Do Young Women Have Worse Breast Cancer Outcomes It Seems To Depend On The Cancers Characteristics
- Tags:Early-stage: Stage IA, Early-stage: Stage IB, Early-stage: Stage IIA, Early-stage: Stage IIB, Early-stage: Stage IIIA, Luminal A Breast Cancer, 39 and younger, Estrogen-Receptor Positive, Progesterone-Receptor Positive, Planning/Considering Hormonal Therapy, Preparing for/Undergoing Hormonal Therapy, and Hormonal Therapy After Surgery
Breast cancer in women age 40 or younger isnt common — about 6% to 7% of all breast cancers in the United States are diagnosed in women in this age group. Still, breast cancer diagnosed in younger women is likely to be more aggressive or metastatic at diagnosis, and women in this age group have worse survival compared to older women.
Researchers wondered if these statistics were really true for all diagnosed younger women, or if outcomes varied based on the characteristics of the breast cancer.
A study suggests that younger women diagnosed with luminal A breast cancer have worse survival compared to older women diagnosed with the same subtype.
The research was published online on August 1, 2016 by the Journal of Clinical Oncology. Read the abstract of Subtype-Dependent Relationship Between Young Age at Diagnosis and Breast Cancer Survival.
Eric Winer, M.D., director of the breast oncology center at the Dana-Farber Cancer Institute and member of the Breastcancer.org Professional Advisory Board, is one of the studys authors.
Luminal A and luminal B breast cancer are two of the four main molecular subtypes of breast cancer:
How Is Breast Cancer Diagnosed
Breast cancer in children is diagnosed with a physical exam to look for breast changes such as:
- A lump in the breast
- Changes in the size or shape of the breasts
- Dimpling skin on the breast
- Pulling in of a nipple
- Discoloration of breast skin
Tests used to confirm a diagnosis of breast cancer include:;
- 3D tomosynthesis is a special new type of digital mammogram
When To Start Screening
We recommend mammogram screening to start no earlier than age 40 and no later than age 50 for women of average risk for breast cancer, and continue through to at least age 74, says Dr. Andrejeva-Wright. Screening;mammography should occur at least once every two years. For women whose screening mammograms show they have dense breasts, an extra testa breast ultrasoundis recommended.
Dr. Andrejeva-Wright says it is important to talk with a health care provider about when you should start getting mammograms, based on your unique health profile, and to make an appointment to see your doctor if you notice any unusual breast changes.;
Any time a woman feels a breast mass, which does not go away, while doing a breast self-exam at any age, she should get it checked out, says Dr. Silber.;
More than half of the time, women detect breast cancers themselves when they notice an unusual breast change.;Whenever there is a new mass or lump, tell your doctorit should be evaluated by a clinical physical examination followed by breast imaging, says Dr. Andrejeva-Wright. Other signs to be aware of include asymmetry of the breasts and nipple changes such as discharge or peeling skin around the nipple.;
Says Dr. Andrejeva-Wright, These symptoms dont mean you have breast cancer, but its a reason to seek an opinion from a medical provider.;
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Detecting Breast Cancer In Younger Women
While theres no way to predict who will get breast cancer, some factors put women at higher risk at a;younger age. Breast cancer risk is higher in women with a family history of breast or ovarian cancers at a young age or who have an Ashkenazi Jewish heritage. Having had radiation therapy in the chest is another important risk to know about.
There are some steps you can take, including discussing your family cancer history with your doctor and taking advantage of genetic testing for BRCA and other genetic mutations, if offered, based on your health and family history.;
Through research, we are learning more about cancer, genetics, and risk factors, says Dr. Andrejeva-Wright. Young women should be aware of their family history and keep their doctors updated over time as it changes.
Also, while guidelines no longer call for monthly at-home breast exams, Dr. Andrejeva-Wright urges women of all ages to be breast aware. She advises women to do a breast self-exam at least quarterly and to learn all they can about their risk factors.
Breast awareness entails knowing your family history of breast and other cancers, says Dr. Andrejeva-Wright, It also means knowing any behavioral factors that may increase your risk of developing breast cancer, such as weight gain and alcohol consumption , and doing something about it.
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.
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What Will The Doctor Do
Sometimes a doctor will discover a lump in a woman’s breast during a routine examination or a patient might come to the doctor with questions about a lump she found.
