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:
Your Race And Ethnicity
White and Black women have the highest risk of developing breast cancer in their lifetime. Asian/Pacific Islander and Hispanic/Latina womens breast cancer rates fall in between two major groupings while American Indian and Alaska Native women are on the lowest end of risk.
While white women are more likely to develop breast cancer than Black women overall, they tend to be diagnosed at an older age . Black women have the highest breast cancer rates among women under age 40. Black women make up a higher percentage of triple-negative breast cancer cases.
What to do: If your race or ethnicity places you at higher risk, make sure you follow all screening recommendations to improve your chances of catching cancer early.
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.
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Teen Breast Cancer Outlook
It is estimated by researchers that 80% of teens diagnosed with breast cancer at the ages of 15 to 19 will still be alive 5 years later. Since its extremely rare in teens, doctors may take the approach of wait and see by delaying treatment. Its still important to take appropriate steps in preventing breast cancer like maintaining a healthy weight and diet, avoiding tobacco products, and staying physically active.
Grade Of Breast Cancer
The grade describes the appearance of the cancer cells.
- Low grade the cells, although abnormal, appear to be growing slowly.
- Medium grade the cells look more abnormal than low-grade cells.
- High grade the cells look even more abnormal and are more likely to grow quickly.
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Example Of Breast Cancer Risk Going Up
Many studies have shown that women who have two or more alcoholic drinks each day have a higher risk of developing breast cancer. You may hear this relative risk described as a percentage or a number:
- Compared to women who do not drink, women who have two or more drinks per day have a 50% higher risk of breast cancer. Put another way, they are 50% more likely to develop breast cancer over the course of a lifetime than nondrinkers are. This doesnt mean that their lifetime risk of getting breast cancer is 50% it means that their risk of getting breast cancer is 50% higher relative to people who dont drink. This percentage is how you are likely to see relative risk reported by television, the Internet, and newspapers.
- Compared to women who do not drink, women who have two or more drinks per day have a relative risk of 1.5. This number is how researchers and scientific papers would usually talk about relative risk. The number 1 is assigned to the baseline group , since their risk remains the same. The .5 describes the relative increase in risk for the other group it is another way of expressing the 50% higher lifetime risk .Another way of saying this is that women who drink two or more alcoholic drinks per day have 1.5 times the risk of developing breast cancer than women who do not drink.
Causes Of Breast Cancer: How Did This Happen
When youre told that you have breast cancer, its natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesnt, and most women who have breast cancer will never be able to pinpoint an exact cause. What we do know is that breast cancer is always caused by damage to a cells DNA.
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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.
How Does Breast Cancer Start
Breast cancer occurs when cells in the breast grow out of control. Different kinds of breast cells develop into different . Most breast cancers begin in the breast ducts or lobules . These are known respectively as invasive ductal carcinoma and invasive lobular carcinoma. Other less common types of breast cancer include inflammatory breast cancer and ductal carcinoma in situ.
Though breast cancer is most common in women, men can develop it as well. A mans lifetime risk of breast cancer is about 1 in 883. This year, the American Cancer Society estimates that about 2,620 men will be diagnosed with breast cancer.
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Taking Charge: Who Gets Breast Cancer
There are no rules about who gets this disease. The two most significant risk factors are being a woman, and increasing age. However, there are other factors that may increase your risk, and some that may lower it.
The development of breast cancer may be influenced by factors that affect the levels of female hormones that circulate in your body throughout life. These factors include the age when you began your menstrual period, the number of times you have been pregnant, your age at first pregnancy, whether you have breastfed your children, and your level of physical activity.
Interval Breast Cancers: Fast Growing And Deadlier
When we think about creating screening guidelines, were thinking about what works for the whole population, she says. We have this blanket recommendation. But are there specific groups of women who are at higher risk and may need more frequent screening or other types of screening? Our idea is we might want to focus on risk factors and prevention strategies for the cancers with the poorest prognosis.
Dr. McCarthy and her colleagues analyzed data from 306,028 women age 40 and older who had no earlier diagnosis of breast cancer and underwent mammography screening. Cases of cancer found after a negative mammography screening were more likely to be linked to a poor prognosis . About 43 percent of interval cancer cases were defined as having a poor prognosis compared with almost 27 percent of cases of cancer found during routine mammography screening.
Higher breast density, with tissue that consists of more supportive material rather than fat, was linked to a higher chance of having an interval cancer. Women with dense breast tissue had twice the odds of having an interval cancer diagnosis compared with women with nondense breasts. Those women did not tend to have a worse prognosis, but women with interval cancers who were younger did have a poorer prognosis.
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The Stages Of Breast Cancer
NOTE: Although a lot of this information is still valid, The American Joint Committee on Cancer has recently updated their classifications for staging breast tumors.
We will be updating all our articles on staging in the near future. In the meantime, please click HERE for a brief summary of the major changes in January 2018.
If a breast biopsy confirms that breast cancer is indeed the diagnosis, the staging process begins.
The stages of breast cancer are really the extent of breast cancer. So, in order to choose and begin the best treatment, it is necessary to stage breast cancer. The staging process shows the progression of breast cancer.
Breast cancer progresses in relatively predictable and consistent ways, so it is possible to categorize breast cancer in terms of stages.
