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.
Clinicopathologic Features Biology And Prognosis
The comparison of clinicopathologic and prognostic features of breast cancer arising in younger women with those in their older counterparts has been the subject of published studies for decades.- Traditionally, breast cancer arising in a younger host is characterized by a more aggressive phenotype. Among 185 premenopausal women carrying a diagnosis of invasive breast cancer, referred for surgery at the European Institute of Oncology from April 1997 to August 2000, those aged less than 35 years had a higher percentage of ER-negative , progesterone receptor -negative , vascular or lymphatic invasion and pathologic grade 3 tumors compared with women aged 35-50 years. Differences in tumor size, lymph node involvement, and Her2/neu status between younger and older women diagnosed with breast cancer have been less clear.-
Having Certain Benign Breast Conditions
Women diagnosed with certain benign breast conditions may have a higher risk of breast cancer. Some of these conditions are more closely linked to breast cancer risk than others. Doctors often divide benign breast conditions into 3 groups, depending on how they affect this risk.
Non-proliferative lesions: These conditions dont seem to affect breast cancer risk, or if they do, the increase in risk is very small. They include:
- Fibrosis and/or simple cysts
- Mild hyperplasia
- Epithelial-related calcifications
- Other tumors
Mastitis is not a tumor and does not increase the risk of breast cancer.
Proliferative lesions without atypia : In these conditions theres excessive growth of cells in the ducts or lobules of the breast, but the cells don’t look very abnormal. These conditions seem to raise a womans risk of breast cancer slightly. They include:
- Usual ductal hyperplasia
- Fibroadenoma
- Several papillomas
- Radial scar
Proliferative lesions with atypia: In these conditions, the cells in the ducts or lobules of the breast tissue grow excessively, and some of them no longer look normal. These types of lesions include:
Breast cancer risk is about 4 to 5 times higher than normal in women with these changes. If a woman also has a family history of breast cancer and either hyperplasia or atypical hyperplasia, she has an even higher risk of breast cancer.
For more information, see Non-cancerous Breast Conditions.
Lobular carcinoma in situ
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Breast Cancer And Birth Control
Some research has shown that taking hormonal birth control slightly increases the risk of breast cancer. However, once you stop using hormonal birth control, risk levels eventually return to normal.
The University of Texas MD Anderson Cancer Center also notes that the overall cancer risk for teens remains low, even though using hormonal birth control minimally increases the risk of developing cancer.
If you use hormonal birth control and youre concerned about your cancer risk, please discuss your options with your doctor before stopping your birth control.
According to research, including a , use of oral contraceptives increases the risk of early onset breast cancer in people under 25 years old who have a BRCA gene mutation.
Doctors should exercise caution before recommending oral contraceptives to someone in this group.
That said, an increased breast cancer risk is just one of many factors to consider before deciding on the right birth control method.
Teens going through the earlier stages of puberty may notice lumps near their nipples. Tenderness and soreness are also possible. These occur during normal breast development and arent a cause of concern on their own.
Your period can also cause tenderness and soreness in the breasts.
What You Can Do
Finding breast cancer early when its small, has not spread, and might be easier to treat can help prevent deaths from the disease. Getting regular screening tests is the most reliable way to find breast cancer early.
The American Cancer Society recommends the following for women at average risk for breast cancer:
Women ages 40 to 44 should have the choice to start yearly breast cancer screening with a mammogram if they wish to do so.
Women age 45 to 54 should get a mammogram every year.
Women 55 and older can switch to a mammogram every 2 years, or can continue yearly screening.
Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
All women should understand what to expect when getting a mammogram for breast cancer screening what the test can and cannot do. They should also be familiar with how their breasts normally look and feel and report any changes to a health care provider right away.
Women at high risk for breast cancer because of their family history, a genetic mutation, or other risk factors should be screened with MRI along with a mammogram. Talk with a health care provider about your risk for breast cancer and the best screening plan for you
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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.
