’s like taking a part of your future away.”
Sitting with Hill in the Cary apartment she shares with her parents, I could relate. I was diagnosed with severe endometriosis at the age of 27, and although I wasn’t at a point in my life where I was ready to start a family, I was terrified the choice to have a child might not ever be mine to make.
Hill didn’t dwell on the unknown for long. And trust me, fear of the unknown can be the worst kind of fear.
Two weeks after she learned she had cancer, her brother and his fiancée had a daughter, Khloé. Hill said the birth of her niece brought her hope and joy.
“It was really an answer to a prayer,” Hill said. “Khloé added life.”
Sharing health history
Hill went through months of chemotherapy treatments that left her exhausted and nauseous.
She would go in for treatment every two weeks, then feel sick for the next 11 days. That left her three days of freedom, when she would play basketball at the gym or eat out at Jimmy V’s or Outback Steakhouse.
Doctors removed lymph nodes under her arm. She opted for a double mastectomy with reconstructive surgery as a precaution because she had HER-2 positive breast cancer, an aggressive form involving a protein that helps cancer cells grow wild.
She is still receiving radiation treatments, but she is cancer-free.
Hill told me the ordeal has changed her life and helped her find new purpose. She’s urging other young women to learn how to recognize early warning signs of cancer. She’s also encouraging women to learn more about their families’ health histories and to get regular mammograms.
When Hill was diagnosed, she didn’t realize there was a history of breast cancer in her family. With some investigative help from her mother, Jamonica Hill, she learned that her paternal aunt had breast cancer in her 30s, and four great-great aunts also had the disease.
Too often, families don’t share enough about their health, said Jamonica Hill, 53.
African-American families in particular should be more open with each other, Jamonica Hill said.
Although Amelia Hill didn’t figure she had much reason to fear breast cancer, she said she has done regular self-examinations since high school – probably “too often.”
This fall, the American Cancer Society released new guidelines that raised the recommended age for annual mammograms from 40 to 45. Hill was disappointed with the change, and so was Dr. Jendro.
“Cancer is not a discriminator of age,” Jendro said. “I see 30-year-olds very commonly with breast cancer.”
Mostly, Hill said, it’s important for women to be aware of their bodies.
“You’re your own best advocate,” she said. “Nobody knows your body like you do.”
Hill still wants to go to law school; she plans to take the entrance exam in February. She would also like to earn a master’s degree in theology or religious studies.
Battling cancer showed Hill that life doesn’t always travel the path we map out. There are detours along the way, and that’s not always a bad thing.
“I was just trying to live up to other people’s standards, and I was really insecure with myself,” Hill said of her life before cancer. “Now I’m more confident.”
Through it all, Hill said, she has leaned on her faith and the support of friends and family.
“I knew she had strength, but it’s like another level of strength that she can endure anything,” Jamonica Hill said.
Amelia’s parents were living in New Jersey when she was diagnosed. Jamonica eventually quit her job with American Express and Derek Hill began working remotely so they could spend much of their time in Cary with their daughter.
Derek Hill said being closer to his daughter gave him peace, and he determined that his role was to instill faith.
Several family members gathered in Cary on Thanksgiving. Amelia felt well enough to cook, making baked chicken, corn pudding and sweet potato and pecan pies.
She plans to travel for Christmas, spending time with friends and Khloé.
This chapter of Hill’s life isn’t over yet. She will continue chemotherapy until April, and there is more reconstructive surgery ahead.
But she knows good things are on their way. Doctors tell her she has a good chance of being able to have children.
“She is just such a beautiful, beautiful young lady – so full of life,” Jendro said. “I don’t think I’ve ever seen her without a smile.”