There are basically five stages of breast cancer, with some subcategories .
What Is Different About Breast Cancer In Younger Women
- Diagnosing breast cancer in younger women is more difficult because their breast tissue is generally denser than the breast tissue in older women, and routine screening is not recommended.
- Breast cancer in younger women may be more aggressive and less likely to respond to treatment.
- Women who are diagnosed with breast cancer at a younger age are more likely to have genetic mutations predisposing them to breast and other cancers.
- Younger women who have breast cancer may ignore the warning signssuch as a breast lump or unusual dischargebecause they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes.
- Some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a “wait and see” approach.
- Breast cancer poses additional challenges for younger women as it can involve issues concerning sexuality, fertility, and pregnancy after breast cancer treatment.
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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.
Myth: Annual Mammograms Guarantee That Breast Cancer Will Be Found Earlyfact: Although Mammography Is The Best Early
Its certainly normal to breathe a sigh of relief any time your mammogram comes back clean. Most women think, Im good for another year and put breast cancer out of their minds.
Although mammography is a very good screening tool, it isnt foolproof. It can return a false-negative result, meaning that the images look normal even though cancer is present. Its estimated that mammograms miss about 20% of breast cancers at the time of screening.4 False-negative results tend to be more common in women who have dense breast tissue, which is made up of more glandular and connective tissue than fatty tissue. Younger women are more likely to have dense breasts.
The reality of false negatives explains why a woman can have a normal mammogram result and then get diagnosed with breast cancer a few months later. Some women can have a series of normal mammograms and still be diagnosed with advanced breast cancer. Also, there are cases where breast cancer develops and grows quickly in the year or so after a true negative mammogram.
Mammography does catch most breast cancers, though, and thats why regular screenings are essential. But its also important to pay attention to any changes in your breasts, perform monthly breast self-exams, and have a physical examination of your breasts by a health professional every year.
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Myth: Using Underarm Antiperspirant Can Cause Breast Cancerfact: There Is No Evidence Of A Connection Between Underarm Antiperspirant And Breast Cancer But The Safety Of Antiperspirants Is Still Being Studied
There have been persistent rumors that underarm antiperspirants, especially those containing aluminum and other chemicals, are absorbed into the lymph nodes and make their way into breast cells, increasing cancer risk. Shaving the underarms was thought to make this worse by creating tiny nicks that allow more of the chemicals to enter the body. Another theory was that antiperspirants, by stopping underarm sweating, can prevent the release of toxic substances from the underarm lymph nodes, also increasing cancer risk.
However, there is no evidence of a link between antiperspirant use and breast cancer. Still, some studies have found that women who use aluminum products under their arms are more likely to have higher concentrations of aluminum in breast tissue.2 If youre concerned about minimizing the use of chemicals under your arms, check out these tips in Are Antiperspirants Safe?
What Do You Need To Know About Breast Cancer
What to know about breastfeeding and breast cancer. One in eight U.S. women will develop breast cancer over the course of their lifetime. And many women find that while theyre breastfeeding or pumping, theyre more aware than ever of their breast health, including how they can reduce the risk of breast cancer and what warning signs to watch for.
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Can You Do Anything To Prevent Or Slow The Spread Of Breast Cancer
Like any type of cancer, there are factors that can put you at higher risk. For breast cancer, these include things like smoking, unhealthy diet, lack of exercise and not performing monthly self-breast exams. Its also important to make sure and get your annual mammogram for breast cancer screening.
Other risk factors can include using hormone-based prescriptions, how many children youve had in the past, getting older and at what age you got your period and went through menopause.
In some instances, you cant necessarily prevent breast cancer, but you can sometimes slow it down, stop it from spreading or reduce the size of the tumor, says Dr. Roesch. You can do this by taking your medications as directed, following through with treatments, going to your appointments and being involved in your cancer care.
Youre in control of taking your medication correctly, eating a healthy diet, participating in an exercise program and managing stress. All of these things can contribute to a stronger physical body and better mental attitude both of which can have a positive impact on your breast cancer diagnosis.
Breast Cancer Doubling Time
An easier way to envision how fast a breast cancer grows is by looking at the growth rate or volume doubling time. Tumor doubling time is the period of time that it takes for the tumor to double in size.
Since it would be unethical to leave a cancer untreated to see how rapidly it grew, doubling time is estimated in a number of ways. Looking at these estimates, however, doubling times have varied widely from study to study.
A 2019 study estimated doubling time by looking at serial ultrasounds between diagnosis and surgery. It was found that growth varied significantly based on the estrogen receptor status of the breast tumors.
During an average interval of 57 days, 36 percent of tumors did not change in size, while 64 percent grew. Of those tumors that increased in size, the average gain in volume was 34.5 percent.
Tumors that were triple negative had greater increases in volume and shorter doubling times than those that were estrogen receptor positive and HER2 negative tumors.
In a 2016 study that similarly looked at growth based on ultrasound between diagnosis and surgery over a 31 day period, tumors increased from 1.47 centimeters to 1.56 centimeters in diameter. Daily growth rate based on type was:
- 1.003 percent per day increase for triple negative tumors
- 0.859 percent per day increase for HER2 positive/estrogen receptor negative tumors
- 0.208 percent per day increase for estrogen receptor-positive tumors
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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.