FORT WORTH -- Deetria Horne was at home, diligently performing a self-examination of her breasts, when she felt it.
It wasn't a lump, but more like a thickening in the tissue.
"Wow, that's strange," Horne thought on that day in November 2011.
The discovery didn't set off alarms in her head. Horne, just 35 and a professional marketing manager, merely filed it away as something for her doctor to check after the holidays.
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Two months, a mammogram and an ultrasound later, the doctor broke the news. She had Stage 3 breast cancer.
"I can only describe it as going through all the stages of grief," Horne said. "At first, I was shocked and in denial. Then I got sad. Then I was laughing and crying about it at the same time on the same day. My mind was blown."
Women under 40 years old account for less than 7 percent of breast-cancer cases, which can make their diagnosis feel even more shocking.
Horne found herself navigating the frightening world of cancer at an age when many women are focused on careers, dating or starting a family.
Last week, a new study concluded that the incidence of advanced breast cancer in women age 25 to 39 has grown slightly, and steadily, in the past three decades. The report, published in the Journal of the American Medical Association, did not identify a cause but speculated that there was likely more than one.
The rate of metastatic breast cancer in young women rose from 1.53 per 100,000 in 1976 to 2.90 per 100,000 in 2009, a small but statistically significant change, the study found.
Some doctors say they have seen anecdotal evidence that supports the study's findings, said Dr. Robin Skrine, medical director of the breast health program at Texas Health Harris Methodist Hospital Fort Worth. The hospital offers 3D mammography that can better identify cancer, she said, which is important because younger women have thicker breast tissue.
"Sadly, I think [the study] confirmed what a lot of physicians were fearful of: that there are an increasing number of young women getting breast cancer and the disease is worse," Skrine said.
Other experts, however, caution that the findings shouldn't cause alarm and that more research is needed.
But the study does highlight the need for greater support for younger cancer patients, advocates for prevention and awareness say.
"They face a whole range of issues that might be a little different," said Suzanne Beckmann, a spokeswoman for the Young Survival Coalition, which helps breast cancer patients age 40 and under. "They might be just starting careers or thinking about having a family and now are worried about infertility after chemotherapy.
"They might struggle more with body image issues if they're single, have had a mastectomy and would like to start dating."
Horne's cancer had spread to her lymph nodes before she discovered the change in her tissue. It might have spread further if not for her mother's own bout with breast cancer in 2008. After her mother successfully underwent treatment, Horne started checking herself.
Still, that awareness didn't make it any easier to tell her family that she was sick. She eventually underwent chemotherapy, six weeks of radiation therapy and surgery to remove both breasts and 21 lymph nodes
"Watching my family deal with their emotions was hard," she said. "My mom was angry. She was more scared for me than she was for herself when she went through it."
Organizations that combat breast cancer are expanding efforts to involve younger women.
This month, Susan G. Komen for the Cure of Greater Fort Worth will launch a young professionals group to become voices in the community for the organization, said Jennifer Wersal, a Komen assistant director.
The new group, which is open to all young professionals, not just cancer survivors, will form just before the organization's April 6 Race for the Cure. The event raises money for education, screening, treatment and research.
Wersal has particular insight into the challenges young breast cancer patients face. She was diagnosed at age 30.
"I kind of have radar if I see a young survivor or a young lady calls," Wersal said. "Unscientifically, yes, I would say we have seen more young survivors looking to get involved. We always hope to engage these young people."
Melanie Medina, 35, of Flower Mound, found online support two years ago when she blogged and shared Facebook statuses about her illness and the double mastectomy, chemotherapy and breast reconstruction surgery that followed.
She was just 33, a married mother of two young children, when she felt the lump in her breast while showering on Christmas Eve. She forced it out of her mind during Christmas dinner, then learned she had cancer a few weeks later.
On her blog, the health care communications professional described her difficulty focusing on job duties such as editing a newsletter and hesitating to sign her young daughter up for ballet because she might be having surgery.
She recounted the challenge in filling out the monster-themed invitations for her son's first birthday party.
"Your mind shuts everything else out so that the only thing there is cancer," she wrote. "Everything around you slowly, gradually grinds to a halt."
Medina eventually connected with two women who were her age when they were diagnosed with breast cancer.
"They told me their cancer stories, what kind of shirts I would need to wear after my mastectomy, and how horrible chemo was," she said. "I was very open about my experience on Facebook, and I am glad I was because I got a lot of support and love. And that is so important."
Alex Branch, 817-390-7689