Having Dense Breast Tissue
Breasts are made up of fatty tissue, fibrous tissue, and glandular tissue. Breasts appear denser on a mammogram when they have more glandular and fibrous tissue and less fatty tissue. Women with dense breasts on mammogram have a risk of breast cancer that is about 1 1/2 to 2 times that of women with average breast density. Unfortunately, dense breast tissue can also make it harder to see cancers on mammograms.
A number of factors can affect breast density, such as age, menopausal status, the use of certain drugs , pregnancy, and genetics.
To learn more, see our information on breast density and mammograms.
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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.
Contraceptive pill
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.
General Considerations For Screening
The goal of screening for cancer is to detect preclinical disease in healthy, asymptomatic patients to prevent adverse outcomes, improve survival, and avoid the need for more intensive treatments. Screening tests have both benefits and adverse consequences .
Breast self-examination, breast self-awareness, clinical breast examination, and mammography all have been used alone or in combination to screen for breast cancer. In general, more intensive screening detects more disease. Screening intensity can be increased by combining multiple screening methods, extending screening over a wider age range, or repeating the screening test more frequently. However, more frequent use of the same screening test typically is associated with diminishing returns and an increased rate of screening-related harms. Determining the appropriate combination of screening methods, the age to start screening, the age to stop screening, and how frequently to repeat the screening tests require finding the appropriate balance of benefits and harms. Determining this balance can be difficult because some issues, particularly the importance of harms, are subjective and valued differently from patient to patient. This balance can depend on other factors, particularly the characteristics of the screening tests in different populations and at different ages.
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What Is A 5
A relative survival rate compares women with the same type and stage of breast cancer to women in the overall population. For example, if the 5-year relative survival rate for a specific stage of breast cancer is 70%, it means that women who have that cancer are, on average, about 70% as likely as women who dont have that cancer to live for at least 5 years after being diagnosed.
Your Race And Ethnicity
Overall, white women are slightly more likely to develop breast cancer than African American women, although the gap between them has been closing in recent years. In women under age 45, breast cancer is more common in African American women. African American women are also more likely to die from breast cancer at any age. Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer.
Risk in different groups also varies by type of breast cancer. For example, African American women are more likely to have the less common triple-negative breast cancer.
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Treating Inflammatory Breast Cancer
Inflammatory breast cancer that has not spread outside the breast or nearby lymph nodes is stage III. In most cases, treatment is chemotherapy first to try to shrink the tumor, followed by surgery to remove the cancer. Radiation is given after surgery, and, in some cases, more treatment may be given after radiation. Because IBC is so aggressive, breast conserving surgery and sentinel lymph node biopsy are typically not part of the treatment.
IBC that has spread to other parts of the body may be treated with chemotherapy, hormone therapy, and/or with drugs that targets HER2.
Our team is made up of doctors and;oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Joint Committee on Cancer. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017:589.;
Curigliano G. Inflammatory breast cancer and chest wall disease: The oncologist perspective. Eur J Surg Oncol. 2018 Aug;44:1142-1147.
Hennessy BT, Gonzalez-Angulo AM, Hortobagyi GN, et al. Disease-free and overall survival after pathologic complete disease remission of cytologically proven inflammatory breast carcinoma axillary lymph node metastases after primary systemic chemotherapy.;Cancer. 2006;106:10001006.
American Joint Committee on Cancer. Breast. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017:589.;
Key Points To Remember
- Mammograms can find some breast cancers early, when the cancer may be more easily treated. Studies show that a small number of women who have mammograms may be less likely to die from breast cancer.
- The risk for breast cancer goes up as you get older. In general, women younger than 50 are at a lower risk for breast cancer. Because of this, women ages 50 to 70 are more likely to benefit from having mammograms than women who are in their 40s.
- Mammograms may miss some breast cancers. And some cancers that are found may still be fatal, even with treatment.
