- Breast Cancer in Young Women
- Breast Cancer In Your 20s Is Different Than Breast Cancer When You’re Older In These 3 Ways, According To An OBGYN
- Breast Cancer Statistics in Young Adults
- Breast Cancer Statistics, Facts, & Disparities
- Unique Challenges for Young Adults
- Health Disparities in Young African Americans
- Take Action to Change Young Adult Breast Cancer Statistics
- Statistics Sources
- But I’m too young to have breast cancer!
- Early diagnosis offers the best chance for a cure.
- So what is breast cancer?
- Cancer stages are determined by the size and location of the cancer cells.
- Breast cancer treatment depends on the cancer stage.
- Radiation after a lumpectomy reduces the rate of recurrence of breast cancer from 40 percent to 4 to 8 percent.
- What’s the difference between radiation and chemotherapy?
- Things you can do to fight breast cancer at any age.
- How common is breast cancer?
- Signs of breast cancer?
- Men get breast cancer too
- What about the breast cancer gene?
- What is triple-negative breast cancer?
- What’s your risk of breast cancer?
- What are the risk factors for breast cancer?
- Statistics Sources
Breast Cancer in Young Women
Are women under 40 at risk for breast cancer?
Younger women generally do not consider themselves to be at risk for breast cancer. However, breast cancer can strike at any age: 5% of breast cancer cases occur in women under 40 years of age. All women should be aware of their personal risk factors for breast cancer. (A risk factor is a condition or behavior that puts a person at risk for developing a disease.)
There are several factors that put a woman at higher risk for developing breast cancer, including:
- A personal history of breast cancer or a high risk lesion found by biopsy
- A family history of breast cancer, particularly at an early age
- A family history that is concerning for a genetic syndrome that may put them at a higher risk for breast cancer (breast cancer diagnosed before age 50, ovarian cancer at any age, triple negative breast cancer, bilateral breast cancer, male breast cancer, pancreatic cancer or metastatic prostate cancer)
- History of radiation therapy to the chest
- A known genetic mutation conferring a high risk for the development of breast cancer
- Ashkenazi Jewish ancestry (one in 40 Ashkenazi Jews carry mutations in BRCA1 or BRCA2)
What is different about breast cancer in younger women?
- Diagnosing breast cancer in younger women (under 40 years old) is more difficult because their breast tissue is generally denser than the breast tissue in older women, and routine screening is not recommended.
- Breast cancer in younger women may be more aggressive and less likely to respond to treatment.
- Women who are diagnosed with breast cancer at a younger age are more likely to have genetic mutations predisposing them to breast and other cancers.
- Younger women who have breast cancer may ignore the warning signs—such as a breast lump or unusual discharge—because they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes.
- Some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a “wait and see” approach.
- Breast cancer poses additional challenges for younger women as it can involve issues concerning sexuality, fertility, and pregnancy after breast cancer treatment.
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.
Measures that all women can take to reduce breast cancer risk include:
- Achieving and maintaining ideal body weight
- Limiting alcohol consumption
- Getting regular exercise
That being said, if breast cancer does develop, early detection and prompt treatment can significantly increase a woman’s chances of survival. More than 90% of women whose breast cancer is found in an early stage will survive.
Young women should be counseled on breast awareness and to report any breast changes to their healthcare provider. These changes can include:
- Nipple discharge
- Focal pain
- Skin changes
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.
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All weekend, my parents were trying to do these soothing, normal-person activities with me — go to a farm, walk in the woods — but I was so out of it. At the beginning of the next week I said to my mom, “I wonder when they’ll call me to give me the final results.” And she told me they already had called; that it, for sure, was cancer.
That was the last week of August. I went back to my apartment and packed a couple of suitcases, and then moved back in with my parents while we figured things out; thankfully, my job was really understanding. I’d started going back to the hospital where I’d had the biopsy, but then my insurance recommended Dr. Chau Dang at Sloan-Kettering, who specialized in my exact kind of cancer — HER2-positive. At first I was told, “We’ll do surgery, and then we’ll see if you need to do radiation, and we can talk about implants or whatever you want to do. It will be fine; you’re only at Stage I.” So I was like, Okay, Robin, calm down. It’s nothing! I remember making some joke about getting a new pair of boobs.
