General Considerations For Screening
The goal of screening for cancer is to detect preclinical disease in healthy, asymptomatic patients to prevent adverse outcomes, improve survival, and avoid the need for more intensive treatments. Screening tests have both benefits and adverse consequences .
Breast self-examination, breast self-awareness, clinical breast examination, and mammography all have been used alone or in combination to screen for breast cancer. In general, more intensive screening detects more disease. Screening intensity can be increased by combining multiple screening methods, extending screening over a wider age range, or repeating the screening test more frequently. However, more frequent use of the same screening test typically is associated with diminishing returns and an increased rate of screening-related harms. Determining the appropriate combination of screening methods, the age to start screening, the age to stop screening, and how frequently to repeat the screening tests require finding the appropriate balance of benefits and harms. Determining this balance can be difficult because some issues, particularly the importance of harms, are subjective and valued differently from patient to patient. This balance can depend on other factors, particularly the characteristics of the screening tests in different populations and at different ages.
What Did They Find
The researchers found that women in their 70 and 80s were less likely to survive breast cancer than women in their 50s and 60s. Older women were more likely to be diagnosed with more advanced cancers and were less likely to be treated with surgery or radiotherapy.
They also found that older women were less likely to have tests to find out their oestrogen receptor status which measures levels of a particular molecule in their cancer cells and can help determine the best treatment. Here are the key findings in detail:
- More than half of women aged 50 to 69 had their breast cancer diagnosed at the earliest possible stage, compared with only a quarter of breast cancers in the over 80s.
- More than a third of older women had unknown oestrogen receptor status, while amongst younger women only about one in 10 had this information missing from their notes.
- 69 per cent of older women had missing data on whether cancer had spread to the lymph nodes compared with 14 per cent women aged 50 to 69.
- The chances of receiving surgery or radiotherapy decreased with age. 96 per cent of younger women had surgery compared to three-quarters of 75 -79 year olds, and fewer than half of women over 80.
- Three-quarters of 50 69s year olds were given radiotherapy, while for the over 80s the figure was around a quarter .
- Of all the disease characteristics and treatment types studied, surgery had the greatest impact on breast cancer survival.
Other Teenage Breast Changes
Plenty of changes happen to your breasts that are not cancer. Most breast lumps in teenage girls are fibroadenomas, which are noncancerous. These are caused by an overgrowth of connective tissue in the breast.
Fibroadenomas are the reason for 91% of all solid breast masses in girls younger than 19 years old. The lump is usually hard and rubbery, and you would be able to move it around with your fingers.
Other less common breast lumps in teens include cysts, which are noncancerous fluid-filled sacs. A breast cyst often feels smooth and soft. If you press on a cyst, it will feel a little like a water balloon.
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Are My Breasts Normal
One of my breasts is bigger than the other.
Its quite common for breasts to be slightly different in size or to have one which sits slightly higher or lower than the other. While theyre developing they might also grow at different rates, although they usually look about the same by the end of the process.
My breasts feel lumpy
As breast tissue continues to develop, your breasts may feel generally lumpy and tender. This is due to fluctuating hormones and will usually settle down over time.
My nipples dont point outwards
In 10-20% of girls, the nipples may be flat or be drawn inwards on one or both sides. This is normal and does not create any health problems. It might have been present from birth or it may occur as the breasts develop.
My nipples dont look the same
Nipples come in many different sizes and shapes. They may point up, down, or away from each other. They can be pale or dark, large or small, and may not look completely alike.
I have little lumps around my nipples
The skin on the areola contains little glands known as Montgomerys tubercles. They look like little bumps or pimples on the skin and they produce a fluid which moisturises the skin of the areola and nipple.
I have hair around my nipples
Some girls will notice a few hairs growing around the edge of the areola. This is quite common and if it bothers you it can be removed by cutting or plucking the hair.
My breasts hurt or feel uncomfortable
Ive got a red spot/area on my breast
Role Of Postoperative Rt
Postoperative RT following breast-conserving surgery, combined with appropriate systemic adjuvant treatment, has been shown to significantly reduce both absolute risk for 5-year recurrence and 15-year absolute breast cancer mortality risk. Proportional reductions were found in all patients regardless of age, although absolute risk was lower in older patients.
No significant increase in RT toxicity has been seen in older women. Therefore, among healthy older women, standard fractionation RT with a boost to the lumpectomy cavity is considered a standard component of breast-conserving therapy.
Studies in older women have found no important increase in RT toxicity. The SIOG panel recommends that RT after breast-conserving surgery and adjuvant systemic treatment should be considered in all older women with breast cancer. Factors that should be taken into account include life expectancy, patient health and functional status, mortality risk from comorbidities , and risk for local recurrence.
Since absolute risk for local recurrence is lower in older women, the benefits of RT may decline with age. In addition, the schedule and duration of conventional RT may be challenging for older women who have limited mobility or transportation. Alternatives that demonstrate promising early results include hypofractionated RT schedules, more rapid fractionation, and partial-breast rather than whole-breast irradiation.
