Breast Cancer Has No Age Limits – Part 2

Bubbles for Breast Cancer Awareness!
Image by Scootzsx via Flickr

Younger women do not consider themselves to be at risk for breast cancer for the most part.  Only 5% of all breast cancers occur in women under 40 and while I know this numbers seems small, younger women need to know their personal risk factors.

There are several factors that put a woman at high risk for developing breast cancer, including:

  • A personal history of breast cancer or non-cancerous breast disease
  • A family history of breast cancer, particularly in a mother, daughter or sister
  • History of radiation therapy.
  • 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.)

So What Then Is Different About Breast Cancer in Younger Women?

Diagnosing breast cancer in younger women is generally more difficult because  breast tissue is generally more dense in the younger woman 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  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.  I have blogged about this in the past and I cannot say it loudly enough ‘IF YOU ARE EVER TOLD LET’S WAIT 6 MONTHS TO SEE HOW THINGS LOOK THEN, RUN OUT OF THAT OFFICE AND SEE ANOTHER DOCTOR IMMEDIATELY”.  I cannot say that enough – in my career as an Oncology nurse I have had to pull the sheet over the face of a young woman too many times whose life might have been saved if she had gotten a second opinion.

Is Prevention in Younger Women Possible?

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 following 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.

Mammograms Under Age 40?

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. This is something to discuss with your doctor.

What’s the Best Way for Younger Women to Screen for Breast Cancer?

The American Cancer Society (ACS) recommends that all women 20 years of age or older should perform monthly breast self-examinations . The best time to perform BSE is the day after your monthly period ends. Becoming familiar with the look and feel of their breasts offers the best chance for a young woman to notice and change.

In addition to monthly BSE, annual clinical breast exams performed by your doctor are recommended for all women beginning at age 20. Annual screening mammograms also are recommended at age 40. 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.

If a Breast Cancer is Found How is it Treated?

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.

My last advice is do your Breast Self Exams monthly.  If you see any physical changes in your breasts see your doctor immediately.  Remember it is always about early detection.

Last of all I will tell you one of the saddest stories I know.  Tracy was a young woman who went to the doctor with what looked like an infection on her breast.  Her skin was red to the touch and looked “odd” to her.  She was not quite 3o years old.  Her physician assumed that she had an infection in her breast and put her on antibiotics for 2 weeks.  At the end of two weeks it looked worse.  Tracy was in trouble because this was not an infection.  It was the most insidious form of breast cancer – inflammatory breast cancer.  In all my years of working as a nurse I have seen this happen before.  Physicians assume it is an infection because of a woman’s age.  Tracy fought hard but inflammatory breast cancer is, while rare, deadly in many cases.  I do know in all my research that I have collected from the experts in breast cancer that if you have any reason to think there is something different or a possible infection, it is safer to ask for a biospy than to wait 2 -3 weeks to see if it clears on antibiotic therapy or by itself.

Breast cancer doesn’t care how old you are-you have to be proactive in your health and that includes the health of your breasts.

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