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Cancer Doesn’t Discriminate: Breast Cancer in Young Women

October 2017 Vol 3 No 5
Laura Farrington, DO
Medical Oncologist, Cancer Treatment Centers of America, Midwestern Regional Medical Center, Zion, IL

According to the Young Survival Coalition, more than 250,000 women in the United States under age 40 have been diagnosed with breast cancer in 2017. Although this number represents less than 5% of all women diagnosed with breast cancer in the country, this finding is significant, demonstrating that cancer does not discriminate. It can happen to anyone, at any time.

Risk Factors

Although every woman is at risk for this type of cancer, those who have a family history of the disease, women who carry the genetic mutation known as BRCA1 or BRCA2 mutation, active smokers, or women of African American descent are at a slightly higher risk.

For women under age 40, however, the diagnosis can be more complicated. These women typically do not have regular mammograms, and when they do, their younger, denser breast tissue makes it more difficult to identify the cancer.

These factors can lead to young women being diagnosed at later, more aggressive stages of the disease, which could be more difficult to treat. It is, therefore, even more important for younger women to understand their personal risks and take steps to screen for breast cancer before age 40, if they have a risk factor (as noted above), to ensure proper treatment, if needed, to promote survivorship and quality of life through treatment.

Prevention

Taking preventive steps toward a healthy lifestyle can potentially make a difference for those at a high risk for breast cancer. Some data show that refraining from, or quitting smoking, eating a healthy diet, and exercising regularly may actually help reduce the risk of breast cancer.

In addition, breastfeeding has been shown to potentially decrease a woman’s risk of breast cancer by 30%, with increased benefits the longer she nurses her child.

Young Women’s Challenges During Treatment

When facing cancer treatment, it’s important to manage the side effects. Beyond some of the more well-known side effects, such as physical scars, fatigue, and/or hair loss, younger women may experience their own set of challenges, such as:

1. Self-image. Although a negative self-image is an issue often faced by women of all ages, young women may be more likely to suffer from a lower self-esteem caused by thoughts about their appearance. For women with breast cancer, medical techniques such as breast reconstruction, nipple-sparing surgery, 3D nipple tattooing for breast reconstruction, and lymphedema management can help many women with this concern.

For some women, the use of cold caps may prevent hair loss during chemotherapy. The social support of a friend, a counselor, or a religious leader may also make a difference in helping women look and feel their best.

2. Being forced to face one’s own mortality. It can be difficult for young women to think about their mortality, but focusing on enjoying life and continuing to partake in what they love—such as walking, reading, or listening to music—can be helpful.

3. Fulfilling normal responsibilities. Between raising families, nurturing relationships with spouses, and working in and outside the home, young women may feel pressured to be a “superwoman,” even without a cancer diagnosis. Add a life-changing breast cancer diagnosis, and it’s not surprising that many of them can become overwhelmed.

To counteract this, it’s important for women of any age to feel comfortable asking for, and accepting, help from others, as well as prioritizing their personal health and well-being over household chores or other tasks that can wait.

4. Loss of sexual function. Some medications and therapies for breast cancer can lead to a decrease in hormones, which may reduce libido (sexual desire). This can be an unwelcome side effect for those who maintain an active sexual lifestyle. However, it is important for women (and their partners) to understand that relationships are defined by much more than sexuality. Keeping the lines of communication open to express love and intimacy in different ways can be a helpful alternative to sexual activity during cancer treatment.

5. Fertility preservation. Early menopause can be another side effect of cancer treatment, with severe implications for young women of child-bearing age. For women interested in having children, fertility specialists can be a great resource. Although only few treatments have a direct effect on fertility, about 35% of women with cancer will struggle with getting pregnant after certain treatments for cancer. Fertility specialists can help preserve fertility for some women by providing medications that can be given before and during chemotherapy.

6. Nursing considerations. If a woman is diagnosed with breast cancer while nursing, most physicians will recommend that they stop breastfeeding. Some of the therapies used to treat breast cancer may be passed to the baby through breast milk; these therapies include chemotherapies, hormone therapies, and anesthesia used for surgery. In future pregnancies, some women may experience a decrease in milk supply, depending on the types of treatments used during the cancer diagnosis.

Be Your Own Advocate

Although studies show that the risk of breast cancer increases with age, breast cancer can happen at any age. Therefore, it is important for women to be in tune with their bodies and understand their family history.

If something seems wrong—take action. And know that with all the advances in cancer treatment, women who are diagnosed today have better opportunities to play an active role in partnering with their care team to manage their breast cancer as if it is a chronic disease.

Cancer care has made great strides in recent years, and a key benefit of this advancement for patients is an improved quality of life during, and we hope after, treatment.

Young Survival Coalition
American Cancer Society
National Cancer Institute

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