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
Risk Factors To Consider
You may be more likely to get diagnosed with breast cancer at an early age if you have a mother, sister, or another close family member who was diagnosed with breast cancer before age 45.
You may also have a higher risk of diagnosis if you have the BRCA1 or BRCA2 gene mutation. The BRCA genes help fix damaged DNA. When theyre altered, the DNA in the cells can change in ways that lead to cancer. Experts link these mutations to an increased risk for breast and ovarian cancers.
Breast cancers that arise from BRCA mutations are more likely to start early and to be more aggressive. Up to 45 percent of those with a BRCA2 mutation, will develop breast cancer by age 70.
Treatment with radiation to the chest or breast as a child or teenager can also increase your risk.
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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The Breast Cancer Diagnosis
Breast cancer is often harder to diagnose in younger women. This is often because younger women:
- Have more lumpy breast tissue, which makes cancerous lumps harder to fee.
- Have more dense breast tissue, which makes a mammogram and ultrasound harder for doctors to read.
- Have a lower expectation of developing cancer so sometimes the diagnosis is delayed.
- May be pregnant or breast feeding when they find their lump, making it harder to know what the lump indicates.
The choices for treating breast cancer are the same for women of all ages.
Breast cancer treatment includes treatment to the breast and to the lymph glands in the armpit, usually with surgery and/or radiotherapy. Treatment to the whole body with chemotherapy and/or hormonal therapies may also be recommended.
Treatment to the breast involves:
- Breast conservation followed by a course of radiotherapy, or
- Mastectomy , which may sometimes be followed by a course of radiotherapy.
Treatment to the lymph glands involves:
- Sentinel node biopsy , or
- Axillary clearance , or
- A combination of these two treatments. Treatment to the body involves:
- Chemotherapy and/or
- Hormonal therapies if the cancer shows hormone receptors on testing
Your treating specialists will be able to advise you on the treatment to the breast and armpit soon after breast cancer is diagnosed. Recommendations on chemotherapy and hormone therapy are often not made until after an operation when the detailed pathology results are available.
Breast Cancer Program Supports Young Women Through The Complicated Issues
Sonia Racco, pictured above with daughter Genna, is a breast cancer survivor. Five years after her lumpectomy, radiation and chemotherapy, she gave birth to her second child.
Young women with breast cancer face medical and psychological challenges that can be very different to those of their older peers.
Thats why Sunnybrook launched the PYNK program.
Sonia Racco was 35 when she gave birth to her first child, a healthy baby girl named Genna.
Twenty months later, Sonia was diagnosed with breast cancer.
I found the lump while I was breastfeeding, says Sonia, but I didnt think it was anything.
She knew that it was normal for breast tissue to change with pregnancy and breastfeeding. She also knew there was no history of breast cancer in her family, nothing to suggest that she might be one of the thousand or so Canadian women under the age of 40 who are diagnosed with breast cancer every year.
When the lump didnt go away after a couple of weeks, Sonia went to her family doctor. Her mammogram was worrisome enough for a referral to Sunnybrooks rapid diagnostic clinic.
I had the mammogram, the biopsy and the diagnosis within 24 hours, she recalls. I kind of knew as soon as they did the biopsy on my breast and under my arm. My husband was a lot more overwhelmed than I was when we got the results, says Sonia.
But there was also the Young Women With Breast Cancer Program, Sunnybrooks support and research program for young breast cancer patients.
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Cancers Of The Female Genital Tract
Cervical cancer tends to occur in midlife. Most often it is found in women younger than 50. It rarely occurs in women younger than 20. Most cervical cancers can be found early, or even prevented, with screening tests. Vaccines against HPV, the virus linked to most cervical cancers, can also help prevent it. The most common symptom of cervical cancer is abnormal vaginal bleeding.
Overall, ovarian cancer is much more common in older women than in women younger than 40. But some less common types of ovarian cancers, known as germ cell tumors, are more common in teens and young women than in older women. Early ovarian cancer usually does not cause symptoms, but some women might feel full quickly when eating or they might have abnormal bloating, belly pain, or urinary symptoms. Women who have any of these symptoms lasting more than a few weeks should see their doctor.
Breast Cancer In Women Under 40
Throughout her lifetime, a woman has a 1 in 8 risk of developing breast cancer. No matter what your age you need to be aware of risk factors. In many cases of breast cancer early diagnosis is the key to survival.
This slideshow will tell you 10 things every young woman should know about breast cancer.
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Health Disparities In Young African Americans
In addition to these unique issues, research has shown that young African American women face even greater challenges.
- African American women under age 35 have rates of breast cancer two times higher than caucasian women under age 35.14
- African Americans under age 35 die from breast cancer three times as often as caucasian women of the same age.14
- Researchers believe that access to healthcare and the quality of healthcare available may explain these disparities. But scientists continue to investigate.
- Research also shows that young African Americans are more likely to get aggressive forms of breast cancer than anyone else.14
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 cancerous cells 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.
In some cases, breast cancer in your 20s and 30s has been found to differ biologically from the cancers found in older women.
For example, younger women are more likely to receive a diagnosis of triple-negative and HER2-positive breast cancers than older women.
more likely in adolescent and young women than in older women who have a diagnosis of early stage breast cancer.
