Know Your Medical History
It is important to know your family history and share it with your doctor. Women with a first-degree relative with breast cancer have nearly twice the risk of being diagnosed with breast cancer as a woman who has no family history. Tell your doctor which family member had breast cancer or other breast diseases, and how old they were when diagnosed.
Risk Factors For Young Women
All women are at risk of developing breast cancer and the risk greatly increases with age with most cases of breast cancer occurring in women over the age of 50. There are a range of factors that can increase breast cancer risk in young women. The causes of breast cancer in young women can include lifestyle factors and non-lifestyle factors . Young women may have an increased risk of breast cancer due to factors such as:
- Family history A history of breast cancer among relatives is a strong risk factor for young women. A young womans risk of breast cancer is increased if a close relative, like a mother or aunt, has had breast or ovarian cancer. A young womans risk is further increased by the number of relatives affected and if her relatives were diagnosed with cancer at a young age
- Genetic susceptibility A high proportion of young women diagnosed with breast cancer have inherited mutations in their BRCA1 or BRCA2 genes .
- Reproductive and hormonal factors- Early menarche increases the risk of breast cancer, and giving birth to the first child at a late age also increases risk.
- Alcohol intake Regularly drinking alcohol can increase the risk of breast cancer for women of all ages. The risk of breast cancer rises as the number of drinks regularly consumed increases. Currently, there does not appear to be a safe level of regular alcohol consumption.
Know It’s Ok To Ask Questions
Ask questions! You should be an active participant in your care. Your medical team should explain to you any medical terms you do not understand, explain your treatment choices, possible side effects, and expected outcome. Ask for references to additional specialists you can talk to so you can learn more about your breast cancer. If you have not yet been diagnosed with breast cancer but are at high risk, ask your doctors about testing and any preventive measures you can take.
Also don’t be afraid to ask family and friends for support. Seek support groups with other people who are going through what you are, or who have gone through it. Bring a close friend or family member to your appointments to both take notes, or record your visit, and to encourage you to request clarification if anything is unclear. Express your feelings and concerns.
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Genetic Risks & Family History
Two genetic factors put you at higher risk for breast cancer at a younger age: family history and the BRCA1 and BRCA2 gene mutation. Heres an explanation via Cancer.org:
BRCA1 and BRCA2
The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 and BRCA2 genes. In normal cells, these genes help prevent cancer by making proteins that keep the cells from growing abnormally. If you have inherited a mutated copy of either gene from a parent, you have a high risk of developing breast cancer during your lifetime.
Although in some families with BRCA1 mutations the lifetime risk of breast cancer is as high as 80%, on average this risk seems to be in the range of 55 to 65%. For BRCA2 mutations the risk is lower, around 45%.
Breast cancers linked to these mutations occur more often in younger women and more often affect both breasts than cancers not linked to these mutations. Women with these inherited mutations also have an increased risk for developing other cancers, particularly ovarian cancer.
Breast cancer risk is higher among women whose close blood relatives have this disease.
First Degree Relative
Having one first-degree relative with breast cancer approximately doubles a womans risk. Having 2 first-degree relatives increases her risk about 3-fold.
What Causes Breast Cancer
The cause of breast cancer in children is unknown, but certain risk factors are linked to the disease.
Risk factors for breast cancer in children, teens, and young adults includes:
- Past treatment with radiation therapy to the breast or chest for another cancer, such as Hodgkin lymphoma
- A personal history of a cancer that tends to spread to the breast, such as leukemia, lymphoma, rhabdomyosarcoma, or soft tissue sarcoma
- A family history of breast cancer in a close relative
- Inherited changes in the BRCA1 or BRCA2 gene or in other genes that increase the risk of breast cancer
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Know The Risk Factors
Younger women may have a higher risk for developing breast cancer with the following risk factors:
- Certain inherited genetic mutations for breast cancer
- A personal history of breast cancer before age 40
- Two or more first-degree relatives with breast cancer diagnosed at an early age
- High-dose radiation to the chest
- Early onset of menstrual periods
- First full-term pregnancy when you are over 30 years old
- Dense breasts
- High intake of red meat and poor diet
- Race
- Personal history of endometrium, ovary, or colon cancer
- Recent oral contraceptive use
Support For Younger Women
Breast cancer affects young women in many ways – from diagnosis and treatment to fertility and concerns for children, family and friends. Breast cancer is less common in younger women than in older women, so being diagnosed at this age can be very isolating.
Our information and support services are dedicated to younger women’s specific needs.
When I started chemotherapy, I didnt really know anyone in the same boat as me. I attended one of Breast Cancer Nows Younger Women Together events in Manchester. I was looking for a few answers to my questions, but most of all wanted to make contact with other women in my situation.
Kreena, Younger Women Together event attendee
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Fertility And Breast Cancer Treatment
Some medications and therapies for breast cancer can cause the ovaries to stop producing eggs or adversely affect a developing embryo. Because of this, some young women with breast cancer may want to discuss fertility preservation options when creating a treatment plan with a healthcare team.