But then I had my full-body PET scan, so they could see everything that was affected, and the cancer had spread to my liver and spine. The liver was what had been hurting on my right side. So there was a jump from this idea that I had Stage I to understanding that I had Stage IV, though that wasn’t immediately clear to me. At some point I offhandedly mentioned to Dr. Dang being at Stage I, and she explained that because the cancer had metastasized, I was actually at a much more advanced stage. So it was decided that I shouldn’t have surgery; instead I’d get a kind of chemo called Taxol and also Herceptin, which was a new medicine that she had helped create.
The treatment was done in several rounds over three, three and a half months — first Herceptin and then the chemo drugs, then just chemo the next week, and then chemo the third week. Leading up to treatment, I was feeling horrible, like my body was falling apart. Everything hurt. (Did you know your liver has nerve endings? I didn’t until my liver biopsy!) But then the first day of my treatment they gave me this megadose, which took nine or ten hours. The day after, I felt amazing; everything that had been hurting, stopped hurting. I think it was the steroids.
After that, it became less enjoyable. The side effects were everything you’d imagine; I got a lot of rashes, I was nauseous, the list goes on. Within two weeks my hair started falling out, and then it was so painful that I had to buzz it. But the worst part for me was probably my skin’s reaction; that stuff is so poisonous, it gave me boils all over. I was also losing a lot of weight, and while I felt like I was dying, I’d get a lot of weird compliments from other people about it. People who knew what was going on! They’d be like, “Oh, I know being sick sucks, but you look great!” Um, thank you? My body is failing? That was so gross to me.
From the day I got my diagnosis until the end of treatment, I didn’t really cry; I was in this state of permanent of disassociation, this prolonged out-of-body experience. I probably didn’t go longer than a minute for the first month without asking someone in the vicinity if I was going to die. They sent someone into my hospital room one day to help me draft up my will; I picked out what I wanted on my grave; I had to think about potential palliative care. And I was so reluctant to do any of it, because there was no part of me that was at peace with dying so young; I was really angry. I made my mom promise she’d tell me if she knew I was going to die, and she was like, “I probably wouldn’t just say it to you; maybe I’d ask you to pick your three favorite vacation spots, and then we’d go there.” Way to ruin the surprise!
But then, at a point, I became really reluctant to even talk much about death; I’d decided continuing to talk about it would make it real. I went to a few support groups, but they were so uncomfortable. I was always the youngest person by far, and it seemed like everyone else was in a totally different headspace. I needed a distraction, but I’d go to these meetings and people were indignant about death, really sad and depressed, which was totally understandable — I just couldn’t handle it. My sisters spent a lot of time at home with me, because I couldn’t be alone.
Having cancer as a young person is alienating. I ended up meeting people around my age by bumping into them at the hospital, or by one of us finding the other on the internet. I found the Leo With Cancer blog, which was super helpful, and I remember sharing an article called “Everything Doesn’t Happen for a Reason,” by Tim Lawrence of The Adversity Within, with, like, everyone. My friend who works for Amy Poehler’s Smart Girls saw me posting about my illness, and asked if I’d be interested in writing something for the site. That ended up turning into a series, which was great because a lot of people responded to it and got in touch. Writing has been a really rewarding part of this; it allowed me to relate to and connect with other people.
When I went in for my “halfway through chemo” checkup, I learned I was in remission; that the cancer cells had shrunk so small, they no longer showed up on a PET scan. Dr. Dang had always seemed more confident than I was fully able to appreciate, but it was then that she told me she wasn’t worried at all anymore, and that I shouldn’t be either. I just celebrated my two-year remission anniversary. I still go in for treatment every three weeks, but it’s not chemo; just immunotherapy. It’s usually about a four-hour day. I go get labs, and then the doctor or nurse examines me, and I get my IVs. Eventually they plan to space it out more — maybe every two or six months, and I’ll only have to get a PET scan once a year.
Things are okay right now, in theory, but still kind of terrifying. If anything, my hypochondria is worse, because I’m like, “See? I was right!” It’s hard to trust my body — what are my cells going to do while I’m not paying attention? I’ve had a few things that make me panic — I randomly throw up, or start bleeding off-schedule, or get a weird pain — but thankfully my hospital has a 24-hour support line, so I can call whenever and talk to a nurse who will tell me what to do. I like to have directions.
I still have nightmares about what happened to me physically. I struggle not to touch my hair all the time, to make sure it’s still there. And gaining weight back after chemo was exciting at first, but then less so because I had other people’s voices in my head — the ones who gave me the idea that I wasn’t going to look as good as when I was in the middle of treatment. Ultimately, I feel really lucky that I didn’t end up having to go through surgery, even though at the beginning I’d felt like, “Just get it out of me!” I’ve dealt with my share of body-image issues, but I imagine surgery would have made things so much harder.
