Which Types Of Breast Cancer Are Young Women Prone To Getting
Younger women are more likely to have higher grade and hormone receptor-negative breast cancers. Higher-grade tumors look very different from normal cells. They divide quickly and are more likely to spread. They often respond well to treatments such as chemotherapy and radiation, which destroy quickly dividing cells.
Hormone receptor-negative cancers dont need the female hormones estrogen and progesterone to grow. Unlike hormone receptor-positive cancers, they cant be treated with hormone therapies such as tamoxifen and aromatase inhibitors. Hormone receptor-negative cancers tend to grow more quickly than hormone receptor-positive cancers.
Triple-negative breast cancer doesnt respond to estrogen and progesterone. It also doesnt respond to a protein called human epidermal growth factor receptor 2. TNBC is more common in young women and African-American women. It also has lower survival rates.
Dcis Has The Same Risk Factors As Invasive Breast Cancers
“The same things that increase a woman’s risk for DCIS are really the same things that increase her risk of invasive breast cancer,” says Dr. Meyers. For example, having a strong family history can be a factorespecially if a woman tests positive for a high-risk BRCA gene mutation.
Women who have a longer period of estrogen stimulation, meaning they started menstruation;early and/or entered menopause;late, also have an increased risk of DCIS as well as invasive cancer. That also goes for women who don’t have children, or who have their first pregnancy after age 30.
A Word Of Caution Regarding Home Genetic Tests For Breast Cancer
The idea of a home genetic test for breast cancer is exciting to many people, as these tests might help them avoid the clinic while being their own advocate in their health. It’s important to thoroughly understand the limitations of these tests, however, if you choose to do one.
For example, a popular at-home genetic test identifies three breast cancer genes that are more common among Ashkenazi women but are rare in other ethnic populations. While the company is transparent in admitting that the test only checks for 3 out of a potential 1000 BRCA mutations, not everyone reads the small print. The bottom line on this test is that for Ashkenazi Jewish woman, a positive test might let them know they should see their doctor . For most women the test is relatively meaningless, and actually be harmful if they trusted the results and did not have formal testing.
How Is Breast Density Categorized
Doctors use the Breast Imaging Reporting and Data System, called BI-RADS, to group different types of breast density. This system, developed by the American College of Radiology, helps doctors to interpret and report back mammogram findings. Doctors who review mammograms are called radiologists. BI-RADS classifies breast density into four categories, as follows:
- Almost entirely fatty breast tissue, found in about 10% of women
- Scattered areas of dense glandular tissue and fibrous connective tissue found in about 40% of women
- Heterogeneously dense breast tissue with many areas of glandular tissue and fibrous connective tissue, found in about 40% of women
- Extremely dense breast tissue, found in about 10% of women
If you are told that you have dense breasts, it means that you have either âheterogeneously denseâ or âextremely denseâ breasts.
The four breast density categories are shown in this image. Breasts can be almost entirely fatty , have scattered areas of dense fibroglandular breast tissue , have many areas of glandular and connective tissue , or be extremely dense . Breasts are classified as âdenseâ if they fall in the heterogeneously dense or extremely dense categories.
I Was Diagnosed With Breast Cancer For The First Time At Age 16
In this essay, Nikia Hammonds-Blakely talks about being diagnosed with breast cancer at age 16, as told to Brittney McNamara.
I was a sophomore in high school, getting ready for school one morning, when I felt a lump. I was not intentionally trying to do a self breast exam, I was just taking a shower. The lump was in my left breast, and though time passed after I found it, it wasnt going away.
Though I was just 16 years old at the time and had no family history, that lump turned out to be a very rare and aggressive form of breast cancer. So before Id even attended my first prom, my doctor recommended I have a double mastectomy a procedure to remove both of my breasts. I really dont have words for how out of body that moment felt. Id never been to the hospital for anything not so much as a sprained ankle. Everything about my diagnosis was beyond my comprehension. It wasnt like I could go to one of my friends, or even a family member and say, hey girl, how did you deal? I didnt even know it was possible that a teen could get breast cancer. Still, as I sat in my doctors office with my mother, thats what I was told.
This, of course, extended well beyond the prom. I would get undressed and look in the mirror every day, and I saw the disfigurement. I felt like a monster; I wondered if anybody would love me; I wondered if I would get married, or if I would ever have a child and breastfeed.