There are a few discussion points to consider in this context.
According to a clinical review that appears in the journal JCO Oncology Practice, using gonadotropin-releasing hormone agonists before and during chemotherapy may reduce the risk of ovarian insufficiency.
Some women may choose to freeze their eggs, ovarian tissue, or embryos through cryopreservation methods.
For those who wish to become pregnant, treatments including tamoxifen and HER2 therapies require delaying pregnancy until a specified time after stopping the medications.
What Are The Survival Rates For Younger Women With Breast Cancer
Overall survival from breast cancer has increased in recent years. The most recent data shows that about 90 per cent of women aged between 40 and 69 years at diagnosis will be alive five years after their diagnosis. However, for women younger than 40 years, survival is lower because their breast cancers are often larger at diagnosis and more aggressive. Of younger women diagnosed with breast cancer, about 82 per cent of those aged 20 to 29 years and 84 per cent of those aged 30 to 39 years will be alive five years after diagnosis.
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Checking Yourself For Breast Cancer
Breast self-exams to check for lumps and other changes can help women detect the early signs of cancer.
Even more important than looking for specific changes is knowing how your breasts feel normally. A change in their shape or texture, a new lump, or other significant change could signal a problem, including cancer.
Women should also get regular breast exams from their doctor. Those at high risk of breast cancer may need annual mammograms, although teens almost never fall into this category.
What Can Young Women Do To Prevent Getting Breast Cancer
Take a look at the list of risk factors you can control and talk to your doctor about family planning, choice of contraceptives and other health factors. Then, make it a priority to lead the healthiest lifestyle possible. Supporting your health by eating well, exercising regularly, getting enough sleep, and avoiding smoking and excess alcohol are more important than almost anything else you can do.
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There Are Several Factors That Put A Woman At High Risk For Developing Breast Cancer Including:
- A personal history of breast cancer or high risk lesion found by biopsy
- A family history of breast cancer, particularly in a mother, daughter, or sister
- History of radiation therapy in the past
- BRCA1/BRCA2 mutation: Women who carry defects on either of these genes are at greater risk for developing breast cancer.
Should Women Under Age 40 Have Regular Mammograms
In general, regular screening mammograms in the absence of breast symptoms 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 of mammography. However, screening mammograms may be recommended for younger women with a family history of breast cancer and other risk factors.
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Premature Menopause And Loss Of Fertility
Premature menopause and loss of fertility are significant considerations in young women undergoing treatment for breast cancer. The risk of menopause with chemotherapy is dependent on age and the intensity of chemotherapy. The likelihood of menopause following chemotherapy increases with increasing age. A woman who has chemotherapy at age 30 years is unlikely to become menopausal with treatment at age 35 the risk is around 18%, and at age 40 years the risk is around 40%.
If future childbearing is planned, the option of using assisted reproduction techniques before chemotherapy and hormone therapy should be considered. Generally, this is more successful if the woman has a partner so that embryos can be frozen for future use following one or more cycles of in-vitro fertilisation.
Network With Other Young Women
It can feel isolating to be diagnosed with breast cancer at a younger age, but there is support available and it can be helpful to connect with other women your age who are going through what you are, or who have beat breast cancer. You can start by asking your doctor about any local support groups. In addition, you can find support groups by searching online.
Some resources to find support groups include:
- The National Cancer Institute’s Cancer Information Service
- Local chapters of the American Cancer Society
- Local chapters of Susan G. Komen for the Cure
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Common Breast Cancer Issues Affecting Young Women
While breast cancer in women under 40 is relatively uncommon, the impact of the disease on a young womans life is devastating. Young women face a unique set of practical, physical and emotional challenges, including:
Employment, Financial and Career
A diagnosis of breast cancer is often difficult for a young woman to communicate in the workplace. It can have a detrimental effect on a young womans career progression and future earning potential. Extended periods of time off work during the early stages of a career can negatively impact on professional development, resulting in lost opportunities for career advancement and pay rises. Breast Cancer Network Australia have further resources to provide emotional and practical support for people affected by cancer, including information and personal stories about young women with breast cancer.
The impact of treatment on fertility, early menopause and pregnancy
The impact of chemotherapy on fertility depends on a number of factors, including the womans age and the type of drugs she receives. The effects experienced can also vary among different women of the same age.
Treatment with hormonal therapies do not cause a woman to become infertile. However, a womans fertility may decrease while taking hormonal therapies. Most hormonal therapies for breast cancer are given for 5 years to prevent cancer recurrence. After 5 years, it is possible that a womans fertility may have decreased naturally.
Physical burden of breast cancer
Frequently Asked Questions About Breast Cancer In Young Women
A: Although it is extremely rare, four women under the age of 20 were diagnosed with breast cancer in Australia in 2020. . Breast cancer is more common in women over 50.