My relationships have also changed; being sick shifts everything. I think my illness was really stressful on my parents, being caretakers for their adult child, and my sisters are obviously at elevated risk. My aunt recently passed away of leukemia, which was especially tough because when I first got diagnosed, she helped me out a lot — even though she’d lost her own daughter not long before to bone cancer, and I can’t imagine how difficult it was on her. And meeting other people around my age with cancer who I could talk to had been so great, but the flip side was that many of them ended up dying. I think constantly about why treatment works for some people, but not for others. I have a lot of guilt around it.
That said, I’ve at least started to enjoy having a drink again, and eating foods that I love, and having my hair back! I didn’t start dating until it had grown back a good amount, because I was too nervous to go out and have someone discover I was wearing a wig. (Though, I definitely still wear my wigs from time to time. Not fancy ones; like, long pink ones from cosplay websites that make me feel like Lady Gaga.) A few times, I told people on the second date about being sick, and they got scared. I even broke up with someone last year who only afterwards told me how anxious the whole thing made him. Like, I’m sorry this was so hard for you! I’ve realized my best bet is to be as up-front about it as possible — not waiting, even for a short time, and letting it become a thing.
I got so used to imagining myself as someone who was going to have a shortened life, that it can still seem like I’m on borrowed time. The further I get from having received good results, the more nervous I get; the closer I get to going in for more tests, the more nervous I get. I’ve asked my doctor a million times if I’m going to have a normal life, and she’s always like, “Yeah, you’re going to live for 30 more years minimum; you’re going to be fine.” And maybe this is wishful thinking, but I feel like she’s not allowed to lie to me.
If I could give someone going through a similar illness any advice, it would be that while it’s wise to avoid Googling symptoms and diseases as much as possible, the internet can be great for finding others who are going through what you’re going through. You’re not alone. Stay positive, find your people, ask for help. And it’s okay to take a Xanax once in a while.
Breast Cancer In Your 20s Is Different Than Breast Cancer When You’re Older In These 3 Ways, According To An OBGYN
Breast cancer is the second most common type of cancer in the United States, and it’s estimated that one in eight women will develop breast cancer over the course of their lifetime, according to the nonprofit Breastcancer.org. While fewer than 5 percent of individuals diagnosed are under 40, according to Susan G. Komen, it’s important to know young people can (and do) get breast cancer. What’s more, breast cancer in your 20s is different compared with when you’re older — and it’s important to know what these differences can look like.
The two kinds of breast cancer can’t be put “in the same category,” Dr. David Ellman of Women’s Healthcare of Boca Raton, Florida, tells Bustle. Some of the major differences include the development of the cancer, how difficult it is to observe, and more. Further, it’s important to be aware of possible symptoms of breast cancer as a young person, and not assume it’s not possible to get the disease when you’re young.
According to the American Cancer Society, a person’s risk of breast cancer doubles if they have a first-degree relative (parent, child, sibling) diagnosed with breast cancer. Also, people with the BRCA1 mutation are 55-65 percent more likely to develop breast cancer over the course of their lives, and people with the BRCA2 mutation are 45 percent more likely, according to Breastcancer.org. What’s more, people who test positive for BRCA1 and BRCA2 mutations are more likely to get breast cancer when they’re young. If you believe you’re at risk of developing breast cancer, it’s important to talk to your doctor about your risk factors and how you can be proactive about your health.
Here are three ways breast cancer can be different in younger people than it is in older people.
1. Younger People Realize They Have It Via Self-Exams
Since most women don’t get annual mammograms until age 40, many younger people actually discover their breast cancer when they’re self-examining their breasts. (If they even opt to do so at all — the Cleveland Clinic reports that many people may dismiss the practice, thinking they’re too young to be at risk.)
According to Dr. Ellman, a great way to regularly self-examine is to pay close attention to your chest area while you shower. By paying close attention when washing your breasts, you can realize if something feels different or out of place. If you do find something concerning, it does not necessarily mean you have cancer. According to the American Cancer Society, many lumps are in fact benign, but a visit to your primary care doctor or OBGYN can help you figure out your next steps.
2. It May Be More Aggressive In Younger People
Although breast cancer is rare in people under 40, it’s also true that when someone is diagnosed young, they may have a more aggressive type of breast cancer than someone who is over 40, according to Susan G. Komen.
Dr. Ellman says that when younger people perform a breast self-exam, they may originally feel a mass that feels more like a “big zit,” and ignore it, but soon they may feel a big mass. “Because it’s a big mass to begin with, it usually tends to be a much more aggressive breast cancer,” Dr. Ellman says.