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Noticing Changes To Your Breasts
The ACS no longer recommends regular breast self-exams, since theres no evidence that they help reduce breast cancer deaths.
However, knowing how your breasts normally look and feel can help you identify any changes early on. Take notice of the following:
- skin dimpling
Once youve established a baseline for how your breasts look and feel, itll be easier to identify any changes in the future.
If you do notice any changes, or if anything causes you worry, let your doctor know. They can determine if theres cause for concern.
Its common to see asymmetry in breast size, which can be normal.
A note on breast exams
The American Cancer Society no longer recommends regular clinical breast exams or breast self-exams. Theres little evidence that these exams help reduce deaths from breast cancer in women at average risk for the condition.
However, these exams may still be performed in certain scenarios.
For instance, some healthcare professionals may choose to perform clinical breast exams and counsel women on risk and early detection, in particular those at a higher-than-average risk for cancer. In addition, some women might prefer to use routine breast self-exams as a way to track possible changes to their breasts.
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.
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Risk Factors For Overall Recurrence
There are several risk factors that raise the risk of recurrence overall . These include:
- Tumor size: Larger tumors are more likely to recur than smaller ones both early and late.
- Positive lymph nodes: Tumors that have spread to lymph nodes are more likely to recur at any time than those that have not.
- Age at diagnosis: Breast cancer recurrence is more common in younger people.
- Treatments received and response to treatments: Both chemotherapy and hormonal therapy reduce the risk of recurrence in the first five years.
- Tumor grade: More aggressive tumors are more likely to recur than less aggressive tumors , especially in the first five years
There are also factors that do not appear to affect the risk of recurrence. Recurrence rates are the same for women who have a mastectomy or lumpectomy with radiation and are also the same for women who have a single vs. double mastectomy.
Can A 16 Year Old Get Breast Cancerand How Exactly Are The Breast Cancer Lumps
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How Is Breast Cancer Treated In Younger Women
Treatment decisions are made based whether or not it has spread beyond the breast, as well as the woman’s general health and personal circumstances.
Treatment options include:
Radiation is generally used following a lumpectomy, and chemotherapyand hormone therapy often are recommended after surgery to help destroy any remaining cancer cells and prevent a return.
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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
The Myth And Stigma Of The 5
Many people still believe that breast cancer, even hormone-positive disease, is essentially cured after five years; this can lead to misunderstandings in families. Loved ones who don’t understand late recurrence may downplay your feelings, or criticize you when you think “brain tumor” each time you get a headache.
Until information on late recurrence becomes more widely known, and even though it’s frustrating, you may need to educate loved ones about the risk, and why you should be concerned when you develop new or unexplained symptoms.
Does Having Dense Breast Tissue Affect A Womans Mammogram
Mammograms can be harder to read in women with dense breasts than in women with fatty breasts. That’s because dense breast tissue and some abnormal breast changes, such as calcifications and tumors, appear as white areas in the mammogram. As a result, mammography is less sensitive in women with dense breasts â that is, it is more likely to miss cancer. Women with dense breasts may be called back for follow-up tests more often than women with fatty breasts. Dense breasts can also put women at higher risk of interval breast cancer. This is breast cancer that is diagnosed within 12 months of a normal mammogram result.
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Tumor Size And Lymph Node Status
The risk of recurrence is linked to the size of the original tumor as well as the number of positive lymph nodes, although these factors alone can’t explain all recurrences. In the 2017 study noted earlier, for women who were cancer-free after five years of hormonal therapy, the risk of recurrence was highest for those who had large tumors that had spread to four or more lymph nodes , and lowest with small, node-negative tumors.
The risk of recurrence of these small, node-negative tumors, however, remains significant at roughly 1% per year until at least 20 years post-diagnosis. Due to the life expectancy of metastatic breast cancer , the risk of death lags somewhat behind recurrence.
|Late Recurrence Rate and Lymph Node Status|
|Years After Diagnosis|
Within these ranges, the risk of recurrence was greater in women who had larger tumors than smaller tumors . Tumor grade and Ki-67 had only moderate predictive value, and progesterone receptor status and HER2 status had no predictive value in this study.
It’s noteworthy that women who had one to three positive lymph nodes were twice as likely to have their cancer recur at distant locations between five years and 20 years post-diagnosis than in the first five years, and those who have node-negative tumors were roughly four times more likely to have a late than an early recurrence.
