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Younger women generally do not consider themselves to be at risk for breast
cancer. Only 5 percent of all breast cancer cases occur in women under 40 years
old. However, breast cancer can strike at any age, and all women should be aware
of their personal risk factors for breast cancer. (A risk factor is a condition
or behavior that puts a person at risk for developing a disease.)
There are several factors that put a woman at high risk for developing breast
cancer, including:
- A personal history of breast
cancer or non-cancerous breast disease
- A family history of breast
cancer, particularly in a mother, daughter or sister
- History of radiation therapy
- Evidence of a specific genetic
chance (BRCA1/BRCA2 mutation) — Women who carry defects on either of these
genes are at greater risk for developing breast cancer.
- A Gail Index score of at least
1.7 percent (The Gail Index uses risk factors such as age, family history of
breast cancer, age of first menstrual period and first pregnancy, and number
of breast biopsies to calculate a woman’s risk of developing breast cancer
within the next five years.)
An extended use of oral contraceptives (birth control pills) later
in life is also sometimes considered a factor for developing breast cancer.
However, this is still subject to much debate in the medical community.
What is different about breast cancer in younger women?
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, the
cancer often is advanced. In addition, breast cancer in younger women may be
aggressive 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 younger
women who have breast cancer ignore the warning signs—such as a breast lump or
unusual discharge—because they believe they are too young to get breast cancer.
Many women assume they are too young to get breast cancer and tend to assume a
lump is a harmless cyst or other growth. Some health care providers also dismiss
breast lumps in young women as cysts and 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.
Can breast cancer in younger women be prevented?
Although breast cancer may not be prevented, early detection and prompt
treatment can significantly reduce a woman’s chances of surviving breast cancer.
More than 90 percent of women whose breast cancer is found in an early stage
will survive.
When women learn at a young age about the risks and benefits of
detecting breast cancer early, they are more likely to following the
recommendations regarding clinical exams and mammograms. Young women also need
to understand their risk factors and be able to discuss breast health with their
health care providers.
Should women under age 40 get mammograms?
In
general, regular mammograms are not recommended for women under 40 years old, in
part, because breast tissue tends to be more dense in young women, making
mammograms less effective as a screening tool. In addition, most experts believe
the low risk of developing breast cancer at a young age does not justify the
radiation exposure or the cost of mammography. However, screening mammograms may
be recommended for younger women with a family history of breast cancer and
other risk factors.
What’s the best way for younger women to screen for breast cancer?
The
American Cancer Society (ACS) recommends that all women 20 years of age or older
should perform monthly breast self-examinations (BSE). The best time to perform
BSE is the day after your monthly period ends. Becoming familiar with the look
and feel of their breasts offers the best chance for a young woman to notice any
change. In addition to monthly BSE, annual clinical breast exams are recommended
for all women beginning at age 20. Annual screening mammograms also are
recommended at age 40. Women younger than 40 who have a family history or other
risk factors for breast cancer should discuss their risk and an appropriate
screening schedule with their health care providers.
How is breast cancer treated in younger women?
The
course of treatment for breast cancer at any age is based on the extent of the
person’s disease (whether or not it has spread beyond the breast), as well as
the woman’s general health and personal circumstances. Treatment options include
a lumpectomy, which involves removing the lump and some surrounding tissue, or a
mastectomy, which is the removal of a breast. Radiation therapy is generally
used following a lumpectomy, and chemotherapy and/or hormone therapy often are
recommended after surgery to help destroy any remaining cancer cells and prevent
recurrence.
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