An article on Breast Cancer Among Young Women by Dr. Mukti Mukherjee, Consultant Radiation Oncologist, Apollo Gleneagles Cancer Hospital, Kolkata

Mar 17, 2022

Why has breast cancer become so common among young women?

Breast cancer is the most common cancer of adolescents and young adult women aged 15 to 39 years, accounting for around 6% of all invasive breast cancer in women. In comparison to older women, younger women are more likely to have genetic predisposition, aggressive breast tumors, unfavorable biological characteristics, distant spread at diagnosis and adverse outcome.

Women who are under 40 years old may feel they are not at risk for breast cancer, but that is not true. Diagnosis can be more difficult in young women due to breast tissue density. Also since the stage of cancer in young adults are usually advance at the time of diagnosis, the outcome is relatively poor. Moreover, treatment in young adults can affect the fertility too.

Are women under 40 at increased risk for breast cancer?

Breast cancer is the most common cancer among women worldwide. The percentage of breast cancer increases rapidly in women during the third and fourth decades of life, from 2% at age 20 to more than 40% by age 40.

Younger women generally do not consider themselves to be at risk for breast cancer. However, breast cancer can strike at any age. All women should be aware of their personal risk factors for breast cancer. (A risk factor is a condition or behaviour that puts a person at risk for developing a disease.)

Can breast cancer in younger women be prevented?

For women with a family history that is suggestive of a hereditary predisposition for breast cancer, a referral for genetic counseling may be appropriate. Identifying such genetic conditions will allow for a more personalized discussion on screening and preventive treatment options. For example, screening in BRCA mutation carriers begins at the age of 25.

Should women under age 40 get mammograms?

In general, screening mammograms are not recommended for women under 40 years old. However, for women with genetic mutations, screening can begin at 25, and in women with a family history of breast cancer, screening is often initiated 10 years earlier than the first affected relative in the family. Breast MRI is often recommended to high risk women in addition to mammography. Even an Ultrasound can be of great help in doubtful breast lump.

Although breast cancer in young women is uncommon, it's the most common malignant tumor in young women. Risk of getting breast cancer at any time of your life is about 1 in 8.

So getting back to the beginning. Why are there more breast cancers among young women? Why do we hear about it more?

There isn't enough to explain all the increase in incidence in young ladies. Obesity increases the risk of breast cancer in women of all ages. And obesity in young women has increased dramatically over the last 2 to 3 decades.

We worry that there are environmental estrogens that may increase the risk of breast cancers. We know there are more synthetic chemicals that fetuses are exposed to in pregnancy and change the way that breast cells see estrogens or chemicals that adolescents are exposed to as the breast is developing. We also know that we are much more connected to people we barely know through social media and other media. So we hear much more about young women with breast cancer.

So, all in all, it seems as if breast cancer in young women is increasing. So what do we do about it? Well, you could turn off your social media and your contacts with your friends and family so you don't hear about it. But that isn't the way of women who are connected by the Woman Wide Web.

We can support research into the role of chemicals in our environment, our water, our cosmetics and our home that might increase the breast cancer risk or make breast cancer grow and spread faster.

We should be personally aware of our breast anatomy, promote breast self-awareness, and bring any new changes in our breast to the attention of our clinicians.

To provide optimal care to young ladies with breast cancer with breast cancer, we should engage multidisciplinary teams that offer fertility preservation, genetic counselling, physical and occupational therapy, nutrition, and psychosocial support, along with medical expertise in tailoring cancer-directed therapy and symptom management toward young women.

However, “Awareness is the key to Prevention” and we know very well that “Prevention is better than cure.”

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