Because you can only typically feel a lump, whether it’s benign or malignant, once it’s a centimeter in size, according to Dr. Ellman, younger people are more likely to only notice potential tumors once they’ve grown, versus having a mammogram that can detect smaller, potentially less aggressive tumors.
3. It’s Harder to Screen In Younger People
According to Dr. Ellman, younger people have more dense breast tissue, which means it’s harder for an x-ray to pass through.
However, as you age, breast tissue gets replaced with fatty tissue, which makes it easier to do an imaging study. “In an older person, goes through more easily, so you’re looking for white spots on a black background in an older breast, versus in a younger breast, you’re looking for white spots on a white background, so it’s much harder to see,” Dr. Ellman says.
Another way to confirm breast cancer in young people is by getting a biopsy, where a part of the breast tissue is removed and examined.
The best ways to stay on top of your breast health is to ask about your family history and genetics, and make sure you’re regularly self-examining. If you have a family history of breast cancer, test positive for the BRCA1 or BRCA2 gene mutations, or are just generally concerned about your breast health as a young person, you can always speak with your doctor and determine what your risks are. Knowledge is power, after all.
Breast Cancer Statistics in Young Adults
Although breast cancer in young adults is rare, more than 250,000 living in the United States today were diagnosed under age 40. In young adults, breast cancer tends to be diagnosed in its later stages. It also tends to be more aggressive. Young adults have a higher mortality rate. As well as a higher risk of metastatic recurrence (return of breast cancer in areas beyond the breast).
Breast Cancer Statistics, Facts, & Disparities
Here are some startling statistics and details on how breast cancer is different in younger adults.
- There is no effective breast cancer screening tool yet for women under 40. This is because most have dense breast tissue that prevents routine mammograms from being a useful screening tool.
- Each year, approximately 70,000 men and women age 15 to 39 are diagnosed with cancer in the US.1 Breast cancer is also the most common cancer for women in this age group.2
- In 2015, the American Cancer Society projected 231,840 new cases of invasive breast cancer among U.S. women annually. As well as an estimated 60,290 additional cases of in situ breast cancer.3 An estimated 12,150 cases of breast cancer in women under age 40. Whereas approximately 26,393 women will be under 45 years of age.7
- Every year, more than 1,000 women under age 40 die from breast cancer.3
- Nearly 80% of young women diagnosed with breast cancer find their breast abnormality themselves.4
- Breast cancer is the most common form of cancer in women who are pregnant or have recently given birth. It occurs once in every 3,000 pregnancies.5 An estimated 30% or more of all breast cancer in young women is diagnosed in the few years after a woman has had a baby.6
- Compared to older women, young women generally face more aggressive cancers and lower survival rates.8,9 More and more evidence tells us that breast cancer before age 40 differs biologically from the cancer faced by older women.10
- The incidence of metastatic breast cancer at the time of initial diagnosis is apparently rising in women under the age of 40.11
- We remain underrepresented in many research studies. This is because breast cancer occurs at a much lower rate among young adults than in our older counterparts.10
Unique Challenges for Young Adults
Breast cancer in young adults is just different. We are at a different phase of our lives and encounter unique challenges compared to older persons. These challenges may significantly impact our quality and length of life. Some of the unique challenges and issues young adults face:
- The possibility of early menopause and sexual dysfunction brought on by breast cancer treatment
- Fertility issues, because breast cancer treatment can affect a woman’s ability and plans to have children
- Many young women are raising small children while enduring treatment and subsequent side effects
- Young breast cancer survivors have a higher prevalence of psychosocial issues such as anxiety and depression13
- Questions about pregnancy (whether it is safe or possible) after diagnosis
- Heightened concerns about body image, especially after breast cancer-related surgery and treatment
- Whether married or single, intimacy issues may arise for women diagnosed with breast cancer
- Challenges to financial stability due to workplace issues, lack of sufficient health insurance and the cost of cancer care
Health Disparities in Young African Americans
In addition to these unique issues, research has shown that young African American women face even greater challenges.
- African American women under age 35 have rates of breast cancer two times higher than caucasian women under age 35.14
- African Americans under age 35 die from breast cancer three times as often as caucasian women of the same age.14
- Researchers believe that access to healthcare and the quality of healthcare available may explain these disparities. But scientists continue to investigate.
