“Bachelorette” alum Katie Thurston, 35, uses her public platform to raise awareness about breast cancer in younger women while navigating her own metastatic, triple‑positive diagnosis with honesty and optimism.
Thurston’s type of cancer is marked by the presence of estrogen receptors (ER), progesterone receptors (PR), and HER2 — a combination that accounts for just 5–10% of all breast cancer cases and typically requires a layered treatment plan involving chemotherapy, HER2‑targeted therapy, and hormone therapy.
Despite the challenges of lifelong treatment, Thurston’s tumor has shrunk, allowing her and her medical team to postpone a planned double mastectomy (removal of the breasts) as she responds well to therapy.
Thurston previously shared that her treatment regimen includes ribociclib, a targeted therapy taken with endocrine therapy. Lleuprolide, a hormone therapy, and Letrozole, which is an aromatase inhibitor that reduces the body’s estrogen production, are commonly used in postmenopausal women with hormone-sensitive breast cancer.
Recent data from the National Cancer Institute confirms a troubling trend: cancers such as breast, uterine, and kidney are rising among people under 50, with the most dramatic increase seen in those between 20 and 29 years old. The Centers for Disease Control and Prevention (CDC) adds that “about 10% of all new cases of breast cancer in the United States are found in women younger than 45 years of age.”
“Bachelorette” alum Katie Thurston, 35, has stepped into the public eye with remarkable openness as she navigates life with breast cancer.
During a recent podcast conversation with actress Miranda McKeon, 24, Thurston reflected on the responsibility that comes with her platform, saying, “In a weird way, I’m thankful I’m someone who has breast cancer because I have this massive platform for women whom I can educate that cancer does not happen 40 and above — it can happen at any time, and here’s how to be proactive.”
Thurston first disclosed her diagnosis in February 2025, revealing she had stage 3 triple‑positive ductal carcinoma, a rare and aggressive form of luminal breast cancer.
Cancer Cell International describes triple‑positive breast cancer as a subtype marked by the presence of estrogen receptors (ER), progesterone receptors (PR), and HER2 — a combination that accounts for just 5–10% of all breast cancer cases and typically requires a layered treatment plan involving chemotherapy, HER2‑targeted therapy, and hormone therapy.
Just one month later, Thurston learned the cancer had spread to her liver, advancing her diagnosis to metastatic (stage 4).
NEW YORK, NEW YORK – OCTOBER 09: Katie Thurston attends The Pink Agenda Annual New York City Gala at Tribeca Rooftop on October 09, 2025, in New York City. (Photo by Noam Galai/Getty Images for The Pink Agenda)
“One important test is checking to see if the cancer has metastasized. Unfortunately for me, mine has,” she shared in a March 2025 Instagram update.
She continued treatment, including ongoing chemotherapy, and spoke candidly about the emotional and physical toll.
“If you’re asking how long treatment is, technically forever. I am optimistic about medical advancements in the future. Fingers crossed as a stage 4 girly,” she wrote, also acknowledging the challenges of side effects like hair loss.
WATCH: Chemotherapy Side Effects
By the end of last year, Thurston offered a hopeful update: her tumor was “still shrinking.” She added, “It is my hope that one day those scans can’t detect the cancer anymore, but for a six-month check-in, this is really good news.”
WATCH: When to Consider a Mastectomy?
Thurston had been preparing for a double mastectomy in November, but the positive response to treatment prompted her and her medical team to postpone the surgery. As she explained, “Major surgery requires pausing medication for an extended period of time,” a risk they agreed wasn’t necessary given her encouraging progress.
Stories like Thurston’s and McKeon’s are at the heart of SurvivorNet’s Breast Cancer Dialogues series, which fosters a space where women feel seen, supported, and empowered to share their experiences — from diagnosis and treatment to relationships, recovery, and everything that comes with the journey.
Katie and Miranda’s Shared Experience
Both Thurston and McKeon were diagnosed with breast cancer at young ages.
McKeon was diagnosed with stage 3 breast cancer at 19.
(@miranda.mckeon/Instagram)
Stage three breast cancer typically refers to a relatively large tumor that may have invaded nearby skin or muscle tissue. It may also mean that lymph nodes near your breast and/or under your armpit are involved. In most cases, stage three breast cancers will need chemotherapy. If the cancer is also hormone receptor-positive, aggressive hormonal therapy may be offered as well.