In other cases, a mammogram may find a lump in the breast that can’t be felt. A mammogram is a special kind of X-ray of the breast that helps doctors see what’s going on inside. Sometimes, other kinds of pictures, like an MRI, also can be taken.
When a lump is found, the doctor will want to test it. The best way to do this is usually with a biopsy. In a biopsy, a small amount of breast tissue is removed with a needle or during a small operation. Then, the tissue is examined under a microscope to look for cancer cells.
The biopsy may be benign , which means the lump is not cancer. If the biopsy shows cancer cells, the lump is malignant . If a breast lump does contains cancer cells, the woman, along with her doctor and family, will decide what to do next.
Women At Higher Risk Of Breast Cancer
Factors that greatly increase breast cancer risk include :
- A BRCA1 or BRCA2 inherited gene mutation;
- A;personal history of invasive breast cancer or ductal carcinoma in situ
- A personal history of lobular carcinoma in situ or atypical hyperplasia
- Radiation treatment to the chest area between ages 10-30
- Li-Fraumeni, Cowden/PTEN or Bannayan-Riley-Ruvalcaba syndrome
- An ATM, BARD1, BRIP1, CDH1, CHEK2, NBN, NF1, PALB2, PTEN, RAD51C, RAD51D, STK11 or TP53 inherited gene mutation
- A greater than 20 percent lifetime risk of invasive breast cancer based mainly on family history
Figure 3.5 below outlines the National Comprehensive Cancer Network breast cancer screening guidelines for women at higher than average risk up to age 75.
The NCCN recommends women older than 75 talk with their health care providers about a breast cancer screening plan thats right for them.;
Figure 3.6 below outlines the American Cancer Society breast cancer screening guidelines for women at higher than average risk .
Figure 3.5: NCCN breast cancer screening recommendations for women at higher than average risk
Every year starting at age 30 or age recommended by health care provider
Every year starting at age 30 or age recommended by health care provider
Adapted from ACS materials .
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What Clinical Trials Are Available For Women With Inflammatory Breast Cancer
NCI sponsors clinical trials of new treatments for all types of cancer, as well as trials that test better ways to use existing treatments. Participation in clinical trials is an option for many patients with inflammatory breast cancer, and all patients with this disease are encouraged to consider treatment in a clinical trial.
Descriptions of ongoing clinical trials for individuals with inflammatory breast cancer can be accessed by searching;NCIs list of cancer clinical trials. NCIs list of cancer clinical trials includes all NCI-supported clinical trials that are taking place across the United States and Canada, including the NIH Clinical Center in Bethesda, MD. For information about how to search the list, see Help Finding NCI-Supported Clinical Trials.
People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from NCIs Cancer Information Service;at 18004CANCER ;and in the NCI booklet Taking Part in Cancer Treatment Research Studies. Additional information about clinical trials is available online.
Anderson WF, Schairer C, Chen BE, Hance KW, Levine PH. Epidemiology of inflammatory breast cancer . Breast Diseases 2005; 22:9-23.
Are We Making Progress In Breast Cancer Survival Advances Made In Research The Positive Impact Of Screening Programs And Improvements In Treatment Are Changing The Future Of Breast Cancer In Fact The Breast Cancer Death Rate In Females Has Dropped By An Estimated 49% Since It Peaked In The 1980s We Know More Than Ever About How To Prevent Detect Diagnose Treat And Live With And Beyond Breast Cancer But Theres Still More To Be Done Thanks To The Support Of Canadians Who Share In Our Passion Were Continuing To Make An Impact And Work On Groundbreaking Research That Will Help Us Change The Future Of Breast Cancer In Canada
We know that a breast cancer diagnosis is not easy it can bring up many emotions and challenges. And if you have more questions about breast cancer, know that were here to help. You can turn to us for;credible information about breast cancer;or reach out to one of our trained;;at 1-888-939-3333 or through live chat right here on our website .
With about 27,000 new breast cancer cases estimated to be diagnosed this year alone in Canada, we all have a reason to care about this disease that impacts our mothers, grandmothers, aunts, sisters, partners, and friends across the country. Show your support for Canadians affected by breast cancer. Join us and together, we can be a force-for-life in the face of breast cancer.
