Why young women may be at a disadvantage in early detection of Breast Cancer

Vuyile Madwantsi

WITH World Cancer Day having taken place on February 4, Dr Fatima Hoosain, a specialist surgeon with an interest in breast, thyroid, and parathyroid health, as well as soft tissue surgical oncology, stresses the critical importance of proper and relevant breast health across the age groups.

Hoosain worries that breast cancer diagnoses do occur in young women.

Although the danger of developing breast cancer increases rapidly with age, in South Africa, one in six breast cancer cases affects women under the age of 40.

Breast cancer is one of the most common forms of cancer for South African women of all races, with a lifetime risk.

One such case is Carla Steyn, a young mother who was diagnosed with breast cancer at only 32-yearsold. Carla found a lump in her breast two months after she stopped nursing. She acted quickly and scheduled an appointment to get it examined because she “knew it shouldn’t be there”.

“I consulted a doctor who specialises in breast health issues. There were no delays between diagnosis and receiving the care I needed, even though it was a very scary time.

“I was fortunate as the level of professionalism I received from my health-care team was only surpassed by their level of care and compassion,” she said.

Hoosain draws attention to the fact that because breast cancer is less common in younger women than it is in older women, routine mammogram screening is not warranted as a public health measure in women under the age of 40.

As a result, breast cancer in younger patients is discovered when a lump is present in the breast. Sadly, this also makes it more likely that it is already advanced.

She emphasises that the potential for a delayed diagnosis in younger women is unfortunately made worse by the fact that many medical professionals may rule out the risk of breast cancer due to the patient’s young age and fail to refer the patient for the necessary breast cancer screening as a result.

“But it’s important to remember that breast cancer can be cured if found in its earliest stages. I strongly recommend all women aged 20 and older to at the very least adhere to the routine and pertinent breast screening methods listed below to guarantee good breast health at all times,” she said.

Age 20+: monthly breast selfexamination.

30+: comprehensive clinical breast examination by a breast health professional every year.

40+: annual mammography with high-definition ultrasound.

Additionally, it’s crucial to highlight that young women can also experience all the symptoms and warning signs associated with breast cancer in older women, except for the fact that younger women are more likely to experience benign breast lumps.

This is due to the breasts still developing, with many of these benign lumps potentially linked to the hormonal changes that occur during the menstrual cycle. As such, most lumps that occur in the breasts of young women are benign.

“You should wait until after your next menstrual cycle to examine your breasts. If not, or if the lump is still the same size at your next menstrual cycle, have it checked out,” advises Hoosain.

She says women need to take responsibility for their bodies and trust their gut!

“Even if your GP feels there is no cause for concern if the lump is growing, or you have any uncertainty, you could seek further help from a breast health centre or request that your doctor assists in referring you for additional imaging or that a biopsy is performed,” she said.

Risk factors known to increase one’s potential risk for breast cancer:

• Prolonged exposure to oestrogen, obesity, sedentary lifestyle, pregnancy after the age of 30, and the omission of breastfeeding.

Genetic factors appear to play a far more significant role when it comes to young women. Some of these include:

• A personal history of breast cancer.

• A high-risk lesion was found in a biopsy of breast tissue.

• A family history of cancer (especially if it was diagnosed at an early age or if multiple firstline family members have been diagnosed).

• A history of radiation therapy to the chest.

• A known genetic mutation that confers a high risk for the development of breast cancer, such as TP53.

• Ashkenazi Jewish ancestry (one in 40 Ashkenazi Jews carry mutations in BRCA1 or BRCA2).

Treatment:

• Chemotherapy, endocrine therapy, radiation therapy, biological agents, and surgical alternatives are all used in the management of breast cancer in young women.

Measures can lessen the risk of most cancers, not only breast cancer. Young women should adhere to the brief list that follows:

• Genetic counselling and testing lead to preventive action.

• Do a monthly breast selfexamination.

• Seek help early should you have any cause for concern or notice any problem.

• Follow a healthy diet.

• Follow a healthy and active lifestyle. Exercise can reduce your breast cancer risk by up to 30%.

• Avoid alcohol and cigarette smoking.