Metastatic breast cancer means that the cancer has advanced to stage 4. It has moved beyond the breast tissue into other areas of the body, such as the bones or the brain.
Survival rates are lower for cancer that has metastasized to other parts of the body.
According to the American Cancer Society, the 5-year survival rate for women with breast cancer that has spread to other parts of the body is 28 percent for all ages.
However, some signs and symptoms of breast cancer may
- changes in the skin
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What Is Breast Cancer
Breast cancer is the most common cancer in American women, and it is the second most common cause of cancer deaths in women. Breast cancer occurs rarely in men as well. There are about 230,000 new cases of breast cancer diagnosed in women the U.S. each year, and about 2,300 new cases diagnosed in men.
To understand breast cancer, it’s important to learn the anatomy of the breast. Most of the breast is comprised of fatty tissue, and within that are ligaments, connective tissue, lymph vessels and nodes, and blood vessels. In a female breast there are 12-20 sections within it called lobes, each made up of smaller lobules that produce milk. The lobes and lobules are connected by ducts, which carry the milk to the nipple.
The most common type of breast cancer is cancer of the ducts, called ductal carcinoma, that accounts for just over 80% of all breast cancers. Cancer of the lobes makes up just over 10% of cases. The rest of the breast cancers have characteristics of both ductal and lobular carcinomas, or have unknown origins.
Unique Challenges For Young Adults
Breast cancer in young adults is just different. We are at a different phase of our lives and encounter unique challenges compared to older persons. These challenges may significantly impact our quality and length of life. Some of the unique challenges and issues young adults face:
- The possibility of early menopause and sexual dysfunction brought on by breast cancer treatment
- Fertility issues, because breast cancer treatment can affect a womanâs ability and plans to have children
- Many young women are raising small children while enduring treatment and subsequent side effects
- Young breast cancer survivors have a higher prevalence of psychosocial issues such as anxiety and depression13
- Questions about pregnancy after diagnosis
- Heightened concerns about body image, especially after breast cancer-related surgery and treatment
- Whether married or single, intimacy issues may arise for women diagnosed with breast cancer
- Challenges to financial stability due to workplace issues, lack of sufficient health insurance and the cost of cancer care
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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.
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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Risks Of Local Recurrence After Primary Therapy
Risk of local recurrence of breast cancer has been shown to be increased in young patients in two separate analyses of clinical trials, namely the EORTC group trials and NSABP group trials . The former showed a hazard ratio of 2.8 for local recurrence in patients less than 35 years compared to those above 50 years. A study by Bharat et al. estimated the risk of breast cancer recurrence for women diagnosed below the age of 40 to be 1.53 times higher than in those diagnosed above 40 years. Voogd et al. combined data on stage I and II breast cancer patients from 2 large clinical trials . They reported a 9.2-fold higher risk of local recurrence in women aged 35 who underwent breast conserving surgery compared to women 65 years and above. As for distant recurrence, the risk was doubled in the young patient group compared to the older patients . If we look at studies examining rates of contralateral breast cancer risks, we can deduce that young age is a quite a strong risk factor . Although the absolute risk of CBC is similar between different age groups, the relative risk increase in younger populations is quite substantial, since the initial risk of breast cancer in young women is low compared their older counterparts .
Body Image In Young Women After Breast Cancer
Another hurdle young women face is how breast cancer treatments and their side effects affect body image.
There are incredible demands placed on women in American society about their appearance, says Dr. Silber, and I would not be truthful if I didnt say that a lot of women really struggle not only with treatment but with the aftermath. Its hard because how someone looks can be a part of their self-worth. They may have lost their hair and gained some weight. Their breasts dont look the same. To act like thats not a thing is not fairof course, it matters.
Young women may be looking for a partner at a time when breast cancer treatment causes them to experience body changes that women generally dont encounter until theyre older and postmenopausal: hot flashes and/or weight gain in the abdomenthe meno-pot.
Its different when these changes happen at 20 and 30, says Dr. Silber, who explains that hormonal therapies are used for certain types of breast cancers to control tumor growth and discourage recurrence. But, this life-saving treatment, which a woman will need to keep taking as long as she lives, puts female breast cancer survivors into premature menopausemany years or even decades before their peers.
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Risk Of Breast Cancer By Age
A womans risk of developing breast cancer based on her age is as follows:
- 30 years old: 0.49% or 1 in 204
- 40 years old: 1.55% or 1 in 65
- 50 years old: 2.4% or 1 in 42
- 60 years old: 3.54% or 1 in 28
- 70 years old: 4.09% or 1 in 24
About 5% of breast cancer cases occur in women under 40 years old. It may be more difficult to diagnose breast cancer in young women because their breast tissue is denser than that of older women. Young women and their doctors may also be more likely to ignore a breast lump because of their low risk.
Breast cancer that occurs in young women tends to be more aggressive and less likely to respond to treatment. Women who are diagnosed with breast cancer before age 40 are more likely to have a genetic mutation that puts them at higher risk. Screening for the BRCA gene mutation may begin at age 25.
Other signs for young women to be aware of include:
- A lump in the breast
- Nipple discharge
- Focal pain
- Skin changes on the breast
Mammogram screening is recommended to begin between ages 40 and 50 based on your individual risk factors.