- Research also shows that young African Americans are more likely to get aggressive forms of breast cancer than anyone else.14
Take Action to Change Young Adult Breast Cancer Statistics
When all young adults affected by breast cancer work together, we can raise awareness, improve our representation in research and make each other stronger. We are dedicated to these goals, working to turn our unique challenges into opportunities for shared success. Join the movement! Become an advocate for young women with breast cancer.
1. National Cancer Institute. A Snapshot of Adolescent and Young Adult Cancers. Available here
2. Archie Bleyer et al., “The distinctive biology of cancer in adolescents and young adults,” Nature Reviews Cancer 8, no. 4 (2008): 288-298. Available here
3. American Cancer Society. Breast Cancer Facts & Figures 2015- 2016. Available here
4. Ruddy, K. et al. “Presentation of breast cancer in young women,” Journal of Clinical Oncology 27:15S (2009). Available here
5. “Breast Cancer during Pregnancy,” American Cancer Society, accessed June 10, 2016. Available here
6. Eryn B. Callihan, et al., “Postpartum diagnosis demonstrates a high risk for metastasis and merits an expanded definition of pregnancy-associated breast cancer,” Breast Cancer Res. Treat. 138 (2013). Available here
7. National Cancer Institute. Surveillance Epidemiology and End Results. SEER Stat Fact Sheets 2013: Breast. Available here
8. Carey K. Anders et al., “Breast Carcinomas Arising at a Young Age: Unique Biology or a Surrogate for Aggressive Intrinsic Subtypes?,” Journal of Clinical Oncology 29, no. 1 (2011): e18-e20. Available here
9. Carey K. Anders et al., “Young Age at Diagnosis Correlates With Worse Prognosis and Defines a Subset of Breast Cancers With Shared Patterns of Gene Expression,” Journal of Clinical Oncology 26, no. 10 (2008): 3324-3330. Available here
10. Ann H. Partridge et al., “Breast Cancer in Younger Women,” Diseases of the Breast (4th ed.,), In J. Harris (Ed.) (2010): 1073-1083.
11. Rebecca H. Johnson, et al. “Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009.” JAMA. 2013; 309(8):800-805. Available here
12. Carey K. Anders et al., “Breast Cancer Before Age 40 Years,” Seminars in Oncology 36, no. 3 (2009): 237-249. Available here
13. J. Howard-Anderson, et al., “Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review,” J. Natl Cancer Inst. 2012; 104(5): 386-405. Available here
14. Lisa A. Carey. et al., “Race, Breast Cancer Subtypes, and Survival in the Carolina Breast Cancer Study,” Journal of the American Medical Association 295, no. 21 (2006): 2492-2502. Available here
But I’m too young to have breast cancer!
Early diagnosis offers the best chance for a cure.
So what is breast cancer?
Breast cancer treatment depends on the cancer stage
Radiation after a lumpectomy reduces the rate of recurrence
What’s the difference between radiation and chemotherapy?
Things you can do to fight breast cancer at any age.
How common is breast cancer?
Signs of breast cancer?
Men get breast cancer too!
What about the breast cancer gene?
What is triple-negative breast cancer?
What’s Your Risk of Breast Cancer?
What are the risk factors for breast cancer?
But I’m too young to have breast cancer!
More than 11,000 women under the age of 40 will be told they have breast cancer this year. It is the leading cause of cancer death in women in this age group.
In the course of a lifetime, 1 in 8 women will fight breast cancer. Most breast cancer (60 to 70 percent) occurs in women over 50 years of age, but the incidence of breast cancer in young women is on the rise.
Rebecca Johnson, MD, of Seattle Children’s Hospital and University of Washington in Seattle, who is a pediatric oncologist and a young breast cancer survivor herself, studied the National Cancer Institute data from 1973 to 2009. In 1975, the study showed that there were 250 cases of metastatic breast cancer in women aged 25 to 34, in 2009 that number had grown to 800 cases per year.
The type of breast cancer affecting younger women is usually more aggressive. If a young woman receives the diagnosis of breast cancer, she will have a better chance of survival if she begins treatment within six weeks of the diagnosis.
Breast cancer in young women grows faster, spreads quickly, and usually requires aggressive treatment. The chemotherapy and radiation therapy can increase the risks of other cancers, heart disease and infertility.
There are other special challenges that face young breast cancer patients. Many young women feel isolated as they wage war on the disease while watching their friends and family building lives and having children. Since there is no cure for breast cancer, young women have to remain committed to having breast cancer screenings and performing self-breast exams.
