Breast Cancer Risk Increases Over Time
The older a person gets, the more likely they are to develop breast cancer. In general, children and teens dont get breast cancer. About 90 percent of breast cancer diagnoses occur in women aged 45 or older. Additionally, about half of women with breast cancer are at least 63 years old when they are diagnosed.
According to the NCI, during each decade of life, a womans breast cancer risk increases.
- A 30-year-old woman has a 0.49 percent chance of developing breast cancer in the next 10 years.
- A 40-year-old woman has a 1.55 percent chance of developing breast cancer in the next 10 years.
- A 50-year-old woman has a 2.4 percent chance of developing breast cancer in the next 10 years.
- A 60-year-old woman has a 3.54 percent chance of developing breast cancer in the next 10 years.
- A 70-year-old woman has a 4.09 percent chance of developing breast cancer in the next 10 years.
These numbers account for all women across the United States. Many other risk factors affect whether any individual will develop breast cancer, so each persons risk may be higher or lower than what these numbers show. It is also unclear whether these figures are affected by a difference in access to health care resources between individuals.
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
Age At First Period First Childbirth And Menopause
The longer a persons breast cells are exposed to the hormone estrogen, the higher their breast cancer risk. The role of the hormone progesterone is less clear. The ovaries start producing these hormones during puberty. This means that women who go through puberty before the age of 12 have an increased chance of developing breast cancer. Likewise, the ovaries stop making estrogen and progesterone at menopause. Women who go through menopause after the age of 55 are at higher risk of breast cancer.
There is a complicated link between breast cancer and pregnancy. A womans risk of developing breast cancer increases in the short term after giving birth she is more likely to be diagnosed within 10 years of having her first child. However, after this time period, women who have had children have a lower risk of breast cancer than women who have never given birth.
Additionally, the younger a woman is when she has her first child, the more her breast cancer risk drops. A woman who has her first child after she turns 35 is 40 percent more likely to be diagnosed with breast cancer than a woman who has her first child before she turns 20.
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Screening Guidelines For Women At Average Breast Cancer Risk
MSK doctors recommend the following for women at average risk* of breast cancer:
- Women between the ages of 25 and 40 should have anannual clinical breast examination.
- Women 40 and older should have an annual mammogram in addition to anannual clinical breast examination.
- Ultrasound may be recommended for women with dense breast tissue.
- All women should consider performing a monthly self breast exam beginning at age 20 and become familiar with their breasts so they are better able to notice changes.
How Can I Detect My Breast Cancer Early
The best way for young women to find breast cancer early is to be breast self-aware. Become familiar with your breasts: their shape, size and what they feel like. Learn what is normal for you. Sometimes your breasts may change throughout your monthly cycle. If you are pregnant or nursing, your breasts will change even more dramatically. If you find anything unusual, see your doctor immediately and insist on a diagnosis. In general, women should have a yearly clinical breast examination by a doctor beginning at age 20 and start having annual mammograms beginning at age 45.
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How You Can Play A Part
Given the high prevalence of this disease, talking and generating awareness regarding this topic can really make a difference.
Protect yourself and your loved ones by understanding the early signs and symptoms and the importance of screening.
This is all the more reason to create awareness about breast cancer, not only in the month of October, but year-round.
Together, we can make a huge impact. So, play your part in spreading the word, as well as donating to breast cancer charities and research initiatives that aim to find novel cures for the disease.
Breast Cancer Diagnosed During Or After Pregnancy
Being pregnant at the time of diagnosis of breast cancer has been associated with a worse outcome. In one study of 797 such cases, compared with 4,177 non-pregnancy-associated breast cancer controls, women diagnosed while pregnant had larger, more advanced tumors, a greater incidence of receptor-negative tumors, and a higher death rate . A smaller study found no association between pregnancy and increased mortality. In contrast, pregnancy and childbirth following a diagnosis of breast cancer do not increase mortality, and actually may improve survival. One study found that 438 women age < 45 years at diagnosis, who delivered a child 10 or more months following a diagnosis of breast cancer, had a decreased relative risk of death , compared to women who did not bear children following diagnosis. Women who were pregnant at the time they were diagnosed had a mortality rate similar to the latter group. This suggests that childbirth following breast cancer diagnosis does not increase mortality.
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What’s The Best Way For Younger Women To Screen For Breast Cancer
The American Cancer Society recommends that all women know how their breasts look and feel and report any changes to their doctor. The ACS states that research has not shown a clear benefit of performing regular breast self-exams. Talk with your doctor about the pros and cons of breast self-exam.
Regular breast exams done at least every 3 years by your doctor are recommended for women beginning at age 20. Expert groups donât all agree when women should start getting mammograms and you should discuss with your doctor whatâs right for you. The U.S. Preventive Services Task Force recommends screening every 2 years from ages 50 through 74 and also that the decision to start yearly screening mammograms before age 50 should be an individual one..
Talk to your doctor about when you should begin to have mammograms. For younger women, digital mammography may be an alternate to a standard mammogram. Digital mammography is better able to see abnormalities in dense breast tissue.
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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Who Provides Breast Cancer Treatment
A medical team may involve several different health professionals. It may include a GP, a radiologist, an oncologist, a breast care nurse, a surgeon and other allied health professionals such as counsellors and therapists. Having a multi-disciplinary team means a patient can receive the best care possible.
