What Causes Breast Cancer In Your 20s And 30s
Breast cancer happens when cells in the breast begin to grow and multiply abnormally. Changes in DNA can cause normal breast cells to become abnormal.
The exact reason why normal cells turn into cancer is unclear, but researchers know that hormones, environmental factors, and genetics each play a role.
Roughly 5 to 10 percent of breast cancers are linked to inherited gene mutations. The most well-known are breast cancer gene 1 and breast cancer gene 2 . If you have a family history of breast or ovarian cancer, your doctor may suggest testing your blood for these specific mutations.
Breast cancer in your 20s and 30s has been found to differ biologically in some cases from the cancers found in older women. For example, younger women are more likely to be diagnosed with triple negative and HER2-positive breast cancers than older women.
Here are some statistics about breast cancer in women under 40:
Types Of Cancers That Develop In Adolescents
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can then spread to other areas of the body. To learn more about cancer and how it starts and spreads, see Cancer Basics.
For statistical purposes, cancers in adolescents are often thought of as those that start between the ages of 15 and 19. Cancer is not common in teens, but a variety of cancer types can occur in this age group, and treating these cancers can be challenging for a number of reasons.
Most cancers occur in older adults. Cancers that start in childhood are much less common. The types of cancers that develop in children are often different from the types that develop in adults. Childhood cancers are often the result of DNA changes in cells that take place very early in life, sometimes even before birth. Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors.
The types of cancers that occur in adolescents are a mix of many of the types that can develop in children and adults. The types of cancers seen in adolescents are not unique to this age group, but the most common types are different from those most common in young children or adults.
How Can I Maintain Good Breast Health
Pay attention to your body. If you notice changes or something feels off, talk to your healthcare provider. Ways to keep your breasts healthy:
- Be aware of breast changes and report any concerns to your healthcare provider.
- Talk to your healthcare provider about screening options.
- Know your breast density and how it may affect your mammogram.
- Report changes in your family history to your provider every year.
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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.
âI never thought that I wouldnât survive it,â said Bryndza, now 20. âIâm still going to be me, and Iâll fight as hard as I can.â
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 theyâve 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.
âAt that time, as a teen, you think youâre invincible,â Bryndza said. âI sort of saw the whole thing as a big inconvenience.â
Cancers Linked To Treatment With Tamoxifen
Taking tamoxifen lowers the chance of hormone receptor-positive breast cancer coming back. It also lowers the risk of a second breast cancer. Tamoxifen does, however, increase the risk for uterine cancer . Still, the overall risk of uterine cancer in most women taking tamoxifen is low, and studies have shown that the benefits of this drug in treating breast cancer are greater than the risk of a second cancer.
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Will I Need Radiation
Most oncologists generally recommend radiation treatment for all breast cancer patients who undergo only removal of the tumor .
For women who undergo whole-breast removal, radiation may be recommended for those who are considered high-risk, especially those with tumors larger than 5 centimeters and with more than four cancerous lymph nodes.
What Does A Breast Lump Feel Like
Breast lumps can look and feel different depending on the type. They can be painful or painless, and may feel hard, soft, or rubbery under the skin. Some breast lumps are moveable and some are not. They can be many different sizes. It is important for girls and young women to be familiar with the normal shape of their breasts, so they can recognize if a lump appears.
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Breast Cancer: Why Me
The most obvious risk factor for breast cancer is being a woman. Men get the disease, too, but itâs about 100 times more common in women. Other things that make it more likely include being over age 55 or having a close relative who had the disease. Still, up to 80% of women with breast cancer have no family history of the illness.
Puberty And Overlapping Breast Cancer Symptoms
When breasts begin to grow, they appear as a lump underneath the nipple. This is a normal part of the development process.
The breasts get bigger and rounder as the fatty tissue and milk-producing glands inside the breasts continue to grow. As the breast buds grow, you may notice tingling, aching, or itching in your chest, and your nipples may swell or become tender.
After your periods start, the changing hormones may make your breasts feel tender, swollen, or sore a week or so just before your period starts. This is all normal.
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What Is Paget’s Disease Of The Breast
Paget’s disease of the breast is a rare type of cancer of the nipple area of the breast. It presents as eczema affecting the nipple and is often associated with an underlying in-situ or invasive carcinoma of the breast.
Many women find that their breasts become more lumpy and tender before periods. Breasts also alter their size and shape with increasing age, pregnancy and marked weight changes. What is important is that you get to know your own breasts – how they look and feel – and report any changes promptly to a doctor.
There are a number of things to look out for which might be breast cancer signs:
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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Breast Cancer Screening In Teens
Although it is not typically recommended for women under 40 to undergo breast screening annually, its important for those teens experiencing symptoms to receive breast screening. Regular screening done at least every 3 years is recommended for women in their 20s. However, the American Cancer Society recommends that all women know how their breasts look and feel, and report any changes to their doctors. For younger women, digital mammography is recommended rather than a standard mammogram. It is most effective at identifying abnormalities in dense breast tissues.
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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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.
