Breast Cancer Strikes Young Women
Women Urged to Know Body, Receive Thorough Care
Although it is rare, women as young as their late teens to early 30s can be diagnosed with breast cancer. That is why Suzanne Gauvreau encourages all young women to conduct monthly breast self-exams and if they find a lump to make sure their doctors take it seriously.
"One of the most common problems that we see is young women who tend to be misdiagnosed by their doctors because they don't think it can be cancer," agrees Eva Singletary, M.D., a professor in the M. D. Anderson Department of Surgical Oncology. "Women have to be careful that if they have a persistent lump in their breast, they don't let their physician ignore it. It needs a diagnostic workup."
Young women unite
Gauvreau, whose mother was diagnosed with breast cancer at 35, was fortunate to find a doctor in New York who in an hour's time had her undergo a mammogram, sonogram and core biopsy. Test results showed cancer. But ignorance persists, she says. "Later I actually had another doctor say I was too young to have breast cancer after I had already been diagnosed with it," she says.
The doctor who took her seriously is a surgeon she sought out who specializes in the treatment of young women with breast cancer. Following her first course of treatment there was no sign of cancer, but it occurred again last year in her other breast. Her doctor is currently treating her again in conjunction with physicians at M. D. Anderson.
In the meantime, Gauvreau is raising awareness about the disease in young women as a member of the Young Survival Coalition (YSC). The YSC is an international, non-profit network of breast cancer survivors and supporters focused on issues specific to patients younger than 40. The five-year-old group has 8,000 members worldwide.
Age statistics
"Being diagnosed at a young age usually is a rare thing, but it can happen," Singletary explains. "Most women who are diagnosed with breast cancer are older than age 40, but some are in their mid to late 30s and a few are in their 20s. There are a very few who develop it earlier."
Singletary sites these U.S. breast cancer diagnosis statistics:
- 39 years old/younger - one in 228 chance of diagnosis
- 40-59 years old - one in 24 chance of diagnosis
- 60-79 years old - one in 14 chance of diagnosis
According to the American Cancer Society (ACS), more than three-quarters of breast cancer patients in the United State occur in women older than 50. About 11,500 women younger than 40 were expected to develop invasive breast cancer in 2003, the ACS says, and 1,400 were expected to die from it.
Singletary recommends the following screening guidelines:
Breast self-awareness(f rom age 20)- Starting at age 20 women should become familiar with how their breasts look and feel and continue to be aware of any changes. If changes are found, women are urged to report them to their doctor immediately. Early detection is the best defense against breast cancer.
Clinical breast exam( From age 20 to 39)- Every one to three years during this time, women should have an examination of their breasts by their doctor for any suspicious lumps or bumps.
Annual mammograms and clinical breast exams (age 40 and older)- Beginning at age 40 women should have a yearly mammogram and clinical breast exam.
Consider additional screening (if at increased risk and younger than 40)- The tests should begin earlier for younger women with a family history of the disease or a genetic predisposition.
Youthful coalition
Although breast cancer is less common for a young woman, the issues affecting younger patients are unique and important to address, says Gauvreau, a Denton, Texas, resident who serves as the head of the seven Texas regional representatives for the YSC.
Denial and ignorance- Oftentimes, a doctor who receives a report of a young woman's breast lump will dismiss it as a benign cyst or fatty tissue and tell the patient to watch it for several months instead of pursuing an ultrasound or mammogram, says Andrea Milbourne, M.D., one of Gauvreau's doctors and an assistant professor in the M. D. Anderson Department of Gynecologic Oncology. If the lump is cancerous, the delay causes a late diagnosis, which means progression of the disease and a poorer outcome.
"If you think something is wrong with your breast, go to your doctor," Milbourne says. "If the first doctor doesn't do anything about it, go to another one. Nine times out of 10, it won't be anything, but you need to have it checked out. That's the moral of the story - trust yourself; listen to your body."
Fertility issues- Current breast cancer drugs can make women infertile. This may not be an issue for women who have already outlived their child-bearing years or already have children. It's a greater problem for younger women whose family-planning days are ahead of them.
"A lot of young people including myself lost our fertility because of our treatment," Gauvreau says. "It's a big issue for us, and I've had doctors who addressed the problem by just saying, 'you can adopt.' ''
Lack of age-appropriate treatments- Breast cancer in younger women can be more aggressive than in older women, and treatments are not designed for the younger population, Singletary says. "Since young people can have more aggressive tumors it would be more likely that in addition to surgery, they also have chemotherapy."
Lack of age-appropriate research- The YSC has lobbied for much-needed research on younger patients and is now involved in three major research studies.
They include surveys of young patients about:
- Fertility issues
- Late diagnosis
- Environmental exposure of their mothers
Details about the studies are available on the YSC website.
"We are a small population but our motto is that often when you study the rare things it leads you to find answers for the norm," Gauvreau says. "I think the results will probably translate over into other age range populations."
In the meantime, the YSC continues to use its resources to educate women about breast cancer before the age of 40. One of the latest projects is a new 40-minute video and book set titled, "You Are Not Alone," which was created in conjunction with the Greater New York chapter of the American Cancer Society.
Gauvreau's main message to women is to be aware of any changes in their bodies with regular breast self-exams, the method that alerted her to her cancer, and to be assertive with doctors.
"I don't take 'no' for an answer," she says. "I'm demanding. It's your life you are talking about, and it's a young life. And it's a shame if you lose it because someone wasn't taking you seriously."
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