Age At First Period Estrogen And Breast Cancer Risk
The increased risk of breast cancer linked to a younger age at first period is likely due, at least in part, to the amount of estrogen a woman is exposed to in her life. A higher lifetime exposure to estrogen is linked to an increased breast cancer risk .
The earlier a woman starts having periods, the longer her breast tissue is exposed to estrogens released during the menstrual cycle. This means a greater lifetime exposure to estrogen.
A woman cant change the age when she started her period, but the age a girl starts her period can be impacted by certain healthy lifestyle factors. For example, girls who are lean and get more exercise tend to start their periods at a later age than other girls.
Its a good idea for all young girls to be physically active and not be overweight. However, its not recommended girls do anything to try to change when they start getting their period.
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If You Have A Gene Mutation
If you have had tests that showed a change in a gene that increases the risk of breast cancer, the recommendations are slightly different.
UK guidelines recommend yearly MRI scans from:
- age 20 for women with a TP53 mutation
- age 30 for women with a BRCA1 or BRCA2 mutation
What Is A Mammogram And Why Is It Important
A mammogram is an x-ray photo of the breast and is the most common and effective way to screen for early signs of breast cancer. Regular screenings for breast cancer are vital since early detection allows for more treatment options and a higher chance of survival. According to the Carol Milgard Breast Center, approximately 1 in 8 women in the U.S. are diagnosed with breast cancer. Women whose breast cancer is detected early have a 93% higher survival rate in the first five years of diagnosis.
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Soft Tissue And Bone Cancers
Sarcomas are cancers that start in connective tissues such as muscles, bones, or fat cells. There are 2 main types of sarcoma:
- Soft tissue sarcomas
- Bone sarcomas
Sarcomas can develop at any age, but some types occur most often in older teens and young adults.
Soft tissue sarcomas: These cancers can start in any part of the body, but they often develop in the arms or legs. Rhabdomyosarcoma, a cancer that starts in cells that normally develop into skeletal muscles, is most common in children younger than 10, but it can also develop in teens and young adults. Most other types of soft tissue sarcomas become more common as people age. Symptoms depend on where the sarcoma starts, and can include lumps , swelling, or bowel problems.
Bone sarcomas: The 2 most common types of bone cancer,osteosarcoma and Ewing sarcoma, are most common in teens, but they can also develop in young adults. They often cause bone pain that gets worse at night or with activity. They can also cause swelling in the area around the bone.
Osteosarcoma usually starts near the ends of the leg or arm bones. The most common places for Ewing sarcoma to start are the pelvic bones, the bones of the chest wall , or in the middle of the leg bones.
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Why You Should Get Tested
A mammogram is an X-ray picture of the breast that can find cancers, even when they are too small for you or your doctor to feel or see.
Getting regular mammograms and proper follow-up testing for abnormal results are important because they can:
- find cancer early when it may be smaller and easier to treat
- lower the risk of dying from breast cancer in women ages 50 to 74
Mammograms are not perfect tests. Some cancers may also develop in the time between tests. Its important to talk to your doctor or nurse practitioner about the benefits and limitations of testing for breast cancer.
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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.
Integrating Geriatric Principles Into Oncology Treatment Decisions
An integral part of the cancer treatment decision is to determine whether the patient will die of cancer, or simply with cancer. Furthermore, one needs to weigh whether the cancer is likely to cause significant disability for the patient in his/her lifetime. While younger patients with breast cancer can usually anticipate that having a diagnosis of cancer will shorten their life expectancy without treatment, the same may not be true for older adults. The prevalence of comorbid conditions increases with age. Competing comorbidities increase the risk that the older adult with cancer may die of another cause., In this setting an indolent cancer may not influence the lifespan or quality of life of the patient.
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Who Has Breast Screening
Each year more than 2 million women have breast cancer screening in the UK. The NHS Breast Screening Programme invites all women from the age of 50 to 70 for screening every 3 years. This means that some people may not have their first screening mammogram until they are 52 or 53 years.
In some parts of England, the screening programme has been inviting women from 47 to 73 years old as part of a trial.
If you are older than 70, you can still have screening every 3 years but you won’t automatically be invited. To make an appointment, talk to your GP or your local breast screening unit.
If you are younger than 50, your risk of breast cancer is generally very low. Mammograms are more difficult to read in younger women because their breast tissue is denser. So the patterns on the mammogram don’t show up as well. There is little evidence to show that regular mammograms for women below the screening age would reduce deaths from breast cancer.
Breast screening is also for some trans or non-binary people. Talk to your GP or Gender Identity Clinic about this.
Guidelines For Elective Surgical Options
Women with BRCA1 or BRCA2 mutations face a significant risk of breast and ovarian cancer. Prophylactic removal of the fallopian tubes and ovaries is recommended by about age 40. Many women with BRCA1 or BRCA2 mutations will also elect to have their breasts removed. Nipple-sparing mastectomy is an effective option for these women.
Making the decision to have an elective preventive double mastectomy and removal of the ovaries is personal and should be based on many life factors. You must balance where you are in your childbearing years, what your future choices may be, and whether you would prefer to follow a rigorous screening schedule instead of making such a life-altering choice.
Whatever your decision, we encourage you to make an informed choice. If you do elect to have a preventive double mastectomy, our breast specialists will guide you in the appropriate breast surgery reconstruction to help restore your body image after treatment.
If you are interested in discussing ovary removal surgery , we will refer you to one of our gynecological oncologists.
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