Breast Cancer in Younger Women: What You Need to Know

At an already busy time in a woman’s life, a breast cancer diagnosis can be overwhelming. While not many women under 40 are at risk of breast cancer and it’s usually a rare concern or diagnosis, breast cancer can strike at any age.

Breast cancer in younger women is possible, with 5% of breast cancer cases occurring in women under 40. All women, no matter their age, should be mindful of their personal risk factors.

Age and breast cancer are not mutually exclusive, here are a few other factors that younger women should consider:

• Any family history of breast cancer, particularly one at an early age
• High-risk lesion found by biopsy
• History of radiation therapy to the chest
• Genetic mutation relating to a high risk for the development of breast cancer (such as BRCA gene mutations)
• Ashkenazi Jewish ancestry

See also: Cancer Risk Factors: What you Can & Can’t Control

Diagnosing breast cancer in younger women (under 40) is more trying due to the denser attributes of breast tissue at this age. Routine screening is in fact not recommended. Considering that screening is not recommended for younger women, it should be noted that breast cancer at a younger age may be more aggressive, and not as responsive to treatment.

Most younger women believe they would be too young to get breast cancer. And often because of this, they tend to ignore warning signs like a breast lump and discharge of any kind. 

These reasons can delay a diagnosis and therefore we see less favorable outcomes. The challenges faced by young women diagnosed at an early age, especially those in their 20s, involve other pressing issues. Issues such as sexuality, fertility, falling pregnant, and other female-forward issues that need to be dealt with after breast cancer treatment.

The first is an invasive form of cancer known as ductal carcinoma, which is the most common type of breast cancer in both women and men. Usually, 85% or more of young women diagnosed with invasive breast cancer had ductal carcinoma. 

Triple-Negative breast cancers (these are cancers that lack estrogen, progesterone, and HER2 receptors) are more common in women under 40. As mentioned before, breast cancer symptoms in young women are likely to have a higher historical background than in older women, as well as genetic mutations contributing to a higher risk rate.

Generally, treatment recommendations for young women are similar to those for any breast cancer patient and are based on the stage at which the disease is at. Other factors include tumor grade, receptor status, and other tumor characteristics also to be considered when planning the appropriate treatment.

Breast cancer treatment options unpacked:

Many young women can choose to have breast-conserving surgery and radiation therapy to treat their breast cancer. However, not all young women can be candidates for this type of therapy. One exception is young women with genetic mutations that cause breast cancer as bilateral mastectomies are a better option for these women. 

If a mastectomy is recommended, most women will have the option to consider reconstructive surgery, as well as to have the unaffected breast removed concurrently. This option hasn’t been shown to improve survival in women without genetic mutations, such as BRCA.

Young women who have a lumpectomy usually require radiation therapy. If a mastectomy is done, radiation is not a necessary treatment path. Factors taken into consideration when choosing treatment options are:

• Size of the tumor found
• Extent, location, and the involvement of lymph nodes
• Type of the surgery performed prior to radiation
• Patient preference

Chemotherapy recommendations are based on the breast cancer biology of younger women, the stage in which the disease is at, and the patient’s medical history. The outcomes of chemotherapy are similar across most age groups. Those under threat of fertility issues can opt for medication to suppress ovarian function, which increases the chance of preserving their option to have children.

This treatment can be likened to chemotherapy, however, more focus on age comes into play when choosing endocrine therapy. For example, postmenopausal women with hormone receptor-positive tumors (ER/PR+) are often treated with aromatase inhibitors, but this treatment is not usually offered to young (premenopausal) unless ovarian suppression is also part of treatment. Instead, most young women with hormone receptor-positive disease are offered Tamoxifen, which can be recommended over a period of five to ten years.

There are certain things young women, who feel they are at a predisposition for breast cancer, can be aware of and act upon preemptively. Identifying genetic conditions, going for genetic counseling, and having personalized discussions surrounding screening outcomes and the available preventative treatments is a good start. For young women at the age of 25, BRCA mutation screenings should be carried out.

Measures that women can take to reduce the risk of breast cancer include:

• Maintaining an ideal body weight
• Limiting alcohol consumption
• Getting regular exercise
• Breastfeeding (if an available option)

Many women wonder if mammograms under the age of 40 are necessary, and when and if to undergo this type of screening.

Generally, screening mammograms aren’t recommended for women under 40 years of age. But there are always exceptions, including women with genetic mutations. Screenings can begin at age 25, and in women with a family history of breast cancer, screening is often initiated up to 10 years earlier than the first affected relative in the family.

Taking the above factors into consideration, early detection and swift action on treatment can drastically increase a woman’s chances of survival. More than 90% of women whose breast cancer is found in an early stage will survive.

Read more about how Celbrea® is making it easier for all women globally to regularly screen for breast cancer and stay on top of their breast health.