Breast Cancer and Young Women

 

Young Women and Breast Cancer
 

Although  the risk of developing breast cancer increases with age, breast cancer can strike at any age, even if there is no family history of breast cancer. All women should be aware of their personal risk factors. Although, younger women generally do not consider themselves to be at risk for breast cancer, unfortunately they can also be affected by the disease. In fact, one in every 230 women between the ages of 30 and 40 will be diagnosed with breast cancer within the next 10 years. Even if breast cancer is caught in its earliest stages; the five-year survival rate for young women with breast cancer is 82 percent, a significantly lower rate than for post-menopausal women.
 

Breast cancer in women under 40 varies from breast cancer in older women in numerous clinical, pathological and biological features. Patients diagnosed with breast cancer before age 36 indicate more often a palpable mass rather than a mammographic finding and their cancers are more advanced.
Diagnosing breast cancer in younger women (under 40 years old) is more difficult because their breast tissue is generally more dense than the breast tissue in older women. By the time a lump in a younger woman's breast can be felt, often the cancer is advanced.
 

Although breast cancer survival is improving because mammography is leading to diagnosis at earlier stages of the disease, young women with breast cancer rarely undergo mammography before diagnosis; this results in advanced stages of cancer in these women. In addition young age at diagnosis is associated with biologically more aggressive cancers with higher rates of local and distant recurrence and less likely to respond to treatment. Women who are diagnosed with breast cancer at a younger age are more likely to have a mutated (altered) BRCA1 or BRCA2 gene.
 

Delays in diagnosing breast cancer also are a problem. Many young women and their doctors are unaware that they are at risk for breast cancer. Additionally, younger women, because they believe they are too young to get breast cancer, ignore the warning signs such as a breast lump or unusual discharge.
Breast cancer tends to be more advanced in younger women than in their post-menopausal counterparts due to the lack of appropriate screening and diagnostic tools and insufficient education about the disease both amongst young women and the medical community. The recent rise in numbers suggests increased detection, possibly due to improved awareness of breast disease among the younger female population.
 

A diagnosis of breast cancer is more traumatic for young women because of psychosocial concerns, side effects of treatment, and a potentially shortened life expectancy.
Younger women with breast carcinoma could experience a range of adjustment problems at various points in the treatment cycle. They struggle with many issues including menopausal symptoms, problems with relationships, sexual functioning, body image, pregnancy after diagnosis, psycho-social and long-term survivorship issues.
 

Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended. Greater sexual problems are associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems. Research shows that younger women with breast cancer have more severe emotional distress than older cohorts. Addressing these problems is essential to improve the quality of life (QOL) of young women with breast cancer. Interventions that would help reduce the negative impact of treatment on QOL need to be designed and integrated into routine clinical practice, especially those at high risk for lower QOL.
 

Young women diagnosed with breast cancer often feel isolated and have little contact with peers who can relate to what they are experiencing.
Although there is much access to information, support and programs/services younger women often feel that these do not 'fit' or match their age or issues concerning their life stage. Young women diagnosed with breast cancer have suggested that information and support matching their age and life stage should be available. They also suggested implementing several topical workshops concerning, their risk, sexuality, reconstruction, treatment, survival and so on. Providing the information to women who are concerned about their risk of developing breast cancer can reduce anxiety, motivate participation in screening programs, and identify those at very high risk who may desire proactive prevention. Preparing younger woman for the impact of breast cancer may also prove beneficial.
 

The best tool for young women to find breast cancer early, when it is often most treatable, is to become familiar with their breasts, the shape, size and their feel. Be aware of changes that are different from the norm — something that was never noticed before.

If you notice a lump or any changes that did not previously exist and they do not go away, especially after one menstrual cycle, consult it with your doctor or breast heath specialist. If your doctor tells you that you are too young to have breast cancer and does nothing more than a clinical breast exam, insist on another test — ultrasound, mammography and/or a biopsy — or find another doctor.

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American Cancer Society, Breast Cancer Facts and Figures 2005-2006
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