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Breast Cancer

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More aggressive in younger womenbreast-cancerMost young women in their early to mid-20s are thinking about graduating from college, starting a career, maybe getting married or starting a family. The furthest thing from the mind of the majority of these women is breast cancer. But for a number of young women, breast cancer is taking over not only their thoughts but their lives.

Even though only 5 percent of breast cancer cases are in women under 40, that still means 11,000 women under the age of 40 will be diagnosed with breast cancer each year. And breast cancer in women in their 20s and 30s tends to be more aggressive and less responsive to treatment—including higher recurrence—than breast cancer in older women.

“Women who develop breast cancer at very young ages often have more aggressive tumors than older women,” according to Dr. Thomas M. Cosgriff, a hematologist-oncologist at East Jefferson General Hospital and an M.D. Anderson–credentialed physician. A study by Duke University Cancer Center and the Duke Institute for Genome Studies published earlier this year in the Journal of Clinical Oncology may provide answers related to these differences.

The researchers found 350 sets of genes present only in the tumors of women under the age of 45. These gene sets, which regulate functions such as oxygen supply, immune function and mutations known to be related to breast cancer, such as BRCA 1, were present in the “younger” tumors, but not in the “older” tumors.

Diagnosing breast cancer in younger women is also more difficult. Because the breast tissue is denser, lumps are often found later and the cancer reaches a more advanced stage before diagnosis occurs, making it more difficult to treat and more likely to be fatal. Young women also often ignore the warning signs because they think they are too young to get breast cancer.

Family history is one of the greatest risk factors in developing breast cancer, particularly if the patient has a mother, daughter or sister who has been diagnosed with breast cancer. “Young women are more likely to have familial breast cancer,” says Cosgriff. It’s important for all women to do monthly breast self-exams, starting at age 20, and having a breast exam by a physician at least every three years from the ages of 20 to 40. Mammograms are not normally recommended for those under 40, although if you have a family history of breast cancer, your physician may recommend otherwise.

Although there is no definite way to avoid breast cancer, there are steps all women should take to lower their risk.

  • Limit alcohol consumption. The type of alcohol is unimportant: beer, wine and spirits have all been linked to increased risk of breast cancer when consuming one or more drinks a day. Risk increases proportionally with consumption, so limit alcohol to less than one drink per day or avoid alcohol completely.
  • Maintain a healthy weight. The link between obesity and breast cancer has clearly been established through many studies. And the effects can be long lasting. To decrease the chance for developing breast cancer later in life, maintain a healthy weight in your early 20s. Women with a waist measurement of 35 inches or greater are at higher risk.
  • Exercise regularly. Get at least 30 minutes of moderate exercise most days. This will help you maintain a healthy weight and could lower the risk of breast cancer by itself, as many studies have shown. A study published in the March 2008 issue of Epidemiology shows women can cut their breast cancer risk by being physically active, regardless of weight. Women in the study who exercised regularly throughout their lifetimes were 20 percent less likely to develop breast cancer.
  • Decrease the amount of fat in your diet. Research has shown a slight decrease in the risk of invasive breast cancer in women who eat a low-fat diet, but most importantly it will help you maintain a healthy weight, one of the most controllable risks for breast cancer, as well as a host of other diseases.
  • DON’T SMOKE. Women who smoke or use tobacco products have a significantly higher risk of developing many forms of cancer.