Penny was a young woman, living away from home and working as a consultant when she was diagnosed with breast cancer. She had an aggressive tumor and chose to have chemo first, then surgery later. Her apartment-mate was unsympathetic and moved out; her boyfriend faded from the picture. At our support group, she was the only young woman, and her concerns were different from menopausal women. With help from her family, she made it through. Let's take a look at young women's concerns when faced with breast cancer.
Youth And Breast Cancer Is a Rare Combination
Young women may feel invulnerable to breast cancer. While it is true that most cases are diagnosed in women age 55 and over, there have been rare cases in schoolchildren. The National Cancer Institute estimates that 207,090 women were diagnosed with breast cancer in 2010. Included in that number were about 4,000 women under 34 years old, or almost one in every 50 young women who were diagnosed with breast cancer. Almost 22,000 women -- one in 10 cases -- were diagnosed between 35 and 44 years old. Double those numbers, and you have the statistics for women who were between 45 and 54 years of age. In fact, when you add up all the women under age 54 who received a breast cancer diagnosis in 2010, young women represent 30% of the total cases.
So, while most breast lumps in young women are benign, it is advisable to have any breast abnormality checked out, even if you are premenopausal. Because breast cancer in girls and young women is relatively rare, symptoms such as breast lumps or breast pain may be ignored or chalked up to hormonal cycles. Women aged 20 to 40 have the option of doing a monthly breast self-exam. Getting to know the texture and natural changes in your breasts is important for your breast health.
Young Women Face Additional Risks With Breast Cancer
Because breast cancer in young women is rare, some cases are diagnosed at a later stage of this disease. Whenever breast cancer is found at a late stage, regardless of the patient's age, treatment will be more aggressive than it would be for early-stage disease. Triple Negative Breast Cancer - TNBC - has been known to affect women under age 40.
A diagnosis of breast cancer in a young woman may even come during pregnancy. A potential mother may face complications with her pregnancy as she makes treatment decisions. While it is possible to have chemotherapy during pregnancy, radiation must come later. And even though breast reconstruction may be an option, the timing of additional surgery must be considered along with other treatments.
Physical Issues Young Women May Face
Treatment for breast cancer can leave a lasting effect on a young woman's body. Surgery, chemotherapy and radiation may change both the way she perceives herself as well as how others see her. Losing part or all of a breast impacts her body image, may threaten her sex life, and challenge her idea of beauty. Although she may opt for breast reconstruction to restore her symmetry, breast sensitivity and sexual response will change.
Chemo and hormonal therapies designed to reduce estrogen levels may temporarily quench her fertility and libido, or she may make an early start on menopause. There are ways to protect fertility, so this should be discussed with your oncologist before treatment begins.
Increased Risk of Hereditary Breast Cancer
When there is a family history of breast and ovarian cancer, young women face the option to have genetic testing. If her mother or sister has had breast cancer, she may have an above-average risk for developing breast cancer. A test can check for the gene mutations labeled BRCA1 and BRCA2 - genes linked to breast and ovarian cancers.
Family Issues Need Attention, Too
Many young women are raising children at the time of their breast cancer diagnosis. They may need to arrange for help with childcare and transportation. Family or friends may be able to step in and offer support by helping with kids, meals, activities, and housework. A young mother may worry about how, or whether, to tell her small children about her diagnosis -- but there are good ways to deal with that, and good books to help children deal with their own emotions. Spouses will be affected, but they can offer support during treatment and recovery -- and taking action can help them cope, too.
Social Scene and Relationship Challenges
Once a young woman is diagnosed with breast cancer, she may find that friends, coworkers and family members react to her in unexpected ways. Friends may fall away suddenly, or they may become part of a support network. Coworkers may be unsure of how to relate, unless they have had some experience with cancer.
Young women can have more difficulty finding a peer support group, which can contribute to their feelings of isolation, and eventually depression can set in. Depression affects many aspects of relationships, among which can be a low sex drive. Therapy, medications, and patience can help restore willingness and interest in sex. Finding the right antidepressants and a good support group can help lift the blues.
Relationship Issues Can Be Overcome
Young women may be in the dating game or in a long-term relationship when they are diagnosed. No matter how intimate the connection may be, a breast cancer diagnosis presents challenges to communication, emotional expression, and physical love. Going through cancer treatment brings new stresses, but it can also bring couples closer together.
Young women might feel that they have lost their normality, or feel socially isolated because few of their peers have experienced cancer. In this case, joining a support group aimed at young women will be very beneficial. Contact your local chapter of the American Cancer Society to ask about breast cancer support groups for young women.
Can breast cancer be found early? American Cancer Society. Last Revised: 12/16/2010.
Depression experienced by young women newly diagnosed with breast cancer. Wong-Kim EC, Bloom JR. Psychooncology. 2005 Jul;14(7):564-73.
SEER Stat Fact Sheets: Breast. Incidence & Mortality. SEER Cancer Statistics Review, 1975-2007. Surveillance Epidemiology and End Results. National Cancer Institute. Updated in 2010.