- Mammograms may show an abnormal result when it turns out there wasn’t any cancer . This means you may need more testssuch as another mammogram, a breast ultrasound, or a biopsyto make sure you don’t have cancer. These tests can be harmful and cause a lot of worry.
- Mammograms may find cancers that will never cause a problem . Some breast cancers never grow or spread and are harmless. You might have this type of cancer, but a mammogram can’t tell whether it’s harmless. So you may get cancer treatmentincluding surgery, radiation, or chemotherapythat you don’t need.
- If you have health problems that would make it too hard to go through cancer treatment, or if you would not want to have treatment, there may not be a good reason to have a mammogram.
A mammogram is an X-ray of the breast that is used to look for breast cancer.
There are two types of mammograms.
This decision aid is about screening mammograms.
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How Common Is It
Breast cancer isnt common in women under 40.
A womans risk of breast cancer throughout her 30s is just 1 in 227, or about 0.4 percent. By age 40 to 50, the risk is roughly 1 in 68, or about 1.5 percent. From age 60 to 70, the chance increases to 1 in 28, or 3.6 percent.
Out of all types of cancer, though, breast cancer is the most common among U.S. women. A womans risk of developing breast cancer during her lifetime is about 12 percent.
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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What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to start mammograms at age 40
Reasons to start mammograms at age 50
I’m worried that I might get breast cancer at an earlier age.
I’m not too worried that I might get breast cancer at an earlier age.
Can I Screen With Ultrasound Instead
An ultrasound scan is also not a reliable stand-alone method of breast screening in young women. Its a useful targeted diagnostic tool for adding extra information when investigating a known abnormality, but its not accurate enough for generally scanning the breast and screening for cancer.
Lifestyle factors
You can reduce your lifetime risk of breast cancer by adopting healthy lifestyle choices while you are still young.
- Be active. Regular exercise is associated with a decrease in the lifetime risk of breast cancer. Read the World Health Organisations exercise recommendations.
- Maintain a healthy body weight. Women who are overweight or obese have a higher risk of breast cancer after menopause so its important to adopt healthy eating patterns early in life. Eat plenty of fruit and vegetables and stay away from junk food or make it only an occasional treat.
- Limit alcohol. Alcoholic drinks raise the levels of oestrogen in the body and contribute to breast cancer risk.
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Why Cant I Have Screening Mammograms
A mammogram is not recommended as a regular screening tool for women under 40 .
This is because:
- Breast tissue in this age group is naturally denser than in older women, meaning there is a greater concentration of glandular tissue versus fatty tissue in the breasts.
- Glandular breast tissue appears white on a mammogram, as do cancers, so it can be difficult in this age group to detect small tumours.
- This means young women might be subjected to unnecessary biopsies or cancers may be missed .
How Old Do You Have To Be To Get Breast Cancer
A woman has a 12% absolute risk for developing breast cancer in her lifetime, but a womans personal cancer risk changes throughout her life. Breast cancer risk increases with age; the two biggest factors for developing breast cancer are getting older and being a woman. Breast cancer doesnt just affect older women, however.
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The Cost Of Breast Cancer Treatment For Young Women
Everyone with breast cancer is at risk for suffering from economic toxicity with the diagnosis, says Dr. Silber. At the time they are diagnosed with breast cancer, younger women are less likely to be financially sound or to have established themselves in a career that provides sick leave and paid time off; theyre also likelier to have small children, she says.
If you suffer from economic challenges prior to a cancer diagnosis, breast cancer is going to make that worse, says Dr. Silber. Thats especially true for younger women who are from poorer socioeconomic backgrounds and dont have access to the services or much leeway in terms of employment, she says.;
I take care of women who are young, poor, single mothers who may be working at jobs that dont have good human resources supportlike, for example, a young woman working at a mini mart at night, says Dr. Silber. She may be doing hard and not particularly safe work, and might not have health benefits.;
It can be a struggle to keep a job or get a raisebreast cancer patients may become semi-unemployable due to all the medical appointments they need, she explains.