Finding Cancer In Adolescents
Cancers are often found later in teens than they are in other age groups. There are a number of reasons the diagnosis of cancer might be delayed:
- Most teens tend to be fairly healthy and might not go to the doctor unless they feel they really need to. This is especially true for young men.
- These years are often a time of growing independence, when young people begin to establish their own identity and lifestyle. Concerns other than health, such as spending time with friends, dating, working, or getting ready for college are often higher priority than health at this time. Many teens might not even have a regular doctor.
- Even when a young person does go to the doctor with symptoms, cancer is not usually high on the list of probable causes because its not common in this age group. Doctors might be more likely to think symptoms like pain or feeling tired are due to causes other than cancer.
Still, some cancers in teens can be found early, when treatment is more likely to be successful.
Practical Problems Abound For Young Breast Cancer Patients
In May, Elizabeth Bryndza, a 19-year-old sophomore at the College of New Jersey, underwent a bilateral mastectomy to remove both breasts. Two weeks before, she had found a lump of cancerous cells in her right breast.
“I never thought that I wouldn’t survive it,” said Bryndza, now 20. “I’m still going to be me, and I’ll fight as hard as I can.”
But there are practical problems that make younger women more vulnerable than older women to the challenges of a breast cancer diagnosis.
Young women are more likely to be treated aggressively for breast cancer than older women because, since they’ve rarely had regular screenings or mammograms, they are less likely to detect early-stage tumors. Young age is an independent risk factor for recurrent cancer, regardless of a family history of cancer, or a genetic predisposition to have BRCA gene mutations.
And since doctors see so few young women with breast cancer, there is a gap in research about fertility, early-onset menopause and other effects of diagnosis, treatment and outcomes in young women.
Young Women Feel More Invincible in the Face of Cancer
Chemotherapy may affect a young woman in many ways, including her ability to have children in the future. But for teenagers, concerns such as body image, sexuality, beauty and peers loom larger.
“At that time, as a teen, you think you’re invincible,” Bryndza said. “I sort of saw the whole thing as a big inconvenience.”
Why Do Girls Need Them
Most teens don’t need breast exams. That’s because it’s rare for girls to have breast problems. Doctors usually just look at a girl’s breasts during her yearly gyn checkup to see where she is in her development. But if you have a family history of breast problems, your doctor or nurse might give you a breast exam.
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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.
Breast Cancer Statistics In Young Adults
Although breast cancer in young adults is rare, more than 250,000 living in the United States today were diagnosed under age 40. In young adults, breast cancer tends to be diagnosed in its later stages. It also tends to be more aggressive. Young adults have a higher mortality rate. As well as a higher risk of metastatic recurrence .
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Previous Breast Cancer Or Lump
If you have previously had breast cancer or early non-invasive cancer cell changes in breast ducts, you have a higher risk of developing it again, either in your other breast or in the same breast.
A benign breast lump does not mean you have breast cancer, but certain types of breast lumps may slightly increase your risk of developing cancer.
Some benign changes in your breast tissue, such as cells growing abnormally in ducts , or abnormal cells inside your breast lobes , can make getting breast cancer more likely.
Breast Lumps In Adolescents: Causes
- Breast masses in teens are almost always benign .
- Breast cancer is very rare in teens
- Fibroadenoma: most breast masses in teens are fibroadenomas. They are 1 inch oval or round, rubbery, non-tender mass. Most often in upper-outer quadrant of breast. Not associated with breast cancer. Natural course: 50% go away within 5 years, others need removal.
- Juvenile fibroadenomas: breast masses that are larger than 2 inches in size. Benign, but need to be removed by surgery.
- Breast cysts
- Breast abscess: this is a red, painful lump. Main cause is Staph bacteria. Main triggers are nipple injury, nipple piercing or lactation . Needs oral antibiotics and needle removal of the pus.
- Breast collections of blood from injury: may take weeks or months to resolve.
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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
- 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.
What If I Have A Lump In My Breast
As you grow and develop, you will probably notice small lumps and other changes in your breasts. You might also find your breasts are sensitive and tender around the time of your period. If you feel a lump in your breast, don’t panic breast cancer is extremely rare in teens. For teen girls, the most common type of breast lump is usually just part of normal breast growth.