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Breast Cancer And Teenage Girls
If youre a teenage girl, you might be worried about your risk of getting breast cancer.
Developing breast cancer when youre a teenager is extremely rare. Its also uncommon in women in their 20s and 30s. The vast majority of breast cancers are diagnosed in women over the age of 50.
There can be a lot of unreliable information and scare stories on the internet, so its important to use reputable websites or talk to your GP if youre worried about any changes to your breasts. You can also call our Helpline free on 0808 800 6000 to speak with one of our experts.
‘i’m Happy With My Mastectomy’
On July 21, surgeons removed her breasts and began reconstruction, per Haneys request. The next day, she tweeted a photo of herself sitting up in her hospital bed: “23 years old, 23 hours after a double mastectomy.”
She included a note of thanks to E! News host and reality TV star Giuliana Rancic, who was diagnosed with breast cancer last fall at 37 and had a double mastectomy in December. Haney says Rancics public struggle with the disease inspired her and gave her courage.
Rancic saw Haneys message the next day and retweeted it to all of her followers, with an added note of support: Welcome to the club!
There are so many well wishes and amazing women sharing their stories with me on Twitter, Rancic says. What caught my attention about Slayton was her young age and that picture she sent me. It reminded me so much of my own experience.
Haney was thrilled to hear from Rancic. But more than that, she was happy to just connect with other women who knew what she was going through.
After her message, a lot of her followers started tweeting at me and sending me their support, she says. “It was really neata happy surprise.
Haney still has to undergo four rounds of chemotherapy beginning later this month, but she wont go it alone. Her family and friends have rallied around her online, and her boyfriend, Mike, has been a huge help in taking care of her in Orlando. Haney says she is pleased.
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‘lightning Strikes’ When Young Girls Get Breast Cancer
Young women experience unique problems when diagnosed with breast cancer.
It started with a casual mention to her mother that she felt a quarter-sized lump in her right breast. Doctors diagnosed her with breast cancer. She was 13 years old.
“I couldn’t tell her, I was just crying,” said her mother, Stephanie Anderson, when she learned of Taylor’s diagnosis. “I thought, ‘How am I going to explain this to my 13-year-old daughter about breast cancer?’ When I tried to talk to her, it just would not come out.”
The lump Thompson found in her breast was a type of fast-growing, potentially malignant tumor generally found in premenopausal women, not in girls Thompson’s age.
In fact, oncologists said finding cancerous breast cells in girls as young as Thompson is akin to being struck by lightning.
And while breast cancer is overwhelming at any age, women who get the disease in their twenties, their teens or younger face a host of unique issues that complicate an already devastating diagnosis.
“They face issues all breast cancer patients face — dealing with a potentially life-threatening illness, mortality, toxic treatments, breast surgery,” said Dr. Ann Partridge, director of the Young Women and Breast Cancer program at the Dana-Farber Cancer Institute in Boston, Mass. “But a person who is young deals with those at an age when they have their own so these are accentuated.”
Breast Cancer in Young Patients Is Rare
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- Other breast lumps
- Could be pregnant
- Change in shape or appearance of breast
- Nipple discharge that is clear or milky
- Breast pain and cause is unknown. Exception: continue if only occurs before menstrual periods or with vigorous exercise.
- Age 13 or older with no breast buds or breast tissue
- You have other questions or concerns
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Example Of Breast Cancer Risk Going Down
Suppose you had early breast cancer and underwent lumpectomy . The absolute risk of a recurrence of the breast cancer within 10 years is about 35%. But if you have radiation therapy to the remaining breast tissue, you can reduce that risk by about 46%, according to a study that reviewed 17 clinical trials of radiation therapy after lumpectomy. To describe this relative risk decrease, your doctor might say:
- Compared to women who have lumpectomy alone, you have a 46% lower risk of developing breast cancer within 10 years if you have radiation therapy after lumpectomy.
Medical researchers might express it this way:
- Compared to women who do not have radiation therapy, your relative risk of developing breast cancer is .54 . Again, the number 1 is assigned to the baseline group, which is not taking the extra action to decrease the risk. The .46 is subtracted from 1 because it represents a decrease in risk. In other words, you have about half, or 54%, of the risk of developing breast cancer again in the same breast as they do within 10 years.
So in this scenario, what difference does radiation therapy really make for you in terms of reducing the absolute risk of cancer recurrence in the same breast? To know that, you have to multiply the 10-year risk of recurrence without radiation by the relative risk of .54:
- .5 means that your risk decreases by half, or 50%
- 1.88 means that your risk increases by 88%
- 3.0 means that your risk triples, or goes up by 300%
Is Teen Breast Cancer Common
Its normal for your breasts to change as you enter your teenage years. Increases and decreases in female hormones, such as estrogen and progesterone, may make your breasts tender.
