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.
Hormones And Hormone Medicine
Hormone replacement therapy
Hormone replacement therapy is associated with an increased risk of developing breast cancer. However, the risk is a very low one.
Women who use the contraceptive pill have a slightly increased risk of developing breast cancer. The risk starts to decrease once you stop taking the pill. Your risk of breast cancer is back to normal 10 years after stopping.
Circulating Tumor Cells At 5 Years Post
In addition, liquid biopsy for the presence of circulating tumor cells at five years post-diagnosis may also help predict late recurrence.
In a 2018 study published in the Journal of the American Medical Association , women who had cancer cells in their blood five years after diagnosis were roughly 13 times more likely to experience a recurrence as those who did not. The finding was significant only for women who had estrogen receptor-positive tumors, and none of the women who had circulating tumor cells in their blood but estrogen receptor-negative tumors experienced a recurrence.
Using liquid biopsies to predict recurrence is still in the investigational stage and not currently used when making decisions on whether or not hormonal therapy should be continued beyond five years.
That said, these findings, along with molecular subtyping offers hopes that doctors will be better able to predict who should receive extended hormonal therapy in the future.
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Prognosis Of Late Vs Early Cancer Recurrence
Late recurrence is associated with a better prognosis than early recurrence in estrogen receptor-positive breast cancer. A 2018 study in Clinical Breast Cancer found that survival after recurrence was significantly longer in people with a late versus early recurrence . In this study, the lungs were the most common site of late distant recurrence.
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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Review Articlebreast Cancer Treatment In Women Over The Age Of : A Tailored Approach
12% of all breast cancer cases occur in women over 80 years of age.
Treatment plans for breast cancer in octogenarians should consider co-morbidities.
Online tools can assess life expectancy and benefits and risks of cancer therapies.
Surgical therapy is well tolerated in octogenarians and should not be underutilized.
Axillary staging and radiation therapy may be omitted in some cases.
What Are The Symptoms Of Breast Cancer
Symptoms of breast cancer can include:
- a lump or area of thickened tissue in the breast
- a change in the size or shape of one or both breasts
- a change in the shape or appearance of the nipple, such as crusting, sores, redness or inversion
- changes to the skin of the breasts, such as dimpling , rash, or redness
- discomfort or swelling in either armpit
Symptoms of breast cancer in men are similar to those that women experience.
If you have any unusual symptoms, such as the above, you should see your doctor to get them checked.
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How Common Is Breast Cancer In Teens
Even in young adult women, the odds of developing breast cancer are very low. Less than 5 percent of breast cancers occur in women under 40. At age 30, the risk of developing breast cancer is 0.44 percent. There are less than 25 cases of breast cancer per year in women in each age group under 30. Among teenagers, the figure is close to zero.
These statistics mean that issues with the breasts are almost certainly due to other causes and these are often just normal development.
Other reasons a teenager might develop a lump in her breast include:
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.
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Can I Be Screened For Breast Cancer
BreastScreen Australia offers a free screening program for women at risk of breast cancer:
- If youre aged between 50 and 74 years, youll be invited to access a free mammograms every 2 years. This is because nearly 4 in 5 breast cancers occur in women aged over 50.
- If youre aged between 40 and 49 years or over 75 years, you are also eligible but wont be contacted about it.
- Women under 40 years of age are usually not offered breast screening because the density of their breast tissue makes it harder to detect cancers on mammograms.
Younger women with a strong family history of breast or ovarian cancer, or women with breast cancer diagnosed in the last 5 years may also benefit from breast screening. For more details, call BreastScreen Australia on 13 20 50 or visit their website.
Causes Of Breast Cancer In Teens
Doctors arent entirely sure what causes teenage breast cancer because there are so few cases.
In general, though, its thought that childhood cancers develop because of changes in cells and DNA that occur early in life. These changes can even happen while youre still in the womb.
The ACS also notes that childhood cancers arent strongly associated with environmental and lifestyle factors such as smoking or eating certain foods.
However, if you introduce these unhealthy behaviors early in life, they can increase your risk for breast cancer when youre older.
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Symptoms Of Breast Cancer
Breast cancer can have several symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue.
Most breast lumps are not cancerous, but it’s always best to have them checked by a doctor.
You should also see a GP if you notice any of these symptoms:
- a change in the size or shape of one or both breasts
- discharge from either of your nipples, which may be streaked with blood
- a lump or swelling in either of your armpits
- dimpling on the skin of your breasts
- a rash on or around your nipple
- a change in the appearance of your nipple, such as becoming sunken into your breast
Breast pain is not usually a symptom of breast cancer.
Find out more about the symptoms of breast cancer.
Relationships With Friends And Family
It’s not always easy to talk about cancer, either for you or your family and friends. You may sense that some people feel awkward around you or avoid you.
Being open about how you feel and what your family and friends can do to help may put them at ease. However, don’t be afraid to tell them that you need some time to yourself, if that’s what you need.
Want to know more?
- Healthtalkonline: How breast cancer affects families
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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 .
Types Of Breast Cancer
There are several different types of breast cancer, which develop in different parts of the breast.
Breast cancer is often divided into either:
- non-invasive breast cancer found in the ducts of the breast which has not spread into the breast tissue surrounding the ducts. Non-invasive breast cancer is usually found during a mammogram and rarely shows as a breast lump.
