Guest post by Nicole Taylor

Breast cancer in young women is not simply a disease diagnosed at a young age. Rather, it has biological characteristics and treatment concerns that differ from breast cancer diagnosed in postmenopausal women.

THE FACTS:
Despite common misconceptions, young women can and do get breast cancer. Here are the facts:

–  Breast cancer is the most common cancer in women ages 15-39 (1)
–  There is currently no effective breast cancer screening tool for women 40 and younger, many of whom have dense breast tissue that prevents mammograms from being a useful screening tool.
–  Nearly 80% of young women diagnosed with breast cancer find their abnormality themselves (2).
–  The American Cancer Society projects 232,340 new cases of invasive breast cancer among U.S. women annually, as well as an estimated 64,640 additional cases of in-situ breast cancer (3).
–  It is estimated that 12,880 cases of breast cancer will be in women under age 40 (3).
–  Approximately 26,275 women will be under 45 years of age when diagnosed (4).
It is projected that over 1,000 women under age 40 will die from breast cancer each year (3).
–  Young women are more likely to have aggressive subtypes of breast cancer, including triple negative and Her2/neu positive disease (5), larger tumor sizes and higher incidence of lymph node involvement (6).
–  Today, there are an estimated 250,000 breast cancer survivors living in the U.S who were diagnosed at age 40 or younger (7).

THE ISSUES “COLLATERAL DAMAGE”
Young women diagnosed with breast cancer face myriad issues that may significantly impact their quality and length of life. These issues are often amplified for women diagnosed with metastatic breast cancer, including:

–  Lack of research: As the incidence of young women with breast cancer is much lower than in older women, young women are often underrepresented in research studies
– Pregnancy: Breast cancer is the most common form of cancer in women who are pregnant or who have recently given birth (8), occurring once in every 3,000 pregnancies (9). 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 (10).
– Early onset menopause: Chemotherapy and hormonal treatments can sometimes bring on premature menopause, which can significantly impact quality of life.
– Fertility: Breast cancer treatment may affect a woman’s ability and plans to have children.
– Child-Rearing: Many young women are raising small children while enduring treatment and subsequent side effects.
– Financial Challenges: Breast cancer can dramatically impact a young woman’s financial stability due to workplace issues, lack of sufficient health insurance, and the cost of child care.
– Body image: It is challenging for some women to embrace their new body after breast cancer-related surgery and/or side effects of medically induced menopause.
– Relationships and dating: Whether married or single, intimacy issues may arise for women diagnosed with breast cancer.

Nicole Taylor, representing the Young Survival Coalition, was diagnosed with Stage III breast cancer at the age of 34. She is currently 11 years from diagnosis, and is the West Regional Field Manager for YSC. Find Nicole on Twitter: @NicoleTYSC. Our thanks to Nicole and to YSC for providing the statistics, issues and references!

2/23/15 Tweet Chat Transcript

Resources that were shared:

Fertility Preservation information from NCI

YSC Resources

Bay Area Young Survivors (San Francisco, CA)

Metastatic Breast Cancer Network – Finding Financial Assistance

Cancer Financial Assistance Coalition

Patient Access Network (Financial Support)

Camp Kesem (Camp for kids affected by parents’ cancer)

Cancer’s Impact on Sexual Health and Intimacy

References:

1. Archie Bleyer et al., “The distinctive biology of cancer in adolescents and young adults,” Nature Reviews Cancer 8 (2008).
2. Ruddy, K. et al., “Presentation of breast cancer in young women,” Journal of Clinical Oncology 27:15S (2009).
3. American Cancer Society. Breast Cancer Facts & Figures 2013-2014.
4. “SEER Stat Fact Sheets:  Breast,” National Cancer Institute, accessed May 21, 2013 http://seer.cancer.gov/
5. 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 29:1 (2011).
6. 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 26:20 (2008).
7. Based on U.S. Census, 2000.
8. “Pregnancy and Breast Cancer,” American Cancer Society, accessed April 26, 2013, http://www.cancer.org/cancer/breastcancer/moreinformation/pregnancy-and-breast-cancer.
9. “General Information about Breast Cancer and Pregnancy,” National Cancer Institute, accessed April 26, 2013, http://www.cancer.gov/cancertopics/pdq/treatment/breast-cancer-and-pregnancy/patient/
10. 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).