Hormones can also cause you to feel thickening, and even some lumps and bumps, in your breasts as your period comes and goes each month.
Could those lumps and bumps be cancer? Its not likely. Its almost unheard of for girls ages 14 years and younger to develop breast cancer.
The chances increase slightly as girls move through their teenage years, but breast cancer in this age group is still very rare.
Between 2012 and 2016, the incidence rate for female breast cancer in 15- to 19-year-olds in the United States was 0.1 in 100,000. This equals 1 teen in 1 million. These statistics were included in a 2020 study published by the American Cancer Society .
- It seems fixed to the chest wall and doesnt move around.
- It ranges in size from about the size of a pea to several inches in diameter.
- It might be painful.
Nipple discharge and having the nipple invert inward are possible symptoms of breast cancer in adult women. However, theyre not very common in teens with cancer.
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Soft Tissue And Bone Cancers
Sarcomas are cancers that start in connective tissues such as muscles, bones, or fat cells. There are 2 main types of sarcoma:
- Soft tissue sarcomas
- Bone sarcomas
Sarcomas can develop at any age, but some types occur most often in older teens and young adults.
Soft tissue sarcomas: These cancers can start in any part of the body, but they often develop in the arms or legs. Rhabdomyosarcoma, a cancer that starts in cells that normally develop into skeletal muscles, is most common in children younger than 10, but it can also develop in teens and young adults. Most other types of soft tissue sarcomas become more common as people age. Symptoms depend on where the sarcoma starts, and can include lumps , swelling, or bowel problems.
For more information, see Soft Tissue Sarcoma and Rhabdomyosarcoma.
Bone sarcomas: The 2 most common types of bone cancer,osteosarcoma and Ewing sarcoma, are most common in teens, but they can also develop in young adults. They often cause bone pain that gets worse at night or with activity. They can also cause swelling in the area around the bone.
Osteosarcoma usually starts near the ends of the leg or arm bones. The most common places for Ewing sarcoma to start are the pelvic bones, the bones of the chest wall , or in the middle of the leg bones.
For more information, see Osteosarcoma and Ewing Family of Tumors.
What Are The Signs Of Breast Cancer
A woman who has breast cancer may have no problems, or she may find a painless lump in her breast. If women examine their breasts monthly, they can help find lumps or other changes that a doctor should examine.
Most breast lumps are not cancer, but all lumps should be checked out by a doctor to be sure. Breast lumps that are not cancer may be scar tissue or cysts or they can be due to normal breast changes associated with hormone changes or aging.
Girls who are beginning puberty might notice a lump underneath the nipple when their breasts start developing. Usually, this is a normal. You can ask a parent or your doctor about it to be sure.
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What Are The Signs And Symptoms Of Breast Cancer In Children
Breast cancer may cause any of the following signs. Check with your childs doctor if your child has any of the following:
- A lump or thickening in or near the breast or in the underarm area.
- A change in the size or shape of the breast.
- A dimple or puckering in the skin of the breast.
- A nipple turned inward into the breast.
- Scaly, red, or swollen skin on the breast, nipple, or areola .
- Dimples in the breast that look like the skin of an orange, called peau dorange.
Other conditions that are not breast cancer may cause these same signs.
Why Do People Get Breast Cancer
Any woman can get breast cancer, but these things can make some women more likely to get it:
- Family history: A woman whose mother, sister, aunt, or daughter has had breast cancer is more likely to get it.
- Age: As women get older, they are more at risk for breast cancer. Teens as well as women in their twenties and thirties are less likely to get breast cancer.
- Diet and lifestyle choices: Women who smoke, eat high-fat diets, drink alcohol, and don’t get enough exercise may be more at risk for developing breast cancer.
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Eat Your Fruits & Vegetables And Avoid Too Much Alcohol
A healthy diet can help lower the risk of breast cancer. Try to eat a lot of fruits and vegetables and keep alcohol at moderate levels or lower . While moderate drinking can be good for the heart in older adults, even low levels of intake can increase the risk of breast cancer. If you dont drink, dont feel you need to start. If you drink moderately, theres likely no reason to stop. But, if you drink more, you should cut down or quit.
What Is Breast Cancer In Children
Breast cancer is a disease in which malignant cells form in the tissues of the breast. Breast cancer may occur in both male and female children.
Breast cancer is the most common cancer among females aged 15 to 39 years. Breast cancer in this age group is more aggressive and more difficult to treat than in older women. Treatments for younger and older women are similar. Younger patients with breast cancer may have genetic counseling and testing for familial cancer syndromes. Also, the possible effects of treatment on fertility should be considered.
Most breast tumors in children are fibroadenomas, which are benign . Rarely, these tumors become large phyllodes tumors and begin to grow quickly. If a benign tumor begins to grow quickly, a fine needle aspiration biopsy or an excisional biopsy will be done. The tissues removed during the biopsy will be viewed under a microscope by a pathologist to check for signs of cancer.
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