Breast Cancer in Young Women
Breast Cancer in Young Women
Breast cancer is the most common cancer among women, affecting about 1 in 8 women during their lifetime. Although breast cancer mostly occurs among older women, it can also affect young women under the age of 40. In fact, about 9% of all new cases of breast cancer in the US are found in women younger than 45 years of age. Breast cancer in young women can pose unique challenges and require special attention.
Prevention
The exact causes of breast cancer are not fully understood, but some factors may increase or decrease the risk of developing the disease. These include:
- Genetic factors: Some inherited genes, such as BRCA1 and BRCA2, can significantly increase the risk of breast cancer, especially at a young age. Women who have a family history of breast or ovarian cancer should talk to their doctor about genetic testing and counseling .
- Hormonal factors: Exposure to estrogen and progesterone, either naturally or through birth control pills or hormone replacement therapy, can affect the risk of breast cancer. The effect of hormonal factors may vary depending on the type, dose, duration, and timing of use .
- Lifestyle factors: Some behaviors and habits can influence the risk of breast cancer, such as maintaining a healthy weight, limiting alcohol intake, avoiding tobacco use, being physically active, and eating a balanced diet .
- Environmental factors: Some chemicals and radiation may increase the risk of breast cancer, such as exposure to pesticides, industrial solvents, plastics, and ionizing radiation (such as from medical tests or treatments) .
There is no sure way to prevent breast cancer, but some steps may help reduce the risk or detect it early. These include:
- Knowing your family history and personal risk factors
- Getting regular clinical breast exams and mammograms as recommended by your doctor
- Being aware of any changes in your breasts and reporting them to your doctor
- Considering genetic testing and counseling if you have a strong family history of breast or ovarian cancer
- Discussing the benefits and risks of hormonal contraception and hormone replacement therapy with your doctor
- Following a healthy lifestyle that includes physical activity, a balanced diet, moderate alcohol consumption, and no tobacco use
- Avoiding unnecessary exposure to harmful chemicals and radiation
Early Diagnosis
Early diagnosis of breast cancer can improve the chances of survival and reduce the need for aggressive treatment. However, breast cancer in young women can be harder to detect because:
- Young women have denser breast tissue that can make mammograms less effective
- Young women are less likely to have regular mammograms or clinical breast exams
- Young women may ignore or dismiss symptoms or signs of breast cancer
- Young women may face barriers to access health care or insurance coverage
Therefore, it is important for young women to be familiar with their breasts and report any changes or concerns to their doctor. Some symptoms or signs of breast cancer include:
- A lump or thickening in the breast or underarm area
- A change in the size, shape, or appearance of the breast
- A change in the skin of the breast, such as dimpling, puckering, redness, scaling, or swelling
- A change in the nipple, such as inversion, discharge, soreness, or rash
- Pain in the breast that does not go away
Not all lumps or changes in the breast are cancerous, but they should be checked by a doctor to rule out any possibility of malignancy.
Surgical Treatment
Surgery is usually the first treatment for breast cancer. The main types of surgery for breast cancer are:
- Lumpectomy: This involves removing only the tumor and a small margin of normal tissue around it. Lumpectomy is also called breast-conserving surgery because it preserves most of the breast tissue. Lumpectomy is usually followed by radiation therapy to kill any remaining cancer cells in the breast area.
- Mastectomy: This involves removing the entire breast that has cancer. Mastectomy may be done for various reasons, such as having a large tumor, having multiple tumors in different parts of the breast, having a genetic mutation that increases the risk of recurrence, or having a personal preference. Mastectomy may be followed by radiation therapy if there is a high risk of recurrence.
The choice between lumpectomy and mastectomy depends on many factors, such as the size, location, and type of the tumor, the size and shape of the breast, the availability and effectiveness of radiation therapy, the risk of recurrence, and the patient's preferences and quality of life.
Some women may also choose to have breast reconstruction after mastectomy, which involves creating a new breast shape using implants or tissue from another part of the body. Breast reconstruction can be done at the same time as mastectomy (immediate reconstruction) or at a later time (delayed reconstruction). Breast reconstruction can help improve the appearance and self-esteem of some women, but it also has risks and limitations .
Another type of surgery that may be done for breast cancer is axillary lymph node dissection or sentinel lymph node biopsy, which involves removing some or all of the lymph nodes under the arm to check if the cancer has spread. This can help determine the stage of the cancer and guide further treatment. However, removing lymph nodes can also cause side effects, such as pain, swelling, infection, and lymphedema (a chronic condition that causes fluid buildup and swelling in the arm).
Radiotherapy
Radiotherapy is the use of high-energy rays or particles to destroy cancer cells. Radiotherapy may be given after surgery to reduce the risk of recurrence, or before surgery to shrink the tumor and make it easier to remove. Radiotherapy may also be given to other parts of the body where the cancer has spread, such as the bones or the brain.
The main types of radiotherapy for breast cancer are:
- External beam radiotherapy: This involves delivering radiation from a machine outside the body to the breast area or other affected sites. External beam radiotherapy is usually given in daily sessions for several weeks.
- Internal radiotherapy: This involves placing radioactive material inside or near the tumor. Internal radiotherapy is also called brachytherapy or implant therapy. Internal radiotherapy may be given as a boost after external beam radiotherapy, or as a single dose during surgery.
Radiotherapy can help kill any remaining cancer cells after surgery and improve survival. However, radiotherapy can also cause side effects, such as skin changes, fatigue, nausea, hair loss, infection, heart problems, lung problems, and secondary cancers.
Breast cancer in young women is a rare but serious disease that requires special attention and care. Young women should be aware of their risk factors and symptoms of breast cancer and seek medical help if they notice any changes in their breasts. Young women should also have regular clinical breast exams and mammograms as recommended by their doctor. The treatment of breast cancer in young women depends on many factors and may involve surgery, radiotherapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy, or a combination of these. The treatment of breast cancer in young women may cause side effects that can be managed with supportive care.