Researchers are not sure why there has been an increase of breast cancer in young women. There are theories that the increase may be due to obesity, lack of exercise, overeating, exposure to chemicals, viruses and environmental toxins, or the increase may be due in part to the decision to delay child bearing until later in life.
Since yearly clinical breast cancer screenings are recommended to start at age 40, breast cancer in young women is usually found by self-breast exam. If a young woman finds a mass in her breast that does not go away, it is important that she seek medical attention immediately.
A young woman diagnosed with breast cancer should also seek support. Along with support from her healthcare provider, young women can find support and information through organizations such as Susan G. Komen and the Young Survival Coalition.
Early diagnosis offers the best chance for a cure.
According to the American Cancer Society, approximately 235,000 men and women will hear the diagnosis of breast cancer this year. Forty thousand of those diagnosed will succumb to the disease.
The average five-year survival rate for all women who have breast cancer is 90 percent. Early detection and early treatment can raise that rate to 99 percent. It’s important to be diagnosed early and start an effective treatment as early as possible.
So what is breast cancer?
Breast tissue is made up of lobules (milk-producing glands shaped in broccoli-like bunches) and milk ducts (tube-like structures that carry milk to the nipple). Eighty percent of breast cancer starts in the milk ducts.
Normally milk ducts and lobules are lined with a single layer of cells. When these cells begin to grow abnormally and begin to create several layers, they are called atypical hyperplasia and need to be removed, examined and biopsied. If the layers grow across the duct or lobule, it is diagnosed as a carcinoma in situ. The cells become invasive when they break through the duct or lobule walls and invade surrounding tissue. These cells, now free of constraints, can enter the lymph system or bloodstream and invade other organs. When this happens, the cancer has metastasized.
Cancer stages are determined by the size and location of the cancer cells.
Breast cancer is diagnosed in five stages ranging from 0 to 4. The definition of stages help surgeons and oncologists determine treatment based on the progression of the cancer.
STAGE 0: This earliest stage of cancer. The cancer cells are still within the ducts or lobules of the breast and has no ability to spread. It is the easiest to treat.
STAGE I: The cancer cells have invaded the walls of the duct or lobule, are less than 2.0 cm in size. The cancer cells are still in the breast and have not invaded the lymph nodes.
STAGE II: Cancer cells are less than 5 cm in size and have spread to one to three axillary (armpit) lymph nodes. Cancers that over 2 cm may also be diagnosed as stage II.
STAGE III: Cancer cells that invade four lymph nodes located in the armpit, collarbone and / or the nodes near the sternum or cancers that are over 5 cm that spread to any number of nodes; and tumors that have grown into the chest wall or skin are defined as Stage III.
STAGE IV: When cancer has spread beyond the breast and lymph nodes and has traveled or metastasized to distant nodes or the liver, lung, brain, bone or other organs, it is known as a Stage IV cancer.
Breast cancer treatment depends on the cancer stage.
A lumpectomy is often followed by radiation treatment.
Mastectomy – Surgery to remove all the breast tissue.
When you receive your diagnosis, you and your healthcare provider will discuss your treatment options. Your treatment choice is highly personal. Some women choose a lumpectomy with radiation treatments; others choose a double mastectomy. The outcomes of both are similar. Your healthcare provider can give you the information to make the right choice for you.
There may be other reasons that you want to consider a mastectomy rather a lumpectomy. If you have small breasts that would be disfigured by the removal of a large lump; cancers in different parts of the breast; would rather not have radiation treatments; already had radiation treatment in the same breast to treat cancer; have the BRCA genetic mutation or have a family history of breast cancer; you will need to factor those situations into your treatment choice.
Radiation is the process of sterilization and reduces the chance of cancer coming back in the breast, chest wall, or breast skin. Radiation causes skin redness and fatigue.
Ask your healthcare provider about the different types of radiation treatments. The traditional treatment is five days a week for about 6-and-a-half-weeks. If you meet certain qualifications, you may be a candidate for accelerated partial breast irradiation (APBI) which may take as little as five minutes, twice a day for five days.
What’s the difference between radiation and chemotherapy?
While radiation sterilizes a localized area, chemotherapy is used to kill the rogue cancer cells that are in the bloodstream or cancer cells that have invaded another organ. Chemotherapy causes hair loss and nausea. With testing, your healthcare provider can help you assess your need for chemotherapy treatment.
If you are diagnosed with breast cancer, the best thing that you can do for yourself is to learn all you can about the disease, talk to your healthcare provider, and find support from other survivors. This information will help you make an informed decision about your treatment and your health. It will give you the knowledge that you need to make the best decision for you.