Lots of girls and women have something called fibrocystic breast changes. This is when small fluid-filled cysts in the breasts change size based on where a girl is in her menstrual cycle. Because these cysts have to do with normal hormone changes, they are typically more obvious and may hurt a bit just before a girl’s period. Fibrocystic breast changes are nothing to worry about and don’t need any kind of medical treatment.
Infections also can cause breast lumps. So can an injury to the breast like getting hit in the chest while playing sports.
If you’re worried about a lump in your breast, talk to your doctor. Also call your doctor if you have any of these problems:
- pain in your breast that seems unrelated to your period
- a red, hot, or swollen breast
- fluid or bloody discharge from your nipple
- a lump in your armpit or near your collarbone
Most breast lumps are nothing to worry about, but it always helps to talk to a doctor or nurse about what to expect as your breasts grow. Getting checked out gives you peace of mind.
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Screening For Cancers In Teens
Screening is testing for a disease such as cancer in people who dont have any symptoms. Cancers are not common between ages 15 and 19, so there are no widely recommended screening tests to look for cancer in people in this age group who are not at increased risk.
Some people have a higher risk of developing certain types of cancer because of a strong family history or because they’ve inherited a specific gene mutation from a parent. These might put a person at higher risk for cancers such as melanoma of the skin or colorectal, thyroid, or other cancers. People with these mutations may need careful, regular exams or tests starting at an early age to look for signs of cancer.
Brain And Spinal Cord Tumors
There are many types of brain and spinal cord tumors, and the treatment and outlook for each is different. In children, most brain tumors start in the lower parts of the brain, such as the cerebellum or brain stem . Adults are more likely to develop tumors in upper parts of the brain. Spinal cord tumors are less common than brain tumors in all age groups.
Brain tumors can cause headaches, nausea, vomiting, blurred or double vision, dizziness, seizures, trouble walking or handling objects, and other symptoms.
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Should You Talk To Your Doctor About Breast Cancer
Understanding breast cancer risk factors, knowing your personal risk of developing breast cancer, and recognizing the signs and symptoms of breast cancer can help women seek the care that they need, when they need it.
Take our Breast Cancer Risk Quiz to learn more about your personal risk. The quiz takes less than one minute to complete.
If you are 40 years or older, schedule a mammogram. The Breast Center along with The American Medical Association, The American College of Radiology, the American Cancer Society, the Society of Breast Imaging, and the National Cancer Institute recommend that women start getting a screening mammogram every year starting at age 40.
You dont have to wait until youre 40 to talk to your doctor about breast cancer, though. Meet with the specialists at the Breast Center if you have questions or concerns about breast cancer or breast health. Request an appointment online or call 479-442-6266.
The Emotional Toll Of Breast Cancer
Younger women are more likely to be affected to the point of depression if they feel overwhelmed by the disease. In addition, unlike older breast cancer patients, they generally lack a strong peer support system
“I think when you’re older you expect it more… it’s not something that’s atypical for your peer group,” said Bryndza’s doctor, Dr. Dawn Hershman, co-director of the breast cancer program at the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center. “When you’re young you feel like you’re the only one. Everybody wants to help but no one knows what it’s like.”
But younger women may not want empathy, craving normality instead. Often, the greatest source of anxiety for a young woman with breast cancer is not the disease — it’s whether their peers will treat them differently. Both Thompson and Bryndza said they felt the most anxious about heading back to school.
“Because she was so young, she did not know exactly what was, and that helped her deal with it,” Anderson said. “But she was worried about her peers — if they were going to talk about her as if she had a disease… She didn’t want a lot of young people to know. I guess because she didn’t understand herself what was going on, they might not understand either.”
Things Fall Apart
“It was hard because I was such a wreck, emotionally, sometimes,” Bryndza said. “I needed to focus on myself and my health and it was hard to be in a relationship when I had to worry about myself.”
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Premenstrual Breast Pain And Swelling
- Main Symptom: breast fullness and pain.
- Cause: extra body fluid from female hormone cycles.
- Other symptoms: headache, swollen feet .
- Timing: mainly noticed in the week prior to menstrual periods.
- Course: improves during menstrual period and goes away between menstrual periods.