It’s Usually Found On A Mammogram
For most women, DCIS is picked up on routine mammograms. “Typically, the mammogram finds a calcificationa small cluster of cells with abnormal shapes and sizesand then it is diagnosed after a biopsy,” says Dr. Meyers.
Occasionally, though, DCIS grows large enough that it forms a noticeable lump. Some people with DCIS may also have unusual nipple discharge, or a condition called Paget’s disease that causes skin around the nipple to become thick and dry.
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Living With Breast Cancer
Being diagnosed with breast cancer can affect daily life in many ways, depending on what stage;it’s at and;the treatment you will have.
How people cope with the diagnosis and treatment varies from person to person. There are several forms of support available, if you need it.
Forms of support may include:
- family and friends, who can be a powerful support system
- communicating with other people in the same situation
- finding out as much as possible about your condition
- not trying to do too much or overexerting yourself
- making time for yourself
Find out more about living with breast cancer.
Intrinsic Subtypes And Late Recurrence
A number of different methods have been evaluated for the ability to predict late recurrence. Some of these include:
Higher expression of estrogen-responsive genes: A 2018 study found that people with ER+/HER2 negative breast cancers who had higher expression of estrogen-responsive genes and were not treated with extended hormonal therapy had a high risk of recurrence after five years.
Multigene assays: Several multigene assays may help predict late recurrence, but using this information to figure out when to extend hormonal therapy requires more research. A 2018 evaluation of an 18-gene, 10-year signature found that the information regarding prognosis was similar to other tests including Oncotype DX Recurrence Score, Prosigna PAM50 risk of recurrence score, Breast Cancer Index and IHC4.
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Some People With Dcis Get Radiation
Next, doctors and patients should decide together whether further treatment is needed to reduce the risk of another DCIS or an invasive cancer. This can be determined through genomic testing, or by looking at factors like the patient’s age, family history, and tumor size and grade.
“Several years ago, radiation would have been given to everyone who had DCIS, period,” says Dr. Meyers. “But now, it’s a little more tailored to the type of DCIS and the type of patient, and there’s been a downward trend of getting less radiation or avoiding it completely, if possible.”
Radiation does come with side effectsand it has not been shown to extend survival in patients with DCIS; it’s only been shown to reduce the risk of another cancer occurring. So patients should weigh the pros and cons carefully, says Dr. Meyers, and make the best individual decision for them.
What’s The Best Way For Younger Women To Screen For Breast Cancer
The American Cancer Society recommends that all women know how their breasts look and feel;and report any changes to their doctor. The ACS states that research has not shown a clear benefit of performing regular breast self-exams.; Talk with your doctor about the pros and cons of breast self-exam.
Regular breast exams done at least every 3 years by your doctor are recommended for women beginning at age 20. Expert groups dont all agree when women should start getting mammograms and you should discuss with your doctor whats right for you. The U.S.;Preventive Services Task Force recommends screening every 2 years from ages 50 through 74 and also that the decision to start yearly screening mammograms before age 50 should be an individual one..
Talk to your doctor about when you should begin to have mammograms. For younger women, digital mammography may be an alternate to a standard mammogram. Digital mammography is better able to see abnormalities in dense breast tissue.
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Body Image In Young Women After Breast Cancer
Another hurdle young women face is how breast cancer treatments and their side effects affect body image.;
There are incredible demands placed on women in American society about their appearance, says Dr. Silber, and I would not be truthful if I didnt say that a lot of women really struggle not only with treatment but with the aftermath. Its hard because how someone looks can be a part of their self-worth. They may have lost their hair and gained some weight. Their breasts dont look the same. To act like thats not a thing is not fairof course, it matters.;
Young women may be looking for a partner at a time when breast cancer treatment causes them to experience body changes that women generally dont encounter until theyre older and postmenopausal: hot flashes and/or weight gain in the abdomenthe meno-pot.;
Its different when these changes happen at 20 and 30, says Dr. Silber, who explains that hormonal therapies are used for certain types of breast cancers to control tumor growth and discourage recurrence. But, this life-saving treatment, which a woman will need to keep taking as long as she lives, puts female breast cancer survivors into premature menopausemany years or even decades before their peers.