Though surgery and treatment are difficult, the 5-year survival rate for Stage 0 and Stage 1 breast cancer is 98 percent. Earlier detection and better treatment options give us hope of survival at every stage.
Things you can do to fight breast cancer at any age.
In your 20s and 30s – get familiar with your breast and perform routine self-breast examinations, at least once a month. The best time is seven to 10 days after your menstrual period starts. If there is a change in your breast tissue or nipples – even a small one – don’t delay, see your healthcare provider right away.
Talk to your relatives and find out their health history. If someone in your immediate family had breast cancer before age 50; or if you have three or more first-degree or second-degree relatives with breast cancer or ovarian cancer, or if you have a male relative with breast cancer, talk to your healthcare provider and consider scheduling routine mammograms before age 40.
In your 40s – Get regular mammogram screenings. Watch the fat content in your diet. Reducing fat to 20 to 30 percent of your daily intake will help you maintain a healthy weight and reduce the amount of fat cells in your body. People with a high number of fat cells in their bodies produce more estrogen. After menopause, fat cells are the major estrogen producers, which may increase your risk.
Discuss hormone replacement therapy (HRT) with your healthcare provider. Make sure the benefits of HRT outweigh the risks. Studies have shown that women who have had five years or more of estrogen and progesterone therapy may have a higher incidence of breast cancer.
For all women – Reduce “bad” fats in your diet, especially polyunsaturated fats like those found in soybean, sunflower and corn oils. Use olive oil instead.
Eat more fatty fish, fruits, dark leafy green and cruciferous vegetables and whole grains.
Limit sweets. According to the journal Cancer Causes and Control women who ate added sugars found in desserts and beverages had a 27 percent greater risk of breast cancer.
Exercise 30 minutes a day; exercise boosts your immunity
Limit alcohol because it increases the estrogen in your system. Drink less than one drink a day.
Make sure you get enough folic acid.
Consider having children earlier rather than later and consider breastfeeding your children. These actions can help you cut your breast cancer risk in half.
Make sure that you are getting enough vitamin D from sun exposure or supplements and make sure that you are getting enough calcium.
Limit your consumption of grilled meats and avoid processed meats such as hot dogs, bacon and sausages; these meats may increase your breast cancer risk.
How common is breast cancer?
- 1 in 2,500 women under 30 will have breast cancer
- 1 in 250 women under 40 will have breast cancer
- One man will be diagnosed with breast cancer for every 100 women diagnosed
- 410 men die from the disease each year
- 1.3 men in 100,000 will get breast cancer
Signs of breast cancer?
- a lump, hard knot or thickening, which may be tender, in your breast or under your arm (in men lump are commonly found under the nipple and areola)
- change in the size or shape of the breast
- dimpling, puckering or redness of the skin of the breast
- itchy, scaly sore or rash on the nipple
- inversion (pulling in) of the nipple or areas of the breast
- swelling, warmth or darkening of the breast
- nipple discharge
- pain that doesn’t go away
Men get breast cancer too
There are 2,240 cases of invasive male breast cancer per year.
Men have breast tissue as well. Though during puberty, the high testosterone levels and low estrogen levels stop breast development in boys, men still may have some underdeveloped milk ducts and they are susceptible to breast cancer.
The prognosis for men and women experiencing breast cancer is the same at each stage. However, men are usually diagnosed at a later stage than women because they mistake the signs for other things or they are too embarrassed to visit the doctor and talk about the changes in their breasts.
Male breast cancer often occurs when men are older, but may develop at any age. Possible risk factors for breast cancer in men include:
- heavy alcohol use
- chronic obesity
- hormone drugs used to treat prostate cancer
- exposure to large amounts of radiation in childhood
- Klinefelter’s syndrome
- getting older
- BRCA gene
What about the breast cancer gene?
BRCA is the breast cancer susceptibility gene. The breast cancer BRCA1 and BRCA2 gene mutations increase the risk of breast cancer in both men and women by 30 to 85 percent. The gene mutation can be inherited from either parent and can be passed on to both sons and daughters.
Up to 40 percent of male breast cancers can be attributed to BRCA2 compared with just 5 to 10 percent of breast cancer in women.