- invasive breast cancer where the cancer cells have spread through the lining of the ducts into the surrounding breast tissue. This is the most common type of breast cancer.
Other, less common types of breast cancer include:
- invasive lobular breast cancer
- inflammatory breast cancer
It’s possible for breast cancer to spread to other parts of the body, usually through the blood or the axillary lymph nodes. These are small lymphatic glands that filter bacteria and cells from the mammary gland.
If this happens, it’s known as secondary, or metastatic, breast cancer.
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Ovarian Ablation Or Suppression
In women who haven’t experienced the menopause, oestrogen is produced by the ovaries. Ovarian ablation or suppression stops the ovaries working and producing oestrogen.
Ablation can be carried out using surgery or radiotherapy. It stops the ovaries working permanently and means you’ll experience the menopause early.
Ovarian suppression involves using a medication called goserelin, which is a luteinising hormone-releasing hormone agonist . Your periods will stop while you’re taking it, although they should start again once your treatment is complete.
If you’re approaching the menopause , your periods may not start again after you stop taking goserelin.
Goserelin is taken as an injection once a month and can cause menopausal side effects, including:
- hot flushes and sweats
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Who Provides Breast Cancer Treatment
A medical team may involve several different health professionals. It may include a GP, a radiologist, an oncologist, a breast care nurse, a surgeon and other allied health professionals such as counsellors and therapists. Having a multi-disciplinary team means a patient can receive the best care possible.
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Stage Of Breast Cancer
When your breast cancer is diagnosed, the doctors will give it a stage. The stage describes the size of the cancer and how far it has spread and helps to predict the outlook.
Ductal carcinoma in situ is sometimes described as stage 0. Other stages of breast cancer describe invasive breast cancer:
- stage is â the tumour is “in situ” and there’s no evidence of invasion
- stage 1 â the tumour measures less than 2cm and the lymph nodes in the armpit aren’t affected there are no signs that the cancer has spread elsewhere in the body
- stage 2 â the tumour measures 2-5cm, the lymph nodes in the armpit are affected, or both there are no signs that the cancer has spread elsewhere in the body
- stage 3 â the tumour measures 2-5cm and may be attached to structures in the breast, such as skin or surrounding tissues, and the lymph nodes in the armpit are affected there are no signs that the cancer has spread elsewhere in the body
- stage 4 â the tumour is of any size and the cancer has spread to other parts of the body
Can Breast Cancer In Younger Women Be Prevented
For women with a family history that is suggestive of a hereditary predisposition for breast cancer, a referral for genetic counseling may be appropriate. Identifying such genetic conditions will allow for a more personalized discussion on screening and preventive treatment options. For example, screening in BRCA mutation carriers begins at the age of 25.
Measures that all women can take to reduce breast cancer risk include:
- Achieving and maintaining ideal body weight
- Limiting alcohol consumption
- Getting regular exercise
That being said, if breast cancer does develop, early detection and prompt treatment can significantly increase a woman’s chances of survival. More than 90% of women whose breast cancer is found in an early stage will survive.
Young women should be counseled on breast awareness and to report any breast changes to their healthcare provider. These changes can include:
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How Common Is Breast Cancer
Breast cancer is the most common cancer in American women, except for skin cancers. The average risk of a woman in the United States developing breast cancer sometime in her life is about 13%. This means there is a 1 in 8 chance she will develop breast cancer. This also means there is a 7 in 8 chance she will never have the disease.
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.
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How Often Should I Get My Breasts Checked
It is recommended that women at age 40 should be getting breast exams with a doctor every year. Depending on your family history, a routine clinical breast exam may be recommended more frequently. If you are wondering when to do a breast exam, doctors advise you to have one done after your menstrual cycle.
Detection And Diagnosis Of Breast Cancer In Young Women
Organised breast cancer screening aims to detect breast cancers at an early stage in women. In Australia, population-based screening is performed by BreastScreen Australia and involves mammograms . As there is currently insufficient evidence that mammography is an effective nation wide breast cancer screening strategy for young women, routine breast screening for under 40s is not offered.
An effective method for early detection of breast cancer in young women is breast awareness. Women of all ages should become aware of how their breasts normally look and feel, and to report any new or unusual changes) to their general practitioner without delay.
Young women classified as being at high risk of developing breast cancer should discuss an individual routine screening program with their general practitioner. Breast imaging use to investigate breast symptoms or for surveillance of young women may include breast ultrasounds, breast mammograms and breast MRIs.
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What Is The Average American Womans Risk Of Being Diagnosed With Breast Cancer At Different Ages
Many women are more interested in the risk of being diagnosed with breast cancer at specific ages or over specific time periods than in the risk of being diagnosed at some point during their lifetime. Estimates by decade of life are also less affected by changes in incidence and mortality rates than longer-term estimates. The SEER report estimates the risk of developing breast cancer in 10-year age intervals . According to the current report, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the following ages, is as follows:
- Age 30 . . . . . . 0.49%
- Age 40 . . . . . . 1.55%
- Age 50 . . . . . . 2.40%
- Age 60 . . . . . . 3.54%
- Age 70 . . . . . . 4.09%
These risks are averages for the whole population. An individual womans breast cancer risk may be higher or lower depending on known factors, as well as on factors that are not yet fully understood. To calculate an individual womans estimated breast cancer risk, health professionals can use the Breast Cancer Risk Assessment Tool, which takes into account several known breast cancer risk factors.