Each year in the United States, nearly 280,000 women are diagnosed with breast cancer. 7 percent of them are under the age of 40. This means that while breast happens mostly in older women, it nonetheless affect people on the younger side of the age spectrum. Thus, it is important for women past a certain age to understand the risk factors and the signs of the cancer.
The symptoms of breast cancer are sometimes subtle, or even nonexistent. They therefore often go unnoticed, and even more so when they affect young women for whom the risk remains relatively unknown. However, out of the nearly 280,000 (estimated) cases of breast cancer diagnosed each year in the United States, nearly 20,000 concerns women under the age of 40, or around 7% of cases. Thus, what are the symptoms should a young person look for? When should she consult a doctor?
What is breast cancer?
It is the disruption of cells in the mammary gland, which multiply and form a tumor. These cancer cells can belong to the milk ducts, which collect milk, or to the lobules, which produce milk. As they multiply, they can invade surrounding tissues. There are several types of cancer, depending on the receptors present on the surface of the cells concerned: hormone-dependent cancers are the most common, around 70% of cases. HER2 positive and triple negative breast cancers each account for about 15% to 18% of cases. This last type of tumor is more aggressive and more complex to treat. It is also slightly more common in younger women.
Regardless of the age at which the cancer starts, the symptoms are the same. Overall, at the slightest abnormality in the breast, you should consult your gynecologist quickly to get the breast checked. It can be a lump in the breast or armpit, pain, discharge, a change in the appearance of the skin or the nipple. The important thing is to know your breasts, and to be able to notice if an abnormality or a modification has appeared.
Fortunately, most of the time these symptoms are due to benign abnormalities. Mastodynia, pain in the breasts, can for example be linked to hormones of the menstrual cycle, and are therefore often benign. This pain mainly occurs in the second part of the cycle, after ovulation, when the breasts increase in size. Swelling or pain may also be related to a cyst or fibroadenoma, a benign tumor common in young women.
See your gynecologist regularly
Seeing your doctor regularly will allow him or her to differentiate these abnormalities from breast cancer. Ultrasound checks, possibly a biopsy, may be performed. In general, it is strongly recommended to go to your gynecologist at least once a year for a check-up. In patients with a heavy family history of breast cancer, or even in patients known to carry a genetic mutation, the doctor will offer special monitoring, sometimes including imaging. After 50 and up to 74 years of age, screening should be systematic, consisting of a mammogram and a clinical examination every two years.
Breast cancer: a multidimensional disease
Young women often ignore certain risk factors of breast cancer: alcohol, tobacco, overweight, obesity, sedentary lifestyle. These are important risk factors for breast cancer regardless of the age of the patient. According to National Cancer Institute, women who are obese after menopause are of a 20% increased risk of breast cancer.
But breast cancers can also be genetic. In the general population, 5% of breast cancers are linked to a mutation, while in young women the figure rises to 12%.
Conversely, regular physical activity reduces the risk of developing breast cancer by 20%. Breastfeeding and pregnancy also reduce the risk of breast cancer.
Treatment of breast cancer in young women
The treatment of breast cancer in young women is little different from any other. Hormonal treatment can take a more specific form, the type of hormone therapy being adapted to the patient’s postmenopausal status or not.
However, there are additional questions related to contraception, fertility, or sexuality, in addition to the impact of the disease on social and professional life. In particular, the preservation of fertility must be taken into account, because of the toxicity of chemotherapy on ovarian function. Sexuality is also often disturbed, in connection with the after-effects of surgery (scars, change in volume, pain and sensitivity disorders, etc.), radiotherapy, chemotherapy (loss of hair and hair growth, etc.) and hormone therapy (vaginal dryness, hot flashes, etc.).