Advanced breast cancer on the rise for young women

Senior Emily Harkins said she has always felt a little nervous about her chances of developing breast cancer at an early age because of its prevalence in her family.

“My grandmother had breast cancer in her thirties and had both breasts removed,” Harkins said. “This definitely increases my chances of getting the disease, but everyone should really just be careful.”

Harkins, who serves as the mission and advocacy chair for Relay for Life, said every woman should start to be cautious around the age of 20 of any changes developed in their breasts.

Young women should start taking this advice more seriously, according to a study released Thursday by the Journal of American Medicine. The study found that the number of instances of advanced breast cancer among young women has nearly doubled since 1976. The study shows cases of the disease increased from 1.37 per 100,000 in 1976 to 2.90 per 100,000 among women between the ages of 25 and 39.

Though the rise of breast cancer in general was not very large, the rise of women in this age group being diagnosed with a specific malignant strand of the cancer was significant, according to the Journal of American Medicine.

Biology professor Daniel Flynn said though breast cancer is overwhelmingly a post-menopausal disease, the rate of this triple negative breast cancer is predominantly a pre-menopausal disease.

“In my opinion, the data says that the average number of breast cancer cases in women of the younger age group is about the same,” Flynn said. “So, incidence is the same, but the severity of the disease is up.”

Usually when a lump is found in the breast it is almost always stage I invasive ductal carcinoma, which means the cancer has not spread throughout the lymph nodes or other parts of the body, Flynn said. The cancer is centralized in the lump and some of the milk ducts, he said, and it is an easier form to treat than triple negative breast cancer. Flynn said 90 percent of the women with this form live at least five years without seeing a reoccurrence of the cancer.

However, the triple negative form young women can develop is much harder to treat and is more advanced than the stage I ductal carcinoma. These women typically have a metasis, which is the spreading of the cancer from one organ to another, Flynn said.

Flynn said the rate of survival for each stage of cancer decreases as the levels of cancer increase. For women who reach the fifth stage of cancer, the survival rate is only 12 percent, he said.

Clinical nurse at the Breast Center of the Greater Baltimore Medical Center Barbara Raksin said there is a lot of debate within the medical community about when women should begin getting annual mammograms, but she recommends women start scheduling them around age 40.

“We recommend here starting mammograms at age 40 unless your mother or close family member was diagnosed with breast cancer at a young age, Raksin said. “Then we would decide to start earlier on an individual basis.”

Raksin said it is very difficult to read young women’s mammograms, which is why most doctors do not recommend that women get them before age 40. 

Genetic testing can be done to test for mutations in the BRCA1 and BRCA 2 genes, which indicate a heightened risk of developing breast cancer, Raksin said. It is important for women to meet with a genetic counselor before getting the tests done, she said. Many times women do not understand what a positive mutation could mean.

Having the BRAC1 or BRAC2 gene mutation does not mean a patient will develop breast cancer but does indicate the individual is at a higher risk for developing it, Raksin said.

“There are a lot of times that OB/GYNs are drawing blood on women and not explaining the implications for test results with positive mutations, which can be very scary,” Raksin said. “Women have no idea what their next step is because it hasn’t been explained to them.”

Raksin said some risk factors for breast cancer include aging, family history, obesity and having children after the age of thirty. Women who are obese and have no children are also at a greater risk for breast cancer, Flynn said.

Raksin said self breast exams are important because they allow women to catch the cancer early on without waiting for their yearly mammogram or doctor visit. She said women should perform exams once a month at the same time every month to look for any abnormalities.

Senior Lisa Scheuing, whose grandmother had breast cancer in her 60s, said although she does not worry about getting breast cancer herself, she thinks the disease is something all college-aged women should be aware of.

“I definitely don’t think about it daily but on occasion when I am in the shower or reading about it in the news, it will cross my mind,” Scheuing said. “But it is scary to hear that rates are going up, and they don’t know why.”

She said she knows about self breast exams but is not aware of what else women should be doing to protect themselves.

There are not many ways to prevent breast cancer other than eating healthy, exercising and performing self breast exams, according to Raksin.

Flynn said researchers still hope to advance their knowledge of the disease so they can help women along with it.

“The next challenge for breast cancer researchers is to find a better way to treat triple negative breast cancer and to understand how it is caused and why it is linked with younger women,” Flynn said.