Signs And Symptoms Of Phyllodes Tumors
The most common symptom of a phyllodes tumor is a breast lump that you or your doctor can feel while examining the breasts. Phyllodes tumors tend to grow quickly, within a period of weeks or months, to a size of 2-3 cm or sometimes larger. This rapid growth does not automatically mean the phyllodes tumor is malignant benign tumors can grow quickly, too. The lump is usually not painful. If left unchecked, the lump can create a visible bulge as it pushes against the skin. In more advanced cases whether benign, borderline, or malignant a phyllodes tumor can cause an ulcer or open wound to form on the breast skin.
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Diagnosis Of Phyllodes Tumors
Like other less common types of breast tumors, phyllodes tumors can be difficult to diagnose because doctors don’t encounter them all that often. A phyllodes tumor also can look like a more common type of benign breast growth called a fibroadenoma. A fibroadenoma is a solid, growing lump of normal breast cells that is the most common kind of breast mass, especially in younger women.
Two key differences between fibroadenomas and phyllodes tumors are that phyllodes tumors tend to grow more quickly and develop about 10 years later in life in the 40s as opposed to the 30s. These differences can help doctors distinguish phyllodes tumors from fibroadenomas.
Diagnosing phyllodes tumors usually involves a combination of steps:
Some experts believe it is better to use excisional biopsy if a phyllodes tumor is suspected. Examining the whole tumor is often necessary to make the right diagnosis. The smaller tissue samples taken during core needle biopsy may not be enough to confirm that a lump is a phyllodes tumor.
A pathologist then examines the tumor tissue under a microscope to make the diagnosis. He or she also classifies the phyllodes tumor as benign, borderline, or malignant. In a benign tumor:
- the edges are well-defined
- the cells are not dividing rapidly
- the stromal cells still look somewhat like normal cells
- there is not an “overgrowth” of stromal cells there are epithelial cells as well
In a malignant tumor:
How Is Breast Cancer Treated
Treatment for breast cancer usually depends on the type of cancer and whether the cancer has spread outside of the breast to other parts of the body.
Here are some common treatments:
- lumpectomy , which removes the cancerous tumor from the breast. A woman usually has this surgery when the cancer is found early and when the lump is small and in only one part of the breast.
- mastectomy , which removes the whole breast. This surgery is done when cancer cells have spread through the breast or into other parts of the body. Itâs a good way to remove all or most of the cancer, and can help prevent the cancer from spreading or coming back. Sometimes, a woman who has a mastectomy may choose to have an operation to reconstruct the breast, so her shape will be more like it was before.
- radiation therapy and chemotherapy, which are often used after lumpectomy or mastectomy to make sure that all the cancer cells are destroyed and do not grow back. Radiation therapy uses high-energy X-rays to kill the cancerous cells. Chemotherapy , or chemo, is special medicine that travels throughout the entire body and kills cancer cells.
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What Are The Risk Factors For Breast Cancer In Children
The risk of breast cancer is increased by the following:
- Having a personal history of a type of cancer that may spread to the breast, such as leukemia, rhabdomyosarcoma, soft tissue sarcoma, or lymphoma.
- Past treatment for another cancer, such as Hodgkin lymphoma, with radiation therapy to the breast or chest.
When To Start Breast Examinations
The American Cancer Society no longer recommends regular breast self-exams, since theres no evidence that they help reduce breast cancer deaths.
The organization still believes that being familiar with what is normal for your breasts will make it easier to recognize any changes that happen. A change in breast shape or texture, a new lump, or other significant change could signal a problem that should be checked out by your healthcare provider.
Most teens dont need breast exams at the doctor because they are not at high risk for cancer. But if you have a family history of breast problems, your doctor or nurse might give you a breast exam during your annual checkup.
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What Can I Do To Reduce My Risk
If several members of your family have had breast or ovarian cancer, or one of your family members has a known BRCA1 or BRCA2 mutation, share this information with your doctor. Your doctor may refer you for genetic counseling. In men, mutations in the BRCA1 and BRCA2 genes can increase the risk of breast cancer, high-grade prostate cancer, and pancreatic cancer.
If genetic testing shows that you have a BRCA1 or BRCA2 gene mutation, your doctor will explain what you should do to find cancer early, if you get it.
All men can lower their risk by keeping a healthy weight and exercising regularly.
Normal And Nothing To Worry About
Below are some things you or your daughter may be concerned about. But these are not problems. Reassure your daughter that she is perfectly normal:
Early or late breast development. The breasts begin to develop at the start of puberty, around age 9 or 10. But this can vary, and some girls develop later or earlier.
One breast larger than the other . Girls commonly have one breast that develops faster than the other. It’s also common and normal for girls and women to have one breast that is larger than the other. The difference can be as much as a bra cup size or more.
Small or large size. Breasts come in all shapes and sizes. There is almost no size that is considered abnormal. If breasts fail to develop at all, or if they are so large they are causing neck or back issues, talk to your daughters healthcare provider.
Breast pain around periods. It’s common for breasts to become sore before or during menstrual periods. This is due to hormone changes and is not a cause for concern. If the pain is severe, your daughters healthcare provider can suggest treatment.
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