Younger women generally do not consider themselves to be at risk for breast cancer. Just under 7% of all breast cancer cases occur in women under 40 years old. However, breast cancer can strike at any age, and women of every age should be aware of their personal risk factors for breast cancer.
There are several factors that put a woman at high risk for developing breast cancer, including:
• A personal history of breast cancer or some non-cancerous breast diseases.
• A family history of breast cancer, particularly in a mother, daughter, or sister.
• History of radiation therapy to the chest before age 40.
• Evidence of a specific genetic defect (BRCA1/BRCA2 mutation). Women who carry defects on either of these genes are at greater risk for developing breast cancer.
• A Gail Index score of at least 1.7% (The Gail Index uses risk factors such as age, family history of breast cancer, age of first menstrual period and first pregnancy, and number of breast biopsies to calculate a woman’s risk of developing breast cancer within the next five years.)
• Other risk factors include heavy alcohol use, high intake of red meat, dense breasts, obesity, and race.
Some studies have suggested that recent use of oral contraceptives (the Pill) results in a very slight increased risk for developing breast cancer over those who have never taken them. Women who have stopped using birth control pills for more than 10 years do not seem to be at any greater risk. Other studies, however, show no such effect. Researchers continue to study the conflicting results in these trials to determine if birth control pills play a role in breast cancer.
What Is Different About Breast Cancer in Younger Women?
Diagnosing breast cancer in younger women (under 40 years old) is more difficult because their breast tissue is generally denser than the breast tissue in older women. By the time a lump in a younger woman’s breast can be felt, the cancer often is advanced.
In addition, breast cancer in younger women may be aggressive and less likely to respond to treatment. Women who are diagnosed with breast cancer at a younger age are more likely to have a mutated (altered) BRCA1 or BRCA2 gene.
Delays in diagnosing breast cancer also are a problem. Many younger women who have breast cancer ignore the warning signs — such as a breast lump or unusual discharge — because they believe they are too young to get breast cancer.
Many women assume they are too young to get breast cancer and tend to assume a lump is a harmless cyst or other growth. Some health care providers also dismiss breast lumps in young women as cysts and adopt a “wait and see” approach.
Can Breast Cancer in Younger Women Be Prevented?
Although breast cancer may not be prevented, early detection and prompt treatment can significantly improve a woman’s chances of surviving breast cancer. More than 90% of women whose breast cancer is found in an early stage will survive.
When women learn at a young age about the risks and benefits of detecting breast cancer early, they are more likely to follow the recommendations regarding clinical exams and mammograms. Young women also need to understand their risk factors and be able to discuss breast health with their health care providers.
Should Women Under Age 40 Get Mammograms?
In general, regular mammograms are not recommended for women under 40 years old, in part, because breast tissue tends to be more dense in young women, making mammograms less effective as a screening tool. In addition, most experts believe the low risk of developing breast cancer at a young age does not justify the radiation exposure or the cost of mammography. However, screening mammograms may be recommended for younger women with a family history of breast cancer and other risk factors.
What’s the Best Way for Younger Women to Screen for Breast Cancer?
The American Cancer Society (ACS) says that breast self-exams are optional for women starting in their 20s. Doctors should discuss the benefits and limitations of breast self-exam with their patients.
Regular clinical breast exams performed at least every three years by your doctor are recommended for women beginning at age 20. The ACS also recommends annual screening mammograms starting at age 40. However, the U.S. Preventive Services Task Force (USPSTF) does not recommend routine screening for women in their 40s. For women between the ages of 50 and 74, USPSTF experts say women should have screening mammograms every two years and do not recommend screening at all after age 74. When you need a mammogram is a personal decision between you and your doctor. If you’re over 40, talk to you doctor about when you should begin mammogram screening. Women younger than 40 who have a family history or other risk factors for breast cancer should discuss their risk and an appropriate screening schedule with their health care providers.
How Is Breast Cancer Treated In Younger Women?
The course of treatment for breast cancer at any age is based on the extent of the person’s disease (whether or not it has spread beyond the breast), as well as the woman’s general health and personal circumstances.
Treatment options include surgery: either a lumpectomy, which involves removing the lump and some surrounding tissue, or a mastectomy, which is the removal of a breast.
Radiation therapy is generally used following a lumpectomy, and chemotherapy and/or hormone therapy often are recommended after surgery to help destroy any remaining cancer cells and prevent recurrence.
Breast cancer poses other challenges for younger women, as well, such as sexuality, fertility, and pregnancy after breast cancer treatment.
2 thoughts on “Danger: So many young women with breast cancer”
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