Younger Women and Breast Cancer

By:    Medically Reviewed: Tom Iarocci, MD   Published: March 4, 2014

Breast cancer in women younger than age 40 is more lethal, and new research suggests why.

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When the diagnosis is breast cancer, women younger than 40 don’t have time on their side. Younger women are less likely to survive breast cancer than older women are, a fact that has puzzled scientists.

 

In a new study, researchers focused on two possibilities: Younger women may have more aggressive tumors or may be diagnosed at later stages because people mistakenly think they’re too young for breast cancer.

 

Both possibilities help explain the lower survival rates in young women, but early detection matters most. “Young women with certain types of breast cancer are more likely to die of their disease,” says researcher Theresa H.M. Keegan, PhD, MS, a scientist at the Cancer Prevention Institute of California, who led the study. Two specific tumor subtypes were also associated with poorer survival, she says.

 

Yet, when Keegan’s team took age out of the equation, researchers found that early detection mattered more. “The stage at diagnosis may explain the survival differences in breast cancer between young and older women,” Keegan says.

 

Subtype VS Early Detection

 

For the study, researchers followed more than 5,000 younger breast cancer patients -- ages 15 to 39 who were diagnosed between 2005 and 2009 -- and compared them with nearly 54,000 breast cancer patients ages 40 to 64.

 

The team looked at breast cancer subtypes, including:

  • Hormone receptor positive or negative cancers. Sex hormones (estrogen or progesterone) fuel cancer growth.
  • HER2. The protein human epidermal growth factor receptor 2 fuels the cancer growth.
  • Triple-negative. Hormonal therapies often used for other breast cancers don’t work.  

 

In the study, younger women with triple-negative cancers were more than twice as likely to die from cancer during the follow-up period than those younger women with a less lethal type.

 

While the tumor subtype mattered, it’s not the whole story. The survival gap between the two age groups narrowed when Keegan’s team considered the stage of the cancer at the time of diagnosis.

 

Bottom line for all age groups: Early detection was a more important factor than tumor subtype when examining survival rate.

 

NEXT STEPS

 

Women can’t pick the type of tumor they have, of course. But as this study suggests, early detection remains critical. Regardless of age, women should not think they are too young for breast cancer, experts say.

 

According to Keegan, a woman younger than 40 who notices something suspicious in her breast (lump, nipple discharge) should take the same actions as older women but may need to be more aggressive to get the care she needs.  

  • Check in with your doctor as soon as you can to get the symptom checked out.
  • If your doctor says you’re too young for breast cancer, don’t allow your concerns to be dismissed. Insist on medical attention and get tested. Remember, even if you do get a diagnosis of breast cancer and your tumor subtype is especially grim, early detection can improve your outlook.

 

 

FOR CAREGIVERS

 

Is a friend or loved one worried about breast cancer?

  • Encourage her to see a doctor.
  • Remind her that early detection can make a big difference.
  • Offer to accompany her to the doctor for support. 
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sources
  • Keegan THM, PhD, MS, research scientist, Cancer Prevention Institute of California, Fremont, and consulting assistant professor, department of health research and policy, Stanford University. http://www.cpic.org/our-research/our-scientists/theresa-keegan.aspx. Interviewed January 2014.
  • American Cancer Society. “What Are the Risk Factors for Breast Cancer?” Updated January 2014. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-risk-factors. Accessed January 2014.
  • Keegan THM, PhD, et al. “Impact of Breast Cancer Subtypes on 3-year Survival Among Adolescent and Young Adult Women.” Breast Cancer Research 2013; 15: R95. http://breast-cancer-research.com/content/15/5/R95/abstract. Accessed January 2014.
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