The two major factors for developing breast cancer are:
- being a woman
- getting older
Other known factors include:
- Family history of breast cancer, ovarian cancer or prostate cancer (10 percent of people diagnosed with breast cancer have other family members who have the disease)
- Having the breast cancer mutation gene (BRCA1 or BRCA2) makes you five times more likely to develop breast cancer
- Personal history of breast or ovarian cancer
- Having high breast and bone density
- Starting menstruation before age 13
- Starting menopause after age 55
- Having children after 35 or not having children
- Being overweight after menopause or gaining weight as an adult (fat cells produce more estrogen)
- Exposure to radiation or frequent X-rays as a child
What is triple-negative breast cancer?
Breast cancer has three receptors – estrogen receptors, progestrone receptors, and human epidermal growth factor receptors (HER2). These receptor proteins live inside or on the surface of a cell and bind to something in the body to cause the cell reactions. These receptors can be positive or negative. Treatments such as tamoxifen and Herceptin target positive receptors and can slow or stop cancer growth. However, triple-negative breast cancers, which are responsible for 10 to 20 percent of breast cancer occurrences, do not respond to these medications. Chemotherapy is the most effective treatment for triple-negative breast cancer.
For more information on triple-negative breast cancer, visit TNBCFoundation.org.
What’s your risk of breast cancer?
About a decade ago, a women’s health newsletter concluded that “unfortunately, there is little we can do to reduce our risk of breast cancer.”
Fortunately, that has changed. Not only are there specific things women can do to lower their risk, but there are clear indications that significant numbers are doing them.
“Breast cancer is the most commonly diagnosed cancer in women and, after lung cancer, the one most likely to lead to death.” according to Peter Gintner, PA-C, a physician assistant with Ascension Medical Group in Thorp. “The death rate from breast cancer has fallen since 1990, however, and more tumors are being found at an earlier stage.”
What are the risk factors for breast cancer?
According to Gintner, there are several breast cancer risks. Some you can control and some you cannot control. So let’s take a look at the risks.
AGE, FAMILY HISTORY: The number one risk factor for breast cancer is age. If you’re 40 years old, your risk of developing breast cancer in the next 10 years is 1 in 48. If you’re 60 years old, that risk jumps to 1 in 26.
Family history is also important. If your mother, sister or daughter has breast cancer, your risk is double that of other women. In a few cases, family history is associated with a gene mutation such as BRCA1 or BRCA2 that substantially increases risk.
Gintner says, “While you can’t change your age, genetics or family history, you can use these risk factors to guide your decisions concerning screening. For women of average risk, the American Cancer Society recommends regular mammograms starting at age 40 and continuing as long as a woman is in good health. At any age, of course, a woman should learn about breast self-examination. Clinical examinations in your healthcare provider’s office are advised once every three years before age 40 and yearly after that time.”
BREAST DENSITY: Two recent studies indicated that breast density may be one of the most important risk factors for breast cancer. Dense breasts have less fat and more glandular material. Young women, who have a high risk, tend to have denser breasts, but so do some older women, particularly those who take hormone replacement therapy or have a genetic tendency.
Early tumors are also more difficult to detect in dense breast tissue. While you have no control over whether your breasts are dense, you can be more vigilant if they are and consider asking your healthcare provider about screening with digital mammography, MRI or ultrasound.
WEIGHT GAIN is a risk factor that you can control. A weight gain of 20 to 30 pounds after age 18 is associated with a 40 percent increased risk compared to a weight gain of five pounds or less. The theory is that fat cells stimulate production of estrogen, keeping the hormone in circulation even after menopause.
PHYSICAL ACTIVITY: Getting regular exercise is one of the best ways of avoiding weight gain. It also helps regulate hormones that have been linked to the growth of cancer cells. Studies have found that women who engage in moderately intense or vigorous exercise at least three or four hours a week are 20 to 30 percent less likely to develop breast cancer. The American Cancer Society recommends 45 to 60 minutes at least five days a week–a step up from what is generally recommended for good health.
FOLIC ACID, ALCOHOL: Women who have more than one drink of alcohol a dayhave an increased risk of breast cancer, but only if they fail to get adequate quantities (at least 500 micrograms a day) of folic acid, a B vitamin
VITAMIN D: Sun exposure triggers vitamin D production in the body, and there is considerable evidence that vitamin D offers protection against breast and a number of other cancers. Experts now realize that the recommended level of vitamin D (400 IU) is too low; 800 to 1,000 IU is best. Since dietary sources are limited, some of this must come from supplements or sun exposure.
“Taking a preventive approach to breast cancer has its frustrations,” Gintner says. “About three quarters of breast cancers occur in people with no known risk factors. If you know your personal risks, there’s no reason for either anxiety or self assurance. With exercise, weight control, healthy habits and regular screening, you can improve your odds.”