When she felt a lump on her left breast two years ago, Cate Morton thought it was probably nothing.
She was just 33, seven years from the recommended age to begin regular mammograms.
Most evenings, she pounded out pushups, box jumps and kettlebell swings with friends at Burn Boot Camp. And, as far as she knew, breast cancer didn't run in her family.
Still, Cate, a Duke University Conference and Event Services Staff Specialist, sent her doctor a Duke MyChart message, asking her to check it out at her next appointment.
At the appointment, when her doctor felt the lump, Cate realized it wasn't nothing.
"I could just tell by the look on her face," said Cate, who is among a growing number of young adults with lives interrupted by breast cancer.
The American Cancer Society reports breast cancer diagnoses among people under 50 has increased by about 1.4% per year . While the median age for a breast cancer diagnosis is 63, people under 45 now account for one of every 10 of them.
Duke Medical Oncologist and Assistant Professor of Medicine Dr. Rani Bansal often meets young people who are shocked to find themselves facing breast cancer.
"I have to tell them that, no, this happens," Bansal said. "It's not common, but it's also not rare."
Last year, 695 Duke employees received breast cancer treatments, the second most common type behind skin cancer. Meanwhile, the incidence rate of breast cancer among employees under 50 ticked up slightly.
Cate, diagnosed with stage 2, grade 3 invasive ductal carcinoma on Dec. 11, 2024, was one of them.
As we mark Breast Cancer Awareness Month in October, hear Cate's story.
In the Fight
Christmas has always been Cate's favorite holiday.
She knows she puts her tree up way too early. If a month ends in "-er," she's ready. She loves how the ornaments and lights make her feel like a kid again.
In the nervous weeks before her first chemotherapy treatment on New Years Eve 2024, she spent quiet mornings by the Christmas tree, letting happy childhood memories drown out the heaviness of the present.
"Sitting there gave me comfort, but at the same time, it was really difficult because I thought, 'Oh what I would do to go back to those times again,'" Cate said.
Soon, Cate's life became a series of three-week respites between difficult chemotherapy treatments.
The cold cap she wore during treatments in hopes of saving her hair was impossibly tight and kept her scalp painfully cold. Afterward, she'd spend days on the couch, her bones aching and her body weak.
Once she'd begin to feel better, it was time for another treatment.
She finished chemotherapy in April 2025 and underwent a double mastectomy a month later, putting the finish line to her cancer battle within sight. But after doctors noticed residual disease near the site of her surgery, Cate learned she'd need another 14 rounds of chemotherapy and radiation treatment to prevent a recurrence.
"That was devastating news to hear," Cate said. "I thought, 'Am I ever going to feel normal again? Am I ever going to be better?'"
A Network of Support
The specific challenges facing people like Cate is why Bansal created Duke Cancer Institute's Young Breast Cancer Program , which officially launched in February.
Currently based in the Duke Cancer Center, the program, known as BEYOND-BC, focuses on improving treatments and expanding clinical research for those diagnosed with breast cancer under the age of 40. Participants receive specially trained navigators to accompany them on their treatment journey and receive help with fertility concerns, access to medical and family therapists, discussions with sexual health professionals and guidance on discussing cancer with young children as well as many other resources specific to young breast cancer patients.
The program also tracks young patients - often underrepresented in clinical trials - over time, giving researchers valuable data.
"Patients in their 20s and 30s are at a transitional period in their lives," Bansal said. "They may be just finishing school or starting careers. They may be thinking about having a family or may have young children. They're in a very different stage than many other patients."
Detecting breast cancer in young adults is especially difficult. Women with average risk are recommended to begin getting mammograms at 40 . Duke's medical plans cover mammograms at no charge through in-network providers.
While some women begin screening earlier, it's often based on family history or other risk factors, none of which Cate had.
Bansal said it is vital to pay close attention to your body and report any changes, no matter how subtle, to a doctor.
"It's about knowing your body, knowing when something is wrong and not being afraid to ask about it," Bansal said.
Reflecting on her journey, Cate points to the decision to alert her doctor to the lump - and the seriousness with which her doctor took her concern - as what saved her life.
"You have to advocate for yourself," Cate said. "We know our bodies better than anybody."
Becoming a Survivor
One day well before last Christmas, Cate's mother, Mary, helped Cate decorate her tree.
For months, Mary, a Store Supervisor at the Duke North Hospital Gift Shop, accompanied her daughter to her appointments and treatments and visited Cate's place often after treatments to do laundry, collect mail or grab her daughter Cookout milkshakes whenever the post-therapy nausea relented enough to let Cate feel hungry.
"We were going to get through this," Mary said. "And I was going to be there for her."
For Cate, the Christmas tree drew mixed emotions.
It both rekindled memories of the dark times from the previous winter, but roughly halfway through her second set of chemotherapy treatments, it was also a reminder that there were joyful times ahead.
Cate finished chemotherapy in May 2026. While she regularly visits her oncologist to watch for recurrence and requires multiple medications to recover from chemotherapy, Cate cherishes every piece of her old life that she gets back.
In July, she returned to Burn Boot Camp. Accompanied by Mary and surrounded by friends who greeted her with tears and hugs, Cate struggled through her first workout in nearly a year.
"I still have so much wrong with my body, but it was arm day," Cate said about that day's upper-body workout. "Arm day has always made me feel strong. I was just like 'I needed this.'"
Recently, Mary has noticed Cate smiling a lot more. There's an optimism in Cate's voice Mary hasn't heard in years.
"This whole thing knocked her down a little bit," Mary said. "But she has been starting to seem like - I guess not the old Cate, but a new-and-improved Cate. I'm just so proud of her. I'm amazed by her."
And Mary can't wait for the call she'll get any day now asking her to come over to Cate's place to help her decorate for Christmas.
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