WATCH: Understanding Stage 3 Breast Cancer
After going to see her doctor about it, she underwent a mammogram, which screens for breast cancer. She also underwent a biopsy and an ultrasound. The tests confirmed her diagnosis of stage 3 hormone-positive breast cancer in June 2021. Interestingly, the young actress said she did not have a family history of the disease.
“I spent most of that time confused and scared, but mostly in shock,” she told Coping magazine. Most of us go through life believing that we are untouchable. It’s a crazy feeling when the spinner lands on you.”
After chemotherapy, she underwent a double mastectomy and reconstruction, followed by 25 rounds of radiation.
McKeon’s breast cancer is hormone-receptive, meaning it needs the hormones estrogen and/or progesterone to grow and thrive. To combat this, doctors may want to lower a patient’s estrogen levels to help slow the growth of the cancer or prevent it from returning.
NEW YORK, NEW YORK – SEPTEMBER 08: Miranda McKeon attends the CLD PR NYFW Kickoff Event & Gifting Experience at Public Hotel on September 08, 2023 in New York City. (Photo by Daniel Zuchnik/Getty Images for CLD PR)
The treatment McKeon is taking, Lupron (generic name leuprolide), is a hormone therapy shot that aims to reduce her estrogen levels so her cancer does not grow.
“This shot is what keeps me in medically induced menopause. What it does is quiet the ovaries…Lupron keeps them quiet like a little baby and lets the chemotherapy pass over without doing a ton of damage,” McKeon explained.
WATCH: Understanding hormone therapy for breast cancer.
Lupron (generic name leuprorelin) is a type of hormone therapy for breast cancer. It acts as an ovarian suppression drug that stops the ovaries from making the hormone estrogen.
Lupron is usually given by injection into a muscle once a month or every three to six months. The length of treatment varies, and your doctor can determine that information.
Some known side effects of Lupron may include tiredness or fatigue, hot flashes, spotting, and muscle or joint pain.
Young and Diagnosed
“You’re almost like trained that cancer doesn’t happen until you’re like 40 and above, which is obviously not true. It’s unfortunate that’s how insurance is laid out, and it sort of tricks us a little bit so we’re not as proactive as we should be for our breasts,” Thurston said.
Recent data from the National Cancer Institute confirms a troubling trend: cancers such as breast, uterine, and kidney are rising among people under 50, with the most dramatic increase seen in those between 20 and 29 years old. The Centers for Disease Control and Prevention (CDC) adds that “about 10% of all new cases of breast cancer in the United States are found in women younger than 45 years of age.”
The American Cancer Society (ACS) suggests women should begin annual mammogram screenings for breast cancer at age 45 if they are at average risk for breast cancer.
The ACS also advises:
Women aged 40-44 have the option to start screening with a mammogram every year
Women aged 55 and older can switch to a mammogram every other year
Women aged 55 and older could also choose to continue yearly mammograms
Although research suggests more young people are screening, which can help catch cancer development in earlier stages, there exists the risk of overdiagnosis.
Younger women, for example, have been found to have more false positive events and biopsies, leading to anxiety, when compared to older women.
Overall, early screenings may take a toll on the emotional, physical, psychological, and financial aspects of a person, but Dr. Paul Doria-Rose, Ph.D., chief of NCI’s Healthcare Assessment Research Branch, tells the National Cancer Institute that “more research is needed to learn how frequently some screening harms happen.”
Helping Patients Cope with a Breast Cancer Diagnosis
Although Thurston’s double mastectomy (removal of both breasts) is delayed, eventually she expects to have it. When it comes to breast cancer surgery, there’s no one-size-fits-all approach. Choosing between a lumpectomy and a mastectomy is a deeply personal decision—one that depends on a range of medical and emotional factors.
“As a breast surgeon, my job is to help patients understand that their long-term survival with mastectomy is equivalent to that with lumpectomy and radiation,” says Dr. Sarah Cate, Chief of Breast Surgery at Stamford Hospital.
Still, many women request a double mastectomy (removal of both breasts), believing it offers the best protection against recurrence. But that’s not always the case. The size of the tumor, its genetic profile, and a patient’s family history all play a role in determining the most appropriate surgical path.
WATCH: Should I Have a Lumpectomy or Mastectomy?
“Mastectomy has very specific indications,” Dr. Cate explains.