A: Breast cancer in teenagers is extremely rare with only four cases reported in Australia in 2020. In 2020 in Australia 19,807 women were diagnosed with breast cancer, 99 were in their 20s and 889 were in their 30s. Although teenagers may experience lumps when their breasts develop, these are more than likely to be benign, meaning theyre harmless. If you are concerned, talk to your GP or local family cancer clinic.
A: Yes. Although it is uncommon, it is possible for women in their 20s to get breast cancer. In 2020, 99 women aged between 20-29 were diagnosed with the disease in Australia, making up less than 1% of all women diagnosed.
A: It is important that young women know the changes in their breasts that could indicate the presence of breast cancer. One of the most effective methods of early detection of breast cancer for young women is being breast aware, knowing the feel and look of their breast so any new or unusual change can be detected. Common changes that could be due to breast cancer include:
These changes do not necessarily mean a young woman has breast cancer. However, if a young woman notices these, or any other, changes in the breast, she should see her doctor. See here for more information on breast cancer symptoms.
See here for more information on breast cancer symptoms.
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Epidemiology And Prognosis Of Breast Cancer In Young Women
Hussein A. Assi, Katia E. Khoury, Haifa Dbouk, Lana E. Khalil, Tarek H. Mouhieddine, Nagi S. El Saghir
Breast Center of Excellence, Naef K. Basile Cancer Institute and Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Abstract
Keywords: Breast cancer young age epidemiology prognosis
Submitted May 09, 2013. Accepted for publication May 25, 2013.
doi: 10.3978/j.issn.2072-1439.2013.05.24
How Does Your Age Affect Treatment
Your doctor will help you choose the most effective breast cancer treatment based on the type, stage, and grade of your tumor. Treatments are generally the same for women of all ages, but a few exceptions exist.
Drugs called aromatase inhibitors arent recommended for women who havent yet gone through menopause. These drugs treat estrogen receptor-positive breast cancer by blocking the enzyme aromatase. Aromatase converts the hormone androgen into estrogen. Without estrogen, the tumor cant grow. Women who havent gone through menopause still produce estrogen in their ovaries. This means that aromatase inhibitors will only work if you also take medicine to stop your ovaries from making estrogen.
If medically feasible, you may opt for a more conservative surgery, such as a lumpectomy. This removes the tumor but keeps the breast intact. Chemotherapy, radiation, or both are usually necessary after a lumpectomy. If you need to have a mastectomy, which removes the whole breast, you can ask your surgeon to preserve your nipple. If you plan to have plastic surgery afterward to reconstruct your breast, this can enable your plastic surgeon to create a more natural looking breast.
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Pregnancy After Breast Cancer Treatment
While people often worry that the hormonal effects of a pregnancy after breast cancer may cause the cancer to come back, worldwide research does not support this. Sometimes fertility may be reduced after treatment for breast cancer so it can be harder to become pregnant, but a pregnancy following treatment for breast cancer does not increase the risk of cancer coming back.
Although a pregnancy is not harmful soon after treatment, many doctors recommend that women take time to recover fully before having a baby. There are lots of things to think about before having a baby after breast cancer treatment. It is important that a pregnancy be carefully planned and that you are not having any anti-cancer treatment like chemotherapy, radiotherapy or hormonal treatment when you fall pregnant. These issues should be talked about in detail with your treatment team if you are thinking about having a baby. You may need to consider how much support you have if your breast cancer returns some time in the future.
Normal breast feeding from a breast that has been previously treated for cancer may not be possible. Treatments like surgery and radiotherapy make it difficult for the breast to produce milk. The treated breast may produce a small amount of milk. Even if the treated breast does not produce milk, successful breast feeding from the healthy breast may be possible. The healthy breast will usually enlarge with pregnancy and breast feeding but the treated breast may not.
What Is A Young Adult Cancer
There is no strict definition of what separates childhood cancers from cancers in young adults, or when exactly a person is no longer a young adult. But for statistics purposes, cancers in young adults are often thought of as those that start between the ages of 20 and 39.
Cancer is not common in young adults, but a wide variety of cancer types can occur in this age group, and treating these cancers can be challenging.
Most cancers occur in older adults. The most common cancers in older people are cancers of the skin, lung, colon and rectum, breast , and prostate . Many cancers in older adults are linked to lifestyle-related risk factors or to other environmental factors. A small portion are strongly influenced by changes in a persons genes that they inherit from their parents.
Cancers that start in children or in teens are much less common. The types of cancers that develop in children and teens are often different from the types that develop in adults. Childhood cancers are often the result of gene changes that take place very early in life, sometimes even before birth. Unlike many cancers in adults, cancers in children and teens are not strongly linked to lifestyle or environmental risk factors.
The types of cancers that occur in young adults are a mix of many of the types that can develop in children, teens, and older adults.
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