- Physical Findings: fullness that can be felt throughout both breasts.
- Onset: usually 2 years after onset of periods . Similar onset as for menstrual cramps.
- Frequency: 10% of teens and 50% of adult women.
- Treatment: mainly ibuprofen and support bra. If breast pain can’t be controlled with ibuprofen, 80% can be improved by birth control pills.
- Other treatments: daily exercise and getting enough sleep.
Breast Lumps In Teenagers
It can be normal to feel lumps when your breasts are developing and these often disappear on their own.
If a lump causes you any discomfort, appears to get bigger or youre worried about it, talk to someone such as your GP. You may also want to talk to someone in your family or a school nurse.
Although its very unlikely that theres anything wrong, a doctor can check it out and should put your mind at rest. You can ask to see a female doctor or the practice nurse if this will make you feel more comfortable.
Very occasionally lumps are a sign of a benign breast condition. Benign means harmless, and a benign condition will not become a breast cancer. The most common benign lump as the breasts are developing is known as a fibroadenoma.
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Risk Factors You Can Change
- Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
- Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
- Taking hormones. Some forms of hormone replacement therapy taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives also have been found to raise breast cancer risk.
- Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
- Drinking alcohol. Studies show that a womans risk for breast cancer increases with the more alcohol she drinks.
Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk.
Can Women In Their 30s Develop Breast Cancer
Most cases of breast cancer are diagnosed in older women. The median age for breast cancer diagnosis between 2010 and 2014 was 62 years. While uncommon, it is possible for young women to develop breast cancer.
Fewer than 5% of the total breast cancer cases in the U.S. are diagnosed in women under the age of 40.
According to Breast Cancer Facts and Figures 2017-2018 from the American Cancer Society, a 20-year-old woman has a 0.1% 10-year probability of developing invasive breast cancer. A 30-year-old woman has a 0.5% risk of developing invasive breast cancer in the next 10 years.
These figures represent absolute risk rather than personal risk of developing breast cancer.
Many other factors contribute to your personal risk for breast cancer including weight, lifestyle choices, and having dense breasts. Some women are born with BRCA1 or BRCA 2 gene mutations. Women with a BRCA1 gene mutation are at a 72% risk of developing breast cancer by the age of 80. Women with a BRCA2 mutation have a 69% risk for breast cancer.
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Does The Amount Of Alcohol Make A Difference
In general, studies have found that the more you drink regularly over time, the higher your chances of having breast cancer. If youâre a woman and you have three drinks per week, your odds are 15% higher than a woman who doesnât drink at all. And this risk goes up an estimated 10% for each extra drink per week.
But what exactly is a drink? In the U.S., a âstandardâ drink is defined as about 14 grams of alcohol. This is equal to:
- 1.5 ounces of liquor
- 5 ounces of wine
- 12 ounces of beer
But everyone is different. Your individual risk may be higher or lower because of your genes, your race, if youâve ever been pregnant, if youâve been exposed to chemicals, and many other things.
Types Of Breast Lumps That Teens Can Get
The most common type of breast cancer found in teens is secretory adenocarcinoma. This is generally a slow growing, nonaggressive cancer.
Though theres little chance of this type of cancer spreading to other parts of the body, spread to local lymph nodes has been noted in a few cases.
Most breast lumps in teenage girls are fibroadenomas, which are noncancerous. An overgrowth of connective tissue in the breast causes fibroadenomas.
The lump is usually hard and rubbery, and you can move it around with your fingers. Fibroadenomas account for 91 percent of all solid breast masses in girls younger than 19 years old.
Other less common breast lumps in teens include cysts, which are noncancerous fluid-filled sacs.
Banging or injuring breast tissue, possibly during a fall or while playing sports, can also cause lumps.
If you feel anything unusual in your breast, see your doctor. They will ask:
- about your familys medical history
- when you discovered the lump
- if theres nipple discharge
- if the lump hurts
If anything looks or feels suspicious, your doctor will have you undergo an ultrasound. This test uses sound waves to see into your breasts. It can help determine whether a lump is solid, which is an indication of cancer.
If its fluid-filled, that will most likely indicate a cyst. Your doctor may also insert a fine needle into the lump to draw out tissue and test it for cancer.
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