“Some of the things that would predict a mastectomy are things like a large tumor size to breast ratio, or having cancer in more than one area of the breast, or having a genetic mutation.”
Katie Thurston, who recently shared her breast cancer journey publicly, is preparing for a double mastectomy. While this procedure is often part of treatment, it’s also used preventatively for women at high risk of developing breast cancer.
“A double mastectomy typically takes about two hours for the cancer part of the operation, the removal of the tissue,” says Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System.
“The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
WATCH: What Goes Into a Double Mastectomy
Today, most women choose to undergo some form of reconstruction, which can significantly extend the duration of surgery—especially when tissue is transferred from another part of the body.
“When you take tissue from another part of the body and transfer it to fill in the empty space where the breasts are, this is a very long operation,” Dr. Port says.
“It can take anywhere from six to 12 hours because it’s really like having a tummy tuck and then transferring the tissue and grafting the tissue, connecting the vessels, so those tissues have blood flow to live in,” Dr. Port adds.
For women with a strong family history or a known genetic mutation—such as BRCA1 or BRCA2—the decision to undergo a preventative mastectomy may be the most effective way to reduce their risk.
“Risk-reducing mastectomies are an operation where we take women at, usually, very high risk for getting breast cancer,” Dr. Port explains. “For genetic mutation carriers, who are the ones at the highest risk, there’s unfortunately only one way to actually prevent breast cancer.”
WATCH: Getting a Preventive Mastectomy
Women who test positive for a BRCA mutation typically face two options.
“One is what’s called high-risk surveillance, which means we check them every six months or so—mammograms, MRIs—with the hope that if, God forbid, they develop breast cancer, we pick it up early,” Dr. Port says. “But that’s not prevention, that’s early detection.”
“Early detection is a goal, it’s not a guarantee. For the woman who wants to be more proactive about actually preventing breast cancer, or as we say, reducing her risk, unfortunately, the only way to do that is to remove the actual tissue at risk, and that is the breast tissue,” she adds.
Katie’s Ongoing Treatment
Thurston previously shared that her treatment regimen includes three key medications:
Kisqali (ribociclib): Approved by the FDA in 2017, this targeted therapy is used in combination with endocrine therapy to treat HR+/HER2- breast cancer. It works by slowing the progression of cancer, offering a more tolerable alternative to traditional chemotherapy.
Lupron (leuprolide): A hormone therapy injection that lowers estrogen levels in the body, helping to prevent the cancer from growing.
Letrozole: An aromatase inhibitor that reduces the body’s estrogen production, commonly used in postmenopausal women with hormone-sensitive breast cancer.
Treatment Options for Advanced Breast Cancer
Metastatic breast cancer (also called stage 4) means cancer cells have spread from the breast to other parts of the body, which may include the bones, liver, lungs, brain, and beyond.
Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different body parts, where they grow as new tumors.
As the cancer spreads to other body parts, patients may experience additional symptoms depending on where the cancer has spread. Examples include:
Bones: Severe bone pain or fractures
Lungs: Difficulty breathing, chest pain, new cough
Liver: Yellowing of the skin (jaundice), abdominal pain, nausea, and/or vomiting
Brain: Headaches, memory loss, changes in vision, seizures
WATCH: Treatment options for metastatic breast cancer.
Although stage 4 breast cancer is not curable, several treatment options exist that can extend the life of patients. Treatment options depend on the stage, type of primary breast cancer, and whether hormone receptors are positive.
Treatment can include a combination of:
Chemotherapy: Oral or IV medications that are toxic to tumor cells
Hormonal therapies: Drugs that lower estrogen levels or block estrogen receptors from allowing the cancer cells to grow
Targeted therapies: Drugs that target your tumor’s specific gene mutations
Immunotherapy: Medications that stimulate your immune system to recognize and attack cancer cells
Radiation: The use of high-energy rays to kill tumor cells and shrink tumors
Surgery: To remove a cancerous tumor or lymph nodes (uncommon with stage IV; more common in stages I, II, and III)
Clinical trials: Studies of new medications, treatments, and other therapies offer hope for better outcomes.
Questions to Ask Your Doctor
If you’re facing the option of having a mastectomy, here are some questions to consider asking your doctor:
What can I do to prepare for a double mastectomy?
What happens before and after the procedure?
For reconstruction, what are the benefits of using implants over my own tissue and vice versa?