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What Causes Breast Cancer
The cause of breast cancer in children is unknown, but certain risk factors are linked to the disease.;
Risk factors for breast cancer in children, teens, and young adults includes:;
- Past treatment with radiation therapy to the breast or chest for another cancer, such as Hodgkin lymphoma
- A personal history of a cancer that tends to spread to the breast, such as leukemia, lymphoma, rhabdomyosarcoma, or soft tissue sarcoma;
- A family history of breast cancer in a close relative
- Inherited changes in the BRCA1 or BRCA2 gene or in other genes that increase the risk of breast cancer
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:
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Using Your Family History
You should certainly share your family history with your medical team. Your doctors might advise genetic counseling or genetic testing if your family history suggests that you could be carrying a breast cancer gene.
Some red flags include:
- Cancer of;any;kind before the age of 50
- More than one relative with the same type of cancer
- One family member who has more than one type of cancer
- A family member who has cancer not typical for that gender, such as breast cancer in a male
- Certain combinations of cancer, such as the combination of breast cancer with ovarian cancer, uterine cancer, colon cancer, prostate cancer, pancreatic cancer, or melanoma
- Cancer in both of one organ, for example, bilateral breast or ovarian cancer
How Is Breast Cancer Treated In Younger Women
Treatment decisions are made based whether or not it has spread beyond the breast, as well as the woman’s general health and personal circumstances.
Treatment options include:
Surgery: either a lumpectomy, which involves removing the tumor and some surrounding tissue, or a mastectomy, which is the removal of a breast.
Radiation is generally used following a lumpectomy, and chemotherapyand hormone therapy often are recommended after surgery to help destroy any remaining cancer cells and prevent a return.
Breast cancer treatment can affect your sexuality, fertility, and pregnancy. If youd like to have children, talk to your doctor it before you begin treatment.
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Understand Your Family History
Talk with your family members about cancer on both sides of your family.
- If your mother or sister has had breast or ovarian cancer before the age of 50, its recommended you get screened annually with mammogram and ultrasound, from 10 years prior to their age at diagnosis, but not earlier than 30 years of age.
- Women at potentially high risk of breast cancer should be referred to a breast specialist for advice on appropriate screening
- High-risk screening may also include breast MRIs.
While the risk of inherited breast cancer is low, talk about it with your doctor. If you are potentially at high risk, you may be eligible for genetic testing with Genetic Health Service NZ. This assessment would require a referral from your doctor.
Living With Breast Cancer
Dealing with breast cancer can be very hard for a woman and her family. A woman who has breast cancer surgery or treatment may not feel well for a while. She may be depressed if she had her breast removed. If a woman needs chemotherapy, she may lose her hair and she may feel sick to her stomach. She also may worry that the cancer will return and she’ll get sick again.
The good news is that many times, especially if a lump is caught early, women with breast cancer go on to live full, healthy lives after treatment. Some join support groups so they can talk to other women with breast cancer who are feeling the same emotions.
There are even groups that kids or other family members can join to talk about their feelings when someone they love has breast cancer. Find a trusted adult to talk with if you’re worried about a loved one.
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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.
Should Women Under Age 40 Get Mammograms
In general, regular mammograms arent recommended for women under 40 years of age, in part because breast tissue tends to be dense, making mammograms less effective.The American Cancer Society recommends women ages 40 to;44 should have a choice to start yearly screening mammograms if they would like.;Women ages 45 through 54 should have a mammogram each year and those 55 years and over should continue getting mammograms every 1 to 2;years..; Most experts believe the low risk at that age doesnt justify the exposure to radiation or the cost of mammography. But mammograms may be recommended for younger women with a family history of breast cancer and other risk factors.
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How Do I Take Care Of My Breasts
The best thing you can do to protect yourself is to be breast aware from the age of 20. This means knowing how your breasts normally look and feel and regularly checking for any unusual changes.
Your breasts may feel heavy or tender before your period, so the best time to check is after your period finishes, once any discomfort has settled down. Show your doctor if you have any unusual symptoms that don’t go away after your period, particularly if you can feel a lump, or thickened tissue in your breast, or notice a discharge or any skin or nipple changes. Of course, most changes are not caused by breast cancer but its important to have any new changes properly checked.