Asha was 23 when she found a lump in her breast. She didn’t receive her diagnosis until a year later, because the doctor she saw during her initial visit told her that breast lumps were not uncommon in young women and that she shouldn’t worry about it. As months passed, Asha’s lump did not go away, so she returned for a mammogram that came back inconclusive. From there, Asha had a breast ultrasound and eventually a biopsy which proved that the lump was, in fact, breast cancer. “It was completely shocking,” she says. “In one second, your entire life changes and the problem was I had known [the lump] had been around a year and I almost knew it had spread. I thought, ‘Okay, I’m going to be dead soon.’”

Asha’s diagnosis story isn’t uncommon. According to Dr. Diane B. Wilson, co-leader of the Cancer Prevention and Control program in Massey Cancer Center in Richmond, Virginia, breast cancer in young women is oftentimes overlooked by both doctors and mammogram tests.

“Unless they’re in a high-risk family, women under 40 are not recommended to have a mammogram and even if they do, it’s harder to detect anything abnormal,” says Dr. Wilson. “Breast self exams have not been associated with lowering mortality rates of cancer, but we do find that a lot of women detect their own lumps.”

Because breast tissue in young women is firmer than in those over 40, finding tissue abnormalities and diagnosing them as cancerous is more of a challenge. The younger the patient is, the more likely a mammogram will come back as inconclusive.

The Young Survival Coalition, a nonprofit agency dedicated to supporting young women with breast cancer, reports that there are currently more than 250,000 women under 40 in the United States living with the disease. This year, more than 11,000 young women will be diagnosed with breast cancer and, of them, one out of every eleven will die.