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It was the fall of 2017. Abby Koch was 24, and life was good.
				In one week, she experienced three major life milestones &mdash; two that were uplifting, one that could have been devastating.
				She and her fiance (now husband) closed on a house. She achieved full-time status at her job in the medical field.
				And she was diagnosed with stage 3 invasive ductal breast cancer.
				While her training put Koch in a good position to understand her condition and subsequent treatment, the diagnosis at such a young age was a shock.
				&ldquo;Never did I think it was even a possibility,&rdquo; the Swoyersville resident, now 28, said this week.
				The only relative Koch knew of who had been diagnosed with breast cancer was her father&rsquo;s first cousin, and subsequent genetic testing came back negative.
				&ldquo;They do not know,&rdquo; Koch said when asked whether her doctors could pinpoint what may have caused her cancer.
				What is known is that Koch is among a relatively small number of Americans diagnosed with breast cancer under 40 &mdash; the age at which many women go for their first mammogram, although some recommendations call for the screenings to begin even later.
				According to the Young Survival Coalition (YSC), a New York-based organization dedicated to providing information and support for young adults facing breast cancer, out of the nearly 232,000 new cases of breast cancer in 2015, an estimated 12,150 cases of breast cancer were in women under 40. Every year, more than 1,000 women under age 40 die from breast cancer, YSC notes.
				Also: Nearly 80% of young women diagnosed with breast cancer find their breast abnormality themselves, the group points out.
				That was the case with Koch.
				&ldquo;I found a palpable lump,&rdquo; she recalled.
				Koch immediately turned to her doctor, and was scheduled for an ultrasound and a mammogram. Within a week, test results confirmed the cancer.
				She had to undergo chemotherapy before surgery to shrink the tumor, followed by a lumpectomy and testing to determine whether the cancer had spread.
				While the margins were negative at first, lab tests revealed metastatic involvement in a lymph node, resulting in axillary dissection.
				Between chemo and radiation, Koch&rsquo;s treatment would extend from September 2017 until May 2018.
				Like most who undergo the procedure, Koch acknowledged that chemotherapy, in particular &ldquo;was tough,&rdquo; and that the entire process was very emotional.
				Still, she worked throughout treatment &mdash; taking a only few days off as needed &mdash; and maintained what many praised as her positive attitude.
				Again, her career knowledge also came in handy.
				&ldquo;I think that helped me,&rdquo; she said. &ldquo;I didn&rsquo;t necessarily know what to expect, but I knew what was supposed to happen next.&rdquo;
				And like so many cancer survivors, Koch credits a strong support network, including her family and her fiance&rsquo;s family and many friends.
				Since her diagnosis and treatment, Koch has attended a breast cancer camp for women in the Poconos, and encourages others &mdash; at any age &mdash; to be aware of any changes in their bodies, including doing regular breast self-exams and taking an active role in their care.
				&ldquo;Be your own advocate,&rdquo; she said. &ldquo;If you feel something is wrong, tell your doctor.&rdquo;
				&ldquo;And,&rdquo; she said, &ldquo;always have a positive attitude.&rdquo;

Breast cancer